Dear OncoLink "Ask The Experts,"
Could you give me any information on any possible negative outcomes using radiation to treat cervical cancer? Could scarring occur in the vagina? Where would I find information or statistics regarding a choice of radiation versus hysterectomy as treatment for this condition?
Ruth Collins, MSN, CRNP, OCN, Advanced Practice Nurse in the Research Division of the Department of Radiation Oncology, responds:
Radiation therapy for cervical cancer can include external beam and intracavitary implants. There are both acute and long-term potential complications, but fortunately most can be treated effectively. The acute effects usually occur within the first 90 days and can include:
Local skin reactions, which can occur during radiation therapy and depend on the area being treated. They usually occur 2 to 3 weeks into treatment and resolve usually within one-month post treatment.
Cystitis (burning with urination, frequency, and urgency) usually after 10 - 14 days which usually resolves within one month after completion of therapy.
Diarrhea, which can be an early side effect or persistent late effect.
Nausea and vomiting usually occur in patients receiving whole abdomen radiation therapy.
Lowering of blood counts usually in patients receiving whole abdomen radiation therapy.
Fatiguemore common in whole abdomen radiation therapy.
Vaginal inflammation usually occurs within the first 14-21 days. Vaginal infections may occur.
Late vaginal effects can happen months or years after treatment and may include stenosis (scarring with decreased pliability and decrease of the vaginal diameter) and a decrease in vaginal length has been documented. The vaginal mucosa can become dry especially if ovarian functioning has been effected. But, these side effects can be treated with regular sexual intercourse or dilators and the use of lubricators or estrogen creams.
Information regarding radiation therapy versus surgery would depend on the stage of the cervical cancer. It is best to discuss your options, based on your individual situation with a Gynecologic Oncologist, Radiation Oncologist and Medical Oncologist. Consults with these specialists would give you the information based on your specific case and allow you to make an informed decision. This is a very personal decision and should be made with information that you receive based upon your personal case.
Hassey Dow, K, Dunn Bucholtz, J., Iwamoto, R., Fieler, V, & Hilderly, L. Nursing Care in Radiation Oncology. (2nd.ed.) 1997. p. 221-233. W.B. Saunders: Philadelphia.
Watkins-Buner, D., Moore-Higgs, G & Haas, M. Outcomes in Radiation Therapy: Multidisciplinary Management. 2001. p.360-362. Jones and Bartlett Publishers: Boston.