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Radiotherapy for cervical cancer
Radiotherapy destroys cancer cells using high energy x-rays (radiation). It is used to treat cervical cancer at different stages.
We know that radiotherapy can have a big impact on your physical and emotional wellbeing, especially if you are dealing with short-term or long-term effects of treatment. We are here to support you, whether you want to talk through options, understand more about radiotherapy, or simply have someone listen to what’s going on.
The information on this page is about external radiotherapy. We have information about internal radiotherapy (brachytherapy) on a different page.
What is radiotherapy?
Radiotherapy destroys cervical cancer cells using high energy x-rays. You may have external and internal radiotherapy.
External radiotherapy uses a machine to deliver radiotherapy from outside the body. This is the type of radiotherapy we talk about on this page.
Internal radiotherapy is called brachytherapy. It involves having radioactive material put into your womb or vagina.
It’s recommended that you have intensity modulated radiotherapy (IMRT). IMRT helps reduce the risk of high doses of radiation to your bladder, back passage, parts of your colon and bowel. This can help reduce side effects.
If you have locally advanced cervical cancer, you may have ‘extended field radiotherapy’ to include areas where cervical cancer may spread to – such as lymph nodes in your stomach (abdomen). This may mean you have more side effects, so your healthcare team will talk to you about the risks and benefits of this.
You can also have radiotherapy alongside chemotherapy.
You may have radiotherapy with chemotherapy (chemoradiation) after surgery. This is to help reduce the risk of the cancer coming back.
Having chemoradiation after surgery is called adjuvant treatment. Not everyone needs adjuvant treatment after surgery. You may only need it if:
- the cervical cancer has spread to your lymph nodes
- the cervical cancer was larger and more likely to spread.
You may have chemoradiation if you have locally advanced cervical cancer that can’t be treated with surgery. This is called radical treatment.
If you have advanced cervical cancer that has spread to other parts of your body you may have a short course of radiotherapy. This can help with symptoms such as pain or bleeding.
Making decisions about treatment
A team of healthcare professionals, called a multidisciplinary team or MDT, will discuss your test results, diagnosis and medical history to help decide which treatments are best for you.
It is important that you are involved in any decisions about your treatment. You need to know and understand all the information about the treatment, including the benefits and risks.
You may also want to think about how having the treatment might impact on your life, including:
- being able to have a child or more children (fertility)
- being able to keep working (employment)
- your finances, for any support you might need
- other commitments or responsibilities you have.
Radiotherapy can damage your ovaries. This means you almost definitely won’t be able to get pregnant and have a child or more children after treatment.
Read more about fertility and cervical cancer >
You will probably feel very emotional about this, which can make it hard to think about some practical steps you could take. But it is important to discuss these options with your healthcare team before you start treatment. Before treatment, you may be able to:
- freeze and store eggs
- freeze and store embryos – these are eggs that have been fertilised
- have an operation to move your ovaries (ovarian transposition).
Read about ways to have a child or more children >
This may delay treatment, so you will need to consider any risks of doing that. Your healthcare team can explain how it might affect your individual situation. Unfortunately, egg freezing, embryo freezing and ovarian transposition are not always possible and these services are not available in every hospital.
Ovarian transposition
Ovarian transposition is a surgery to move your ovaries away from where the radiotherapy part of your treatment will be aimed. It is done to try and prevent early menopause, which means you may still be able to have a child or more children through surrogacy.
You have it before radiotherapy starts. Whether it can be done will depend on:
- the stage of the cancer
- the risk of the cancer having spread to the ovaries.
Unfortunately, ovarian transposition does not always work. You may have the surgery but still go through early menopause and be unable to have children.
Read about fertility preservation on the Macmillan Cancer Support website >
Your immune system protects the body from infection by finding and killing germs, bacteria or viruses. Radiotherapy doesn’t usually have a big impact on the immune system.
Having radiotherapy usually means you need to go to the hospital a lot for appointments. Your hospital is doing as much as possible to reduce the risk of getting or becoming ill with COVID-19. When your healthcare team are supporting you to make treatment decisions, they will consider the risk of COVID-19 as part of this. In most hospitals we have spoken to, radiotherapy is continuing as usual for cervical cancer patients. But your healthcare team may talk to you about:
delaying your treatment
using telephone calls and video calls to avoid face to face appointments where possible.
having a test to check for COVID-19 before each treatment session.
Your healthcare team may ask you to self-isolate for about 2 weeks before and after radiotherapy. They will let you know what you should and shouldn’t do during this time.
If you are having chemotherapy as well as radiotherapy (chemoradiation), your immune system may be weaker and you might be asked to follow different guidance.
More information and support about radiotherapy
Radiotherapy and its effects can have a huge impact on your physical and emotional wellbeing. You may be dealing with the effects of other treatments, such as chemotherapy, as well as continuing to process a cervical cancer diagnosis and all that can bring.
Your healthcare team, both at the hospital and at your GP surgery, are there to support you with any questions or worries you have. Remember that we are here for you too, whether you are waiting for radiotherapy, in the middle of treatment, or years past it. Our trained volunteers can listen and help you understand what’s going on via our free Helpline on 0808 802 8000.
Check our Helpline opening hours >
Sometimes connecting with others who have gone through a similar experience can be helpful. Our online Forum lets our community give and get support. You can read through the messages or post your own – whichever feels most comfortable.
Thank you to all the experts who checked the accuracy of this information, and the volunteers who shared their personal experience to help us develop it.
References
- British Gynaecological Cancer Society (2020). BGCS framework for care of patients with gynaecological cancer during the COVID-19 Pandemic. Web: www.rcog.org.uk/globalassets/documents/guidelines/2020-05-05-bgcs-covid-19-framework-v3.pdf. Accessed October 2020.
- Thamronganantasakul, K. et al (2018). Extended‐field radiotherapy for locally advanced cervical cancer. Cochrane Database of Systematic Reviews. 10.
- Falcetta, FS. et al (2016). Adjuvant platinum‐based chemotherapy for early stage cervical cancer. Cochrane Database of Systematic Reviews. 11.
- British Gynaecological Cancer Society (2020). Cervical Cancer Guidelines: Recommendations for Practice. Web: www.bgcs.org.uk/wp-content/uploads/2020/05/FINAL-Cx-Ca-Version-for-submission.pdf. Accessed October 2020.
- Marth, C. et al (2017). Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 28;s4. pp.iv72-iv83.
- Ghadjar, P. et al (2015). Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation. Radiatherapy Oncology. 10;50.
We write our information based on literature searches and expert review. For more information about the references we used, please contact [email protected].
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Date last updated:
04 Nov 2020
Date due for review:
01 Nov 2023