Cervical Cancer

Cervical cancer is a type of cancer that occurs in the cells of the cervix which is the lower part of the uterus that connects to the vagina. Brachytherapy is a type of radiation therapy that involves placing a radioactive source inside the body, close to the tumor, to kill cancer cells.

Brachytherapy, or internal radiation therapy, is often used as a treatment option for cervical cancer, either alone or in combination with other treatments such as external beam radiation therapy and chemotherapy.

While brachytherapy can be an effective treatment for cervical cancer, it can also cause side effects. In this article, we will discuss the potential side effects of brachytherapy for cervical cancer and how they can be managed.

Side effects of brachytherapy

The side effects of brachytherapy for cervical cancers can vary depending on the individual, the type and radiation dose used, and other risk factors such as the patient's overall health. As with all radiation therapy, there will be some side effects of brachytherapy. Often the side effects will go away once the methods to treat cervical cancer have stopped.

People respond to treatments in different ways. The type of side effects that may be experienced depends on a number of factors such as the stage of cervical cancer and whether there are any compounding health problems.

The majority of brachytherapy patients receive a multimodality treatment with other treatments such as surgery, external beam radiation therapy, and chemotherapy. This makes it very difficult to distinguish between side effects from brachytherapy, side effects caused by other treatments, and disease-related symptoms and complications.

Common side effects of brachytherapy for cervical cancer include vaginal discharge, discomfort or pain during sex, and a temporary increase in urinary frequency or urgency. Other potential side effects may include vaginal dryness, irritation or inflammation of the bladder or rectum, and fatigue.

It is important to discuss any potential side effects with your healthcare provider and report any symptoms that you experience during or after treatment. With proper management and support, most side effects of brachytherapy for cervical cancer can be effectively managed.

Cervical Cancer Treatment Options

The options for cervical cancer treatment depends on several factors, including the stage of the cervical cancer, the size and location of the tumor, and the woman's overall health and preferences. The main treatment options for cervical cancer include:

Surgery

Surgery may involve removing the cancerous tissue, the cervix, and/or the uterus. In some cases, nearby lymph nodes may also be removed. Surgery may be a good option for women with early-stage cervical cancer who wish to preserve their fertility.

External Beam Radiation therapy

External Beam Radiation therapy (EBRT) is a type of cancer treatment that uses high-energy rays to kill cancer cells. It is a non-invasive treatment that can be used to shrink tumors or destroy cancer cells in the body.

EBRT is delivered from a machine outside the body, and the radiation is precisely targeted to the area of the body where the cancer is located. The treatment is usually given daily over a period of several weeks, with each treatment session lasting only a few minutes.

The specific dose and duration of EBRT will depend on the individual case and will be determined by the healthcare team. While EBRT is an effective treatment option, it can also cause side effects such as fatigue, skin irritation, and damage to healthy tissues surrounding cancer.

Chemotherapy

Chemotherapy involves using drugs to kill cancer cells. It can be used alone or in combination with radiation therapy and may be given before or after surgery. The drugs used in chemotherapy circulate throughout the body and attack cancer cells wherever they are.

Chemotherapy may be given before or after surgery to shrink the tumor or to kill any remaining cancer cells. It may also be given in combination with radiation therapy to make it more effective. The specific drugs and timing of chemotherapy will depend on the individual case and will be determined by the healthcare team.

Targeted therapy

Targeted therapy is a type of cancer treatment that uses drugs to target specific molecules that are involved in the growth and spread of cancer cells. Unlike chemotherapy, which attacks all rapidly dividing cells (including healthy ones), targeted therapy is more precise and aims to selectively target cancer cells.

It is a newer form of treatment that is rapidly advancing and has shown promising results in the treatment of various types of cancer, including advanced cervical cancer. Targeted therapy may be used alone or in combination with other treatments such as chemotherapy, radiation therapy, or surgery.

The specific type of targeted therapy and the duration of treatment will depend on the individual case and will be determined by the healthcare team. While targeted therapy has fewer side effects than chemotherapy, it can still cause some adverse effects such as fatigue, nausea, and skin rash.

Immunotherapy

Immunotherapy is a type of cancer treatment that works by boosting the body's own immune system to fight cancer cells. It uses drugs that help the immune system to recognize and attack cancer cells more effectively.

Immunotherapy has been approved for the treatment of various types of cancer, including some forms of cervical cancer. It can be given as a standalone treatment or in combination with other treatments such as chemotherapy or radiation therapy.

The specific type of immunotherapy and the duration of treatment will depend on the individual case and will be determined by the healthcare team.

Immunotherapy has shown promising results in the treatment of cervical cancer, but it can also cause some adverse effects such as fatigue, flu-like symptoms, and skin rash. The side effects vary depending on the specific type of immunotherapy used and the individual patient's response to the treatment.

Brachytherapy Treatment

Brachytherapy is a type of radiation therapy that involves placing radioactive sources inside or next to the tumor, delivering a high dose of radiation directly to the cancerous cells while minimizing the exposure of nearby healthy tissue. Brachytherapy is often used as a treatment option for cervical cancer, as well as other types of cancer such as prostate, breast, and lung cancer.

There are two types of brachytherapy: low-dose rate brachytherapy (LDR) and high-dose rate brachytherapy (HDR). LDR brachytherapy involves implanting small, radioactive seeds directly into the tumor, where they slowly release low doses of radiation over a period of weeks or months.

