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Potential side effects of radiation therapy for vaginal cancer
Side effects can occur with any type of treatment for vaginal cancer, but not everyone has them or experiences them in the same way. Side effects of radiation therapy will depend mainly on the:
- size of the area being treated
- specific area or organs being treated
- total dose
- treatment schedule
Radiation therapy damages cancer cells, but healthy cells in the treatment area can also be damaged, even though steps are taken to protect them as much as possible. Different cells and tissues in the body tolerate radiation differently.
Side effects can happen any time during radiation therapy. Some may happen during, immediately after or a few days or weeks after radiation therapy. Most side effects go away after radiation therapy is finished. Late side effects can occur months or years after radiation therapy. Some side effects may last a long time or be permanent.
It is important to report side effects to the healthcare team. Many side effects can be relieved by medications, a change in diet or by other measures.
Fatigue is one of the most common side effects of radiation therapy. Fatigue may be caused by anemia, poor appetite or depression. It may also be related to toxic substances that are produced when cancer cells break down and die. During radiation therapy, the body uses more energy to heal itself, so fatigue will not always be relieved by rest. Making frequent, daily trips for radiation treatments can also be tiring.
Radiation therapy to any area of the body can make a person feel more tired than usual, but fatigue is more common when larger areas of the body are treated. Anemia is more likely to occur when radiation is given to areas where the majority of blood cells are formed, such as the pelvic bones.
Fatigue usually occurs during the second week of radiation treatment or later. Symptoms of fatigue may increase or become more severe over the course of treatment. Fatigue usually goes away gradually after treatment has ended, but some people continue to feel tired for several weeks or months after radiation therapy.
Skin reactions occur because external beam radiation must travel through the skin to reach the area being targeted for treatment. The skin in the irradiated area may become red, dry or itchy, or it may change colour (become darker or tanned looking). Most skin reactions occur within the first 2 weeks of receiving radiation treatment. They usually go away a few weeks after treatment, but some skin changes, like skin darkening or scarring, can persist. Some people do not experience any skin reactions with radiation therapy.
Diarrhea is frequent and very loose (watery) stools. Abdominal cramping may occur with the diarrhea. Diarrhea often begins 2–3 weeks into radiation therapy. Diarrhea usually goes away once radiation therapy treatments are completed. Report diarrhea to the radiation therapy team. They may recommend a change in diet and can suggest over-the-counter or prescription medicines to help relieve diarrhea.
Radiation therapy can irritate the bladder and cause it to become inflamed (called cystitis). Cystitis can cause discomfort, an urge to urinate often and bleeding.
Symptoms usually occur 3–5 weeks after radiation therapy starts. They gradually go away 2–8 weeks after radiation is completed. Sometimes bladder problems develop when the treatment is over.
Drink plenty of fluids to ensure a regular flow of urine, and empty the bladder frequently. Report bladder problems to the radiation therapy team. They may be able to recommend medicines to help treat some of these side effects.
Nausea and vomiting are more common if the upper abdomen is irradiated but may occur with radiation to the pelvis. People may start to feel nauseous about 1–3 hours after their daily treatment (about 1–2 weeks into therapy). Report nausea and vomiting to the radiation therapy team. It may help to not eat or to have a small snack a few hours before treatment, or to wait a few hours after treatment before eating.
Nausea and vomiting can usually be managed with anti-nausea medication and usually go away after treatment is finished.
Bone marrow suppression is a condition in which one or more of the main types of blood cells are decreased.
- A low white blood cell count (neutropenia) increases the risk for infection.
- A low platelet count (thrombocytopenia) increases the risk for bruising and bleeding.
- A low red blood cell count (anemia) causes fatigue, paleness and malaisemalaiseA general feeling of discomfort or illness.. (Red blood cells are usually not affected very much by radiation treatment, except when there is bleeding and blood loss.)
Low blood cell counts occur because of radiation’s effect on the bone marrow, where blood cells are made. Blood counts are more likely to be affected when the pelvic bones (where many of an adult’s blood cells are made) lie in the treatment area.
Decreases in blood cell counts are rarely severe enough to cause problems. When there is a break from treatment for a few days, blood cell counts usually recover.
Radiation therapy to the pelvis can cause changes to the function of a woman’s reproductive organs. This can lead to:
- vaginal dryness, burning or itching
- vaginal stenosis (narrowing and scarring of the vagina)
- menopausal symptoms
- decrease in sexual desire
- fistula (abnormal connection between 2 organs)
- may cause leakage of urine or stool through the vagina, depending where it occurs
- may occur between the:
- bladder and vagina
- ureters and vagina
- rectum and vagina
A bowel obstruction is not a common side effect of radiation therapy, but it can result from narrowing of part of the bowel (called a stricture). The large or small bowel (intestine) may become partially or completely blocked (obstructed). As a result, the contents of the bowel cannot pass through.
Lymph fluid can build up in the tissues when the lymph nodes are removed. This can lead to lymphedema (swelling of the limbs). Radiation to the lymph nodes in the pelvis can cause lymphedema in the legs.