Chemotherapy & Radiation

Chemotherapy

Chemotherapy, often shortened to chemo, is a group of medicines that kill cancer cells or stop them from growing. [1] It is most often given through a thin needle into a vein, and sometimes through a small port placed under the skin so that a new needle stick is not needed every visit. [1] Treatment comes in cycles: a period of treatment, then a rest period that gives your body time to recover. [1]

Chemotherapy is used in different ways. After surgery, it can destroy cancer cells that are too small to see, to lower the chance the cancer returns. Before surgery, it can shrink a cancer so the operation works better. [1] A gynecologic oncologist trains in both the surgery and the chemotherapy for these cancers, so this part of your treatment stays with my team.

Side effects happen because the medicines also affect healthy fast-growing cells, like the ones lining the mouth and intestines and the ones that grow hair. Feeling worn out is the most common one; nausea, mouth sores, and hair loss depend on the specific drugs. [1] Most side effects improve or go away once treatment is finished. [1] One thing worth knowing early: how strong your side effects are says nothing about how well the treatment is working. [1]

Radiation therapy

Radiation therapy uses carefully aimed, high doses of radiation to kill cancer cells by damaging their DNA. It is a local treatment, which means it treats one specific area rather than the whole body. [2]

It comes in two main forms. External beam radiation comes from a machine that moves around you and aims at the treatment area. It does not touch you, and you are not radioactive afterward. Internal radiation, called brachytherapy, places a small radiation source inside the body, in or next to the area being treated. Brachytherapy is used often for cervical cancer. [2] If a course of internal treatments is planned after a D&C, a Smit sleeve may be placed to make each visit easier.

Radiation works over time. It takes days to weeks of treatment for the damage to add up, and cancer cells keep dying for weeks to months after the course ends. [2] Side effects come from the effect on nearby healthy tissue, so they depend on the area being treated, and tiredness is common. [2] A radiation oncologist, a doctor who specializes in this treatment, directs this part of your plan, and we work from the same chart.

Where these fit for the cancers I treat

• Uterine cancer: surgery first for most women. Whether anything further is offered, including radiation or chemotherapy, depends on the final pathology. [3]
• Ovarian cancer: treatment usually combines surgery and chemotherapy. Sometimes the chemotherapy comes first. [4]
• Cervical cancer: early disease is usually treated with surgery. Locally advanced disease is usually treated with radiation and chemotherapy together, including brachytherapy. [5]
• Vulvar cancer: surgery is the main treatment, and radiation is used in some situations, depending on the stage. [6]