HDR brachytherapy, on the other hand, involves delivering a high dose of radiation to the tumor in a short amount of time using a machine that delivers the radiation through catheters or applicators placed in or around the tumor.

Brachytherapy may be used as a stand-alone treatment or in combination with other treatments such as surgery, chemotherapy, or external beam radiation therapy. The choice of treatment depends on the stage of cancer, the size and location of the tumor, and the patient's overall health.

While brachytherapy is generally well-tolerated, it can cause some side effects such as pain, swelling, and bruising in the area where the seeds or applicators were placed, as well as urinary or bowel problems depending on the location of the tumor. However, these side effects are often temporary and can be managed with medication or other supportive measures.

Advantages of Brachytherapy to Treat Cervical Cancer

Brachytherapy offers several advantages to treat cervical cancer effectively. Some of these advantages include:

  1. Targeted treatment: Brachytherapy delivers radiation therapy directly to the tumor site, minimizing radiation exposure to healthy tissues and organs.
  2. High success rates: Brachytherapy has been shown to have high success rates in treating cervical cancer, with cure rates comparable to surgery.1
  3. Shorter treatment time: Brachytherapy typically requires fewer treatment sessions than external beam radiation therapy or chemotherapy.
  4. Reduced side effects: Since brachytherapy delivers radiation directly to the tumor site, it can minimize the side effects associated with other treatments, such as external beam radiation therapy.
  5. Outpatient procedure: Brachytherapy is typically performed on an outpatient basis, meaning that patients can usually return home the same day as the procedure.

FAQs

Brachytherapy for cervical cancer may cause menopausal symptoms such as hot flashes, vaginal dryness, and decreased sex drive, but it does not usually cause menopause itself. However, if the radiation treatment affects the ovaries, it may cause premature menopause in some women. This can happen if the radiation affects the eggs in the ovaries, which can lead to a decrease in hormone production and the onset of menopause.

The likelihood of this happening depends on the dose of radiation used and the location of cervical cancer. It is important for women to discuss the potential risks and side effects of brachytherapy with their healthcare team before undergoing treatment.

If you have been treated for cervical cancer, it's important to continue follow-up appointments and tests to monitor for any potential recurrence or complications. You should ask your doctor how often you will need to come in for follow-up appointments and what tests will be performed during these appointments.

Typically, follow-up appointments are scheduled every few months for the first year or two after treatment, and then less frequently after that. During these appointments, your doctor will likely perform a pelvic exam and may also order imaging tests such as a CT scan or MRI to check for any signs of recurrence. It's important to attend all scheduled follow-up appointments and notify your doctor if you experience any new symptoms or concerns between appointments.

Managing your emotional and mental health during and after treatment for cervical cancer can be a challenging experience. Here are some strategies that may help:

  • Seek support from loved ones: Talking to friends and family can be a great source of emotional support during treatment.
  • Consider joining a support group: Joining a support group for cancer survivors can be a helpful way to connect with others who understand what you are going through.
  • Take care of your physical health: Eating a healthy diet, getting enough sleep, and engaging in physical activity can help improve your emotional and mental well-being.
  • Practice stress-reducing techniques: Techniques such as mindfulness meditation, deep breathing, and yoga can help reduce stress and promote relaxation.
  • Consider seeing a mental health professional: A mental health professional can provide support and counselling to help manage the emotional and mental challenges of cancer treatment.

Remember that it is normal to experience a range of emotions during and after treatment, including anxiety, depression and fear. By taking care of your emotional and mental health, you can improve your overall well-being and quality of life.

Brachytherapy for cervical cancer may cause menopausal symptoms such as hot flashes, vaginal dryness, and decreased sex drive, but it does not usually cause menopause itself. However, if the radiation treatment affects the ovaries, it may cause premature menopause in some women. This can happen if the radiation affects the eggs in the ovaries, which can lead to a decrease in hormone production and the onset of menopause.

The likelihood of this happening depends on the dose of radiation used and the location of cervical cancer. It is important for women to discuss the potential risks and side effects of brachytherapy with their healthcare team before undergoing treatment.

There are some lifestyle changes and support groups that may help cervical cancer patients during their treatment and recovery. Some possible suggestions include:

  • Eating a healthy, balanced diet which supports your immune system and overall health.
  • Getting regular exercise, if possible, to improve your physical and emotional well-being.
  • Avoiding smoking and excessive alcohol consumption, which can both have negative impacts on your health.
  • Joining a support group for cervical cancer patients, which can provide emotional support, helpful tips and resources, and a sense of community with others who are going through similar experiences.
  • Talking to a mental health professional or counsellor if you are experiencing significant anxiety, depression, or other emotional challenges during or after treatment.

Your healthcare team can also provide you with additional guidance and resources for managing your physical and emotional health during and after treatment.

Brachytherapy:
The Precise Answer for Tackling Cervical Cancer

Download the cervical cancer patient guide (pdf)

Citations

1 - Jay P. Ciezki, M.D.E.A.K. (2009) Brachytherapy or surgery? A composite view, Cancer Network. MJH Life Sciences. Available at: https://www.cancernetwork.com/view/brachytherapy-or-surgery-composite-view