Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Chemotherapy drugs are sometimes given as tablets or, more usually, by injection into a vein (intravenously). Chemotherapy can often be given to you as an outpatient, but sometimes it will mean spending a few days in hospital.
Chemotherapy may be used at the same time as radiotherapy, to improve the effectiveness of treatment. There are different ways in which this is done, depending on the drugs used and the chemotherapy plan that is being followed.
Sometimes it means that chemotherapy is given continuously over a four-day period during the first and last week of the radiotherapy treatment. More commonly it is given once a week during the radiotherapy course.
Our section on chemotherapy discusses the treatment and its side effects in more detail. This section also includes information about individual drugs you may have as part of your treatment, and their particular side effects.
Side effects
Chemotherapy can cause unpleasant side effects, but for women with vulval cancer that has come back or spread it can also make them feel better by relieving the symptoms of the cancer. Most people have some side effects from chemotherapy, but these can usually be well controlled with medicines.
Lowered production of blood cells While the drugs are acting on the cancer cells in your body, they also temporarily reduce the number of normal cells in your blood. When these cells are reduced, you are more likely to get an infection and you may tire easily. If you have any signs of infection during chemotherapy, you will be given antibiotics. Less commonly, if people become anaemic due to the chemotherapy they may need a blood transfusion.
Nausea and vomiting Some chemotherapy drugs may cause nausea and vomiting. There are now very effective anti-sickness drugs (anti-emetics) to prevent or reduce nausea and vomiting. Your doctor will prescribe these for you. We can send you a factsheet on dealing with nausea and vomiting.
Sore mouth and loss of appetite Some chemotherapy drugs can make your mouth sore and cause small mouth ulcers. Regular mouthwashes are important and your nurse will show you how to do these properly. If you don’t feel like eating during treatment you could try replacing some meals with nutritious soft drinks or a soft diet.
Hair loss Unfortunately, some chemotherapy drugs can make your hair fall out. You can ask your doctor if the drugs you are taking are likely to cause hair loss. People who lose their hair often cover up by wearing wigs, bandanas, hats or scarves. Most patients are entiltled to a free wig from the NHS. Your doctor or nurse will be able to arrange for a wig specialist to visit you. If your hair does fall out it will grow back over a period of 3–6 months, once the chemotherapy has finished.
Chemotherapy for vulval cancer may also increase any soreness of the skin caused by radiotherapy.
Although they may be hard to bear at the time, most of these side effects will disappear once your treatment is over.
Chemotherapy drugs affect different people in different ways. Some people find that they are able to lead a fairly normal life during their treatment, but many become very tired and have to take things much more slowly. Just do as much as you feel like and try not to overdo it.