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Facts About Gynecologic Cancers

Gynecologic cancers affect the female reproductive system, including the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. According to the American Cancer Society, approximately 109,000 women in the United States are diagnosed with gynecologic cancers annually, with uterine and cervical cancers accounting for about 75,050 of these cases. Regular screening, such as Pap tests, enables early detection of precancerous changes in the cervix and vagina.

Treatment Approaches

The management of gynecologic cancers depends on various factors, including the cancer type, stage, location, and the patient’s overall health. A multidisciplinary team—comprising a radiation oncologist, gynecologic oncologist, and, in some cases, a medical oncologist—collaborates to develop a personalized treatment plan. Treatment may involve radiation therapy, surgery, chemotherapy, or a combination thereof.

Radiation Therapy

Radiation therapy aims to eradicate cancer cells, control tumor growth, or alleviate symptoms like pain and bleeding. It works by damaging the DNA of cancer cells, leading to their death and subsequent removal by the body. While healthy cells can also be affected, they possess a greater ability to repair themselves compared to cancer cells.

Types of Radiation Therapy:

  1. External Beam Radiation Therapy (EBRT): This method delivers radiation from an external source, targeting the cancerous area. Treatment typically occurs five days a week over five to six weeks. A planning session, known as CT simulation, is conducted to map the treatment area using imaging techniques like CT, PET/CT, or MRI scans. Small skin tattoos may be applied to ensure precise positioning during each session. Advanced techniques such as Three-Dimensional Conformal Radiotherapy (3D-CRT) and Intensity-Modulated Radiation Therapy (IMRT) allow for precise targeting of the tumor while minimizing exposure to surrounding healthy tissues. Proton Beam Therapy (PBT) is another form of EBRT that may reduce radiation exposure to healthy tissues.
  2. Internal Radiation Therapy (Brachytherapy): This technique involves placing radioactive sources directly into or near the tumor site, allowing for a higher radiation dose to the cancer while sparing surrounding healthy tissue. Brachytherapy is commonly used for gynecologic cancers and can be administered alone or in conjunction with EBRT. The radioactive material is typically placed inside the body temporarily. There are two main types:
    • High-Dose-Rate (HDR) Brachytherapy: Delivers a higher dose of radiation over a shorter period, often used in treating cervical cancer and, in some cases, early-stage uterine cancer. Treatment usually consists of three to six sessions, administered one to two times per week.
    • Low-Dose-Rate (LDR) Brachytherapy: Involves a continuous, lower dose of radiation over a more extended period.

Self-Care During Treatment

Maintaining overall health during radiation therapy is crucial. Patients are advised to:

  • Adhere to Medical Guidance: Follow all instructions provided by healthcare professionals.
  • Maintain a Balanced Diet: Consult a dietitian for personalized nutritional advice.
  • Stay Hydrated: Consume adequate fluids daily.
  • Communicate Openly: Ask questions and express concerns to the medical team.
  • Engage in Physical Activity: Incorporate daily exercises as recommended.
  • Review Medications: Inform the radiation oncologist about all medications, vitamins, or supplements being taken to ensure they are safe during treatment.
  • Protect the Skin: Care for the skin in the treatment area by avoiding sun exposure, extreme temperatures, and using approved lotions or ointments.

Potential Side Effects

Side effects vary based on the treatment area and radiation type. Some patients may experience minimal or no side effects and can maintain their regular routines. Common short-term side effects for pelvic radiation include fatigue, skin irritation, increased bowel movements, urinary urgency or discomfort, bloating, nausea, and reduced blood cell counts. Long-term effects may involve changes in bowel or bladder habits, vaginal narrowing, and discomfort during sexual intercourse due to vaginal dryness and reduced flexibility. It’s essential to discuss any side effects with the healthcare team, as interventions like medications, vaginal dilators, and moisturizers can help manage these issues.

Support and Resources

Completing treatment and recovery can be challenging. Establishing a support network of friends, family, or support groups before and during treatment can provide emotional and practical assistance. If additional support is needed, patients should inform their healthcare providers.

Our Radiation Oncology Team

Dr. O’Connor and Dr. Montes are experienced radiation oncologists specializing in cancer treatment through radiation therapy. The multidisciplinary team includes radiation therapists, physicists, dosimetrists, oncology nurses, medical assistants, an oncology nurse navigator, and certified nutrition specialists, all dedicated to providing comprehensive care.

For more information or to schedule a consultation, please contact our office.

© American Society for Radiation Oncology, 2020.