Vaginal Cancer: Chemotherapy

What is chemotherapy?

Chemotherapy uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that grow quickly. Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects. 

For this treatment, you may see a gynecologic oncologist. This is a gynecologist with extra training in women's cancer. Or you may see a medical oncologist. This is an internal medicine healthcare provider with extra training in the use of medicines to treat cancer.

Many women who get chemotherapy for vaginal cancer have it combined with radiation. This is called radiosensitization or chemoradiation. This helps radiation work better. It also reduces the chance that the cancer will spread. Chemotherapy may be used by itself either before or after surgery. Chemotherapy is the main treatment in women whose vaginal cancer has spread. 

How is chemotherapy given for vaginal cancer?

Most women with vaginal cancer get chemotherapy in an outpatient part of the hospital, at the healthcare provider’s office, or at home. In some cases, depending on your health or the medicines you take, you may need to stay in the hospital during treatment.

You may take these medicines into a vein (IV) or by mouth as a pill. In some cases, when vaginal precancer is found, chemotherapy medicines may be used as a cream or lotion. The medicine is then applied to the affected area of the vagina. Chemotherapy given by IV or pill is a systemic treatment. This means that the medicines travel all through the body in the bloodstream. Chemotherapy given as a cream or lotion is local treatment.

You receive chemotherapy in cycles. This means you will be treated for a time with chemotherapy and then you will have a rest period. Each treatment and rest period make up 1 cycle. You’ll likely have more than 1 cycle of treatment. Your healthcare provider will explain what your treatment plan will be and what you can expect. The length of each treatment period differs, depending on the type of medicine you take. 

What types of medicines are used to treat vaginal cancer?

The medicines used to treat vaginal cancer include:

• Fluorouracil (5-FU)

• Cisplatin

• Carboplatin

• Paclitaxel

• Docetaxel

For chemotherapy with radiation, you will likely get low doses of cisplatin or fluorouracil. Or you may get both medicines.

What are common side effects of chemotherapy?

Side effects are common with chemotherapy. But it's important to know that they can often be prevented or controlled. The side effects usually go away over time after treatment ends. Side effects depend on the type and amount of medicines you’re taking. They vary from person to person.

Some common side effects include:

• Nausea and vomiting

• Mouth sores

• Constipation or diarrhea

• Hair loss

• Infections from low white blood cell counts

• Easy bruising or bleeding from low blood platelets

• Tiredness from low red blood cell counts

• Loss of appetite

• Dizziness

• Skin problems, such as dryness, rash, blistering, or darkening skin

• Tingling, numbness, or swelling in hands or feet

Most side effects will go away or get better between treatments and after treatment ends. You may also be able to help control some of these side effects. Tell your healthcare providers about any side effects you have. They can help you cope with the side effects.

Checking your health during chemotherapy

You will have blood tests done regularly while you're getting chemotherapy. This is to make sure you aren't having harmful reactions. Make sure you ask which problems require that you call your healthcare provider or nurse right away. For example, chemotherapy can make you more likely to get infections. Your healthcare provider or nurse may advise you to call them if you have any of these symptoms:

• Fever

• Sore throat

• Shaking chills

• Redness, swelling, and warmth at the site of an injury, injection, or IV catheter

• New cough or shortness of breath

• Nasal congestion

• Burning during urination

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your medical team to make a plan to manage any side effects you have.