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Role of Radiation in Gynaecological Cancer?

Radiation therapy plays an essential role in Gynaecology. Especially in the primary non-surgical management and the postoperative treatment of selected malignancies in the female reproductive tract. Hence, ionizing is necessary for treating Gynaecological cancers which are among the first malignancies. The most common form of cancer in women is cervical cancer.

The causes of gynecological cancers are different for every female. This happens because cancer can affect different parts of the female reproductive system. The different parts include the uterus, cervix, ovaries, vagina, and vulva. However, the other causes and risk factors for gynecological cancers among women are:

• Human papillomavirus infection (HPV) – The HPV virus is transmitted sexually and is linked to cervical, vaginal and vulvar cancers. Practicing safe sex techniques will help you to prevent the transmission of HPV. Also, routine Pap smears and examinations can help detect the conditions at an early stage.
• Age – If you’re above 50 years of age then you have a higher risk of developing gynecological cancers.
• Genetics – Any kind of mutations or growth in the BRCA1 and BRCA2 genes may also increase your risk for cervical cancer. On the other hand, a family history of ovarian, fallopian tube, primary peritoneal, breast, and colon cancers can also put you at a higher risk.
• Low socio-economic status- Most women who come from a low economic background suffer from cervical cancer due to their low hygienic lifestyle. 

Two vaccines can prevent infection with disease-causing HPV. The two vaccines are, Gardasil and Cervarix. Both of these vaccines can prevent infection with HPV types 16 and 18. These are the two types of high-risk HPVs that cause about 70% of cervical cancers. These may also cause a higher percentage of some of the other HPV-caused cancers.

However, the Gardasil vaccine also prevents infection with HPV types 6 and 11, which causes 90% of genital warts. Gardasil 9 prevents infection with the same four HPV types. It can also prevent five additional cancer-causing types (31, 33, 45, 52, and 58) which are responsible for 10 to 20% of cervical cancers. Gardasil 9 is now the only HPV vaccine available for use in the United States. Cervarix and Gardasil are still in use in other countries.

The management and treatment of cervical cancer mostly depend on the various stages of cancer which includes stage 1, stage 2, stage 3, and stage 4. Surgery is usually done in stage 1 or in early stage 2. Radiation and Chemotherapy is usually suggested from stage 2 to stage 4. The curable rate of cervical cancer is quite high and ranges from 80% to 90%. The duration for radiation therapy is 25 days and the duration for chemotherapy is 5 weeks. Radiation therapy treats Gynaecological cancer in two ways:

• External beam radiation

It is a radiation therapy that aims at damaging cancer cells by using high-energy x-rays. Moreover, this treatment is much like getting a regular x-ray, but the radiation is much stronger. Each radiation therapy lasts for only a few minutes. However, getting yourself ready for the treatment usually takes a longer time, but the procedure itself is painless.

External beam radiation is the main therapy for treating gynecological cancer, additionally combining it with chemotherapy. The radiation treatment continues 5 days a week for about 5 weeks. Often, a low dose of the chemo drug is given which is known as Cisplatin.

• Brachytherapy (internal radiation therapy)

Brachytherapy puts a source of radiation near the cancer cells of your body. This type of radiation only travels a short distance. The type of Brachytherapy for treating cervical cancer is known as Intracavitary brachytherapy. The oncologist places a radiation source in a device and then places it in the vagina and sometimes in the cervix.

Have queries or concern ?

There are various radiation techniques on which the complications of radiation are based. The better the techniques, the fewer the complications. Proctitis and Cystitis are the most common complications faced during the radiation therapy. The techniques of radiation therapy are as follows:

• 3D CRT
• IMRT
• IGRT
• VMAT
• True Beam

A hysterectomy can cure early-stage cervical cancer. But removing the uterus makes it impossible to become pregnant.

• Simple hysterectomy – The cervix and uterus are removed along with cancer. A simple hysterectomy is for early-stage cervical cancer.
• Radical hysterectomy – The cervix, uterus, part of the vagina, and lymph nodes in the area are removed along with cancer.

The evolution of practice along with modern technology is improving radiation treatment. Therefore, this treatment has the potential to escalate doses, reduce toxicity and improve outcomes.

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