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Cervical
Treatments - Internal Radiation - Full Selectron
Lymphoedema - Information and Advice
What is Cervical Cancer?
The cervix is the lowest part of the womb (uterus) and is often called the neck of the womb. It is possible for a Doctor/Nurse to see and feel the cervix during an internal (vaginal) examination. Situated near the cervix are small glands called lymph nodes, these make up part of the body’s lymphatic system, which is a network of small glands that act as the body’s defence system.
There are two main types of cancer of the cervix. The most common is called squamous cell carcinoma; the other type is known as adenocarcinoma. These names indicate the type of cells on the cervix which are growing abnormally.
As a cancer can take many years to develop a smear test is designed to detect early cell changes on the cervix. You may also need further tests to help with the planning of treatment. These may include blood tests, chest x-ray, colposcopy, cone biopsy, pelvic ultrasound, MRI scan and an examination under anaesthetic (EUA).
Treatments - General
Your treatment will be individually planned and discussed with you by your Consultant and Specialist Nurse. Your Consultant will plan your treatment with you taking into account a number of factors including the type and size of tumour, stage of cancer, your age and general health. Your partner or a close family member or friend are welcome to attend consultations and may like to make notes on your behalf.
In the early stages of cancer of the cervix surgery and radiotherapy are both effective forms of treatment. As radiotherapy has some side effects, in most cases surgery (hysterectomy) is usually considered to be the most appropriate form of treatment. If the cancer has spread beyond the cervix and for example, involves the lymph nodes, there may be a risk of cancer coming back after surgery therefore treatment with radiotherapy may be recommended as the treatment of choice.
In a few cases chemo-radiation may be considered, as giving chemotherapy before the radiotherapy may shrink the tumour prior to radiotherapy and may control the disease and give a good quality of life.
Treatments - Internal Radiation - Full Selectron
What is internal radiotherapy (Full Selectron)?
Internal radiotherapy is a method of treating cancer of the cervix with radiation. This enables the treatment to be given directly to the diseased area reducing the exposure to healthy surrounding tissue.
Where will I go for my treatment?You will be admitted to a single room on Tyneham Ward for your treatment. The room is specially designed to ensure that radiation does not leak into the surrounding area. This prevents unnecessary exposure to staff and visitors. There is an intercom to allow you to talk to the staff or your family without interrupting the treatment.
How is treatment given?In order to treat the area your Consultant will insert applicators (they will feel like a large tampon) into the womb. A catheter will be placed in your bladder so that the applicators are not dislodged when you pass water. You will then be taken to the radiotherapy department to have an X-ray to check the position of the applicators. Following this you will return to the ward whilst the exact dose and length of treatment is calculated individually prior to you commencing treatment.
What happens when treatment starts?During treatment you will need to lie down and remain in bed. Flexible tubes will connect the applicators to a radiotherapy machine, although the machine is in the room next door you may still find it a little noisy. For safety reasons it is not possible for anyone to enter the room while the machine is running. Your treatment will however be interrupted for short periods throughout the day and night so that the nursing staff can attend to your needs. You can use the intercom to speak to the nurses and there is a pre-pay telephone to enable you to contact family and friends at home.
Can I have visitors?The treatment is continuous but can be interrupted for visitors to enter your room for a short period, however please remember that this will extend the course of the treatment and is therefore not encouraged. Relatives may use the intercom briefly but are discouraged from waiting outside the room for their own safety.
What can I eat?Please select food that you can eat when lying down and choose a low fibre food that will not stimulate a bowel action (do not select high fibre food marked with a * on the menu). You will be given something to prevent a bowel action during treatment.
Treatments - Vaginal Dilation
Some treatments given for your type of Cancer can cause scar tissue to form in the vagina. This can lead to a reduction in the elasticity of the vagina and may lead to painful sexual intercourse. It is very important to maintain a healthy vagina for your general health and well-being. This is important not just for those who wish to resume sexual intercourse.
Vaginal dilation is recommended in order to:
- Keep a healthy supple vagina and increase natural vaginal moisture.
- Enable those who wish to do so to comfortably resume sexual intercourse (sex).
- Allow a more comfortable and effective physical examination at your regular check ups