Vaginal Cancer: Chemotherapy

What is chemotherapy?

Chemotherapy (chemo) uses strong medicines to kill cancer cells. The medicines attack and kill cells that grow quickly, like cancer cells. But some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects. 

You may see a gynecologic oncologist to get chemo for vaginal cancer. 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 using medicines to treat cancer.

Many people who get chemo for vaginal cancer, get it along with radiation. This is called radiosensitization or chemoradiation. It helps radiation work better.

Chemotherapy may be used by itself either before or after surgery. It's the main treatment in people whose vaginal cancer has spread. 

How is chemotherapy given for vaginal cancer?

Most people with vaginal cancer get chemotherapy in an outpatient part of the hospital, at the healthcare provider’s office, or at an infusion center. In rare cases, depending on your health or the chemo, you may need to stay in the hospital during treatment.

You may get chemo put right into your blood through a vein (by IV or intravenously), or take it by mouth as a pill. In some cases, vaginal precancer may be treated with chemo that's a cream or lotion. The medicine is put on the affected part of the vagina. Chemo given by IV or pill is a systemic treatment. This means the medicines travel all through your body. Chemo given as a cream or lotion is local treatment.

Chemotherapy is given in cycles. This means you're treated for a time with chemo and then you have a rest period. Each treatment and rest period make up one cycle. You’ll likely have more than one cycle of treatment. Your healthcare provider will talk with you about your treatment plan and what you can expect. The length of treatment depends on the type of chemo used. 

What type of chemotherapy is used to treat vaginal cancer?

The chemo medicines most often used to treat vaginal cancer include:

• Fluorouracil (5-FU)

• Cisplatin

• Carboplatin

• Paclitaxel

• Docetaxel

• Irinotecan

For chemotherapy along with radiation, you'll likely get low doses of cisplatin or carboplatin.

What are common side effects of chemotherapy?

Side effects are common with chemotherapy. But it's important to know that they can often be controlled or even prevented. Most side effects go away over time after treatment ends. Side effects depend on the type and dose of chemo you get. They vary from person to person. Ask what side effects you might expect and what to do if they become serious.

Some common side effects include:

• Nausea and vomiting

• Mouth sores

• Constipation or diarrhea

• Hair loss

• Infections from low white blood cell levels

• Easy bruising or bleeding from low numbers of platelets in the blood

• 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 (called neuropathy)

• Hearing problems

• Kidney problems

• Changes in menstruation or ability to have children (fertility). Most people with vaginal cancer have already gone through menopause.

Most side effects will go away or get better between treatments and after treatment ends. But some can last longer or be permanent. There may be things you can do to help control some of these side effects. Tell your healthcare providers about any side effects you have. They can help you cope with them.

Checking your health during chemotherapy

Blood tests will be done regularly while you're getting chemo. This is to make sure you aren't having harmful reactions. Make sure to ask which problems need you to call your healthcare provider or nurse right away. And make sure you know what number to call with questions or problems. Is there a different number for evenings, holidays, and weekends?

For instance, chemo can make you more likely to get infections. Your healthcare provider or nurse may ask you to call them if you have any of these symptoms:

• Fever of 100.4°F (38°C) or higher

• Confusion

• Shaking chills

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

• New cough or shortness of breath

• Headache

• Burning during urination or bloody or cloudy urine

• Unusual bleeding

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