Ovarian (or tubal cancers) can develop on the external surface of the ovary or tube, or inside the ovary or tube itself.
Endometrial cancer, or uterine cancer, typically originates in the lining of the uterus and is the most frequently diagnosed gynecologic cancer.
Cervical cancer forms in the cells lining the cervix or the lower part of a woman’s uterus that connects to the vagina.
Each type of gynecologic cancer has a different set of treatments available. Your cancer care team will create a plan that typically uses one or more of the following:
Surgery, performed by a gynecologic oncologist
Radiation, provided by a radiation oncologist
The combination of treatments used depends on several factors, including the type and stage of cancer, possible side effects, the woman’s future plans for her family, and her general health.
External radiation therapy uses high-intensity beams of radiation, directed at a very specific area of the body, to kill cancer cells and shrink tumors. For gynecologic cancers, a large machine directs radiation at your pelvis or other tissues where the cancer has spread. The treatment is done in our clinic. You may receive external radiation 5 days a week for several weeks. Each treatment takes only a few minutes.
Side effects from external beam radiation therapy may include fatigue, diarrhea, mild skin reactions, upset stomach, and loose bowel movements. External-beam radiation therapy will also result in your ability to become pregnant. If you are premenopausal and your ovaries have not been surgically removed, you will most likely enter menopause, even if just temporarily.
Intracavitary brachytherapy places the radioactive material inside a tube that is then placed into the vagina and/or uterus for short periods of time over the course of several days. The specific dose and number of treatments will be decided by the radiation oncologist.
The most common side effect of internal radiation therapy is irritation of the vagina. You may also experience other side effects such as fatigue, irritation of the bladder, and diarrhea.
The decision to use radiation therapy for a gynecologic cancer is dependent on the type of cancer and its location in the body. Generally speaking there are two types of radiation therapy: external beam and brachytherapy (internal).
Radiation therapy is not always used for ovarian cancer patients as one of the primary treatments. It’s helpful, however, if the cancer has spread to another area of the body where external beam radiation can be used to shrink the tumor.
Women with uterine or cervical cancers may receive radiation therapy before or after surgery. For women who can’t have surgery for other medical reasons, radiation therapy may be used instead to destroy cancer cells in the uterus.
External beam radiation is an option if the tumor is localized and can be reached without damaging too much surrounding tissue and organs.
Internal radiation therapy is an option for uterine cancer and for cervical cancer treatment. This is called intracavitary brachytherapy. A narrow cylinder is placed inside your vagina, and a radioactive substance is loaded into the cylinder. This common method of brachytherapy may be repeated two or more times over several weeks. Once the radioactive substance is removed, no radioactivity is left in the body.
Both external beam radiation therapy and intracavitary brachytherapy may be used for treating vaginal cancer. External beam is often administered before surgery to shrink the tumor before removing it.
If brachytherapy is used it can be high dose rate (HDR) brachytherapy or lose dose rate (LDR) brachytherapy. LDR requires the tube with the radioactive material to stay in place about 2 days and is then removed. HDR requires the tube to stay in place for a few minutes during each application. The patient would go through 3-4 treatments of HDR, usually given 1-2 weeks apart.
External beam radiation therapy is commonly used to treat vulvar cancer, often at the same time as chemotherapy. This is called chemoradiation. External beam radiation can also be used after surgery to be sure any left over cancer cells have been killed.