Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy can be given to the pelvic area to treat a number of different types of cancer. It is mainly used to treat cancer of the vulva, vagina, cervix and womb, but may also be used to treat cancer of the bladder, rectum and anus. Radiotherapy may sometimes be given to the lymph nodes in the pelvic area.

Radiotherapy can either be given externally from outside the body or from within the body as internal radiotherapy. Some women may have a combination of the two.

External radiotherapy

This is normally given as a series of short daily treatments in the radiotherapy department at the hospital, using equipment similar to a large x-ray machine. Treatment is often given over four to six weeks, once a day from Monday to Friday, with a rest at the weekends. Each treatment takes several minutes and is painless. It will not make you radioactive and it is safe for you to be around other people, including children. You may be able to have your treatment as an outpatient, or you may need to stay in the hospital.

Internal radiotherapy

This is also known as intracavitary radiotherapy or brachytherapy. It is sometimes used to treat cancer of the vagina, cervix or womb.

Hollow plastic or metal tubes (applicators) are inserted into the vagina. A machine feeds small radioactive metal balls (the source) into the tubes. The tubes are usually put in position under a general anaesthetic, but for some treatments an epidural anaesthetic or light sedation may be used.

Depending on the type of cancer, the treatment may take a few minutes to several days. Once the radiotherapy treatment has finished, the applicator tubes are removed by a doctor or nurse.

Internal radiotherapy gives a high dose of radiation to the area close to the applicator, but only a low dose to areas more than a few centimetres away. You will need to stay in bed during the treatment. You may need to have a tube put into your bladder (urinary catheter) to drain away any urine. The catheter can be uncomfortable and you may need to take painkillers.

The source gives off radioactivity which may be harmful to other people, so you will usually be nursed in a separate room, apart from the ward. Visitors may only be allowed to stay for a short time, during which the machine is switched off and the radioactive sources go back into the machine. Children and pregnant women are advised not to visit. Once the applicators have been removed, it is completely safe for you to be around other people.

Some women find that this treatment can make them feel isolated and depressed. It is important to let the staff looking after you know how you feel. It can also help to have plenty of things to keep you occupied, such as books to read, for the day or two that you are having treatment.

Internal radiotherapy may be uncomfortable and the staff will make sure that you are made comfortable and given painkillers if you need them, especially before the source is removed.

In some radiotherapy departments an implant containing a higher dose of radioactivity (microselectron) is used and this is only in place for a few minutes. These shorter treatments may need to be repeated several times, a few days apart, and may be given as an inpatient or outpatient. This treatment does not need a tube (catheter) in the bladder to drain the urine, but a catheter may be needed when x-ray pictures are taken during the planning of the treatment.