Internal radiotherapy to the vaginal vault

Internal intracavity radiotherapy (also called brachytherapy) may be used to treat the top of the vagina following surgery if there is a chance that the cancer may return. It may be used on its own or combined with external radiotherapy. It involves the insertion of an applicator, like a tampon, into the vagina. Intracavity radiotherapy gives a high dose of radiation to the area close to the applicator, but only a low dose to tissues and organs more than a few centimetres away. This reduces the risk of side effects from the treatment.

What happens during internal intracavity radiotherapy?

At Addenbrooke’s, intracavity radiotherapy to the vagina is given by a machine called a high dose rate (HDR) microSelectron. The treatment will be given in the oncology outpatient department in one session (if you have received external radiotherapy) or three sessions (if you have not had external radiotherapy). You will be sent written notification of the appointment date(s) and time(s) before your treatment is due.

It is advisable to wear loose-fitting skirts or trousers when you attend for your treatment, as you will be required to remove your lower garments during the treatment. Before the treatment starts, a gentle internal vaginal examination will be carried out to ensure that the correct size applicator is used for your treatment. The radiographer will then insert the applicator into the vagina. This may feel a little uncomfortable but should not be painful. The radiographer and physicist will calculate the time required for your treatment, depending on the size of applicator used. This may take a few minutes.

Once all the calculations have been completed, the radiographer will connect the treatment applicator to the HDR machine. The machine will feed a radioactive source into the applicator to treat the top of the vagina. During your treatment, you will be left alone in the room but the radiographers will be watching you from an adjoining room and you can raise your hand if you require the treatment to be paused or need a radiographer’s assistance. The treatment is painless and will take approximately 10 minutes. After the treatment, the applicator will be removed and it will be safe for you go home and be with other people. You should be in the department no longer than one hour. Once your course of radiotherapy is finished, you will receive an appointment to be seen in the outpatient clinic in approximately 3 months’ time.

Side effects

It is not unusual to have slight bleeding or discharge after the treatment has been completed. The treatment can also cause a burning or painful sensation when passing urine. These side effects are usually mild and should gradually disappear a few days after your treatment is over.

Radiotherapy may cause scarring and narrowing of the vagina. This can make it difficult for your doctor to examine you at follow-up appointments and can make normal sexual intercourse uncomfortable.

To help minimise this problem you will be given a dilator kit. This kit contains a range of plastic tubes of various sizes which dilate or stretch the vagina. This helps the muscles of the vagina to relax and prevents scar tissue developing.

Your advanced practitioner in gynaecological oncology is available to discuss any questions or concerns that you may have about your treatment on the following telephone number: 01223 256710. Please leave a message on the answerphone if the radiographer is unavailable.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and / or specialist one to one care is required.