Vulvar Cancer: Chemotherapy
What is chemotherapy?
Chemotherapy (chemo) uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cells that grow quickly. Some normal cells also grow quickly. Because of this, chemo can also harm those cells. This can cause side effects.
When might chemo be used for vulvar cancer?
Healthcare providers don’t often use chemo as a primary treatment for vulvar cancer. Instead, they generally use it along with radiation to treat advanced cancer that has spread to other parts of the body. Chemo enhances or improves the effectiveness of radiation. Chemo and radiation may be used before surgery to shrink a tumor and make it easier to remove. Healthcare providers may also use it to treat cancer that comes back. This is called recurrent cancer.
The goal of chemo is to kill the cancer cells while also reducing the chance that the cancer will spread to other parts of your body.
How is chemo given for vulvar cancer?
You may take these medicines in a pill or through an intravenous (IV) line into one of your veins. When you receive them in this way, they enter your bloodstream and reach all areas of your body. This is called systemic treatment.
Most women with vulvar cancer have chemo in an outpatient part of the hospital, at a healthcare provider’s office, or at home. You may also receive medicines in ointment form. You or your healthcare provider applies it to the skin of your vulva. This is a local treatment because it affects only the area treated. It may be used for precancer, but not true cancer of the vulva.
You’ll get chemo in cycles over a period of time. That means you may take the medicine for a set amount of time and then you have a rest period. Each period of treatment and rest is one cycle. You may have several cycles. Having treatment in cycles helps by:
Killing more cancer cells. The medicine can kill more cancer cells over time, because cells aren't all dividing at the same time. Spacing out the cycles allows the medicine to fight more cells.
Giving your body a rest. Treatment is hard on other cells of the body that divide quickly. This includes cells in the lining of the mouth and stomach. This causes side effects, such as sores and nausea. Between cycles, your body can get a rest from the chemo and normal cells can heal.
Giving your mind a rest. Having chemo can be stressful. Taking breaks between cycles can let you get an emotional break between treatments.
What common medicines are used to treat vulvar cancer?
The most common chemo medicine healthcare providers use for vulvar cancer is Fluorouracil, also called 5-FU.
What are common side effects of chemo
Because chemo medicines also damage some normal cells, you may have side effects during and for some time after treatment. These depend on the type and amount of the medicine you take, as well as the length of treatment. If you get chemo as an ointment on your skin, you may have some skin irritation. These are other temporary side effects after systemic chemo. Ask your healthcare provider which are most likely to happen to you:
Changes in appetite
Bleeding or bruising
Tingling or numbness in the fingers or toes (neuropathy)
Menstrual cycle changes, early menopause, or infertility
Nausea and vomiting
Extreme tiredness or fatigue
Diarrhea or constipation
Most of these side effects will go away or get better between treatments and over time after treatment ends. Talk with your healthcare provider about ways to manage any side effects you have. There may be things you can do and medicines you can take to help prevent or control side effects.
Checking your health during chemo
You’ll have regular blood tests while you're getting chemo. This is to make sure you aren't having harmful reactions. Make sure you ask which problems, if any, require calling your healthcare provider right away. For instance, chemo can make you more likely to get infections. Your healthcare provider may tell you to call them if you have any of these symptoms:
Shaking or chills
Redness, swelling, and warmth at the site of an injury or IV catheter
New cough or shortness of breath
Burning during urination
Working with your healthcare provider
It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.
Talk with your healthcare providers about what signs to look for and when to call them. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?
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 healthcare team to make a plan to manage your side effects.
March 21, 2017
Goodman, Howard, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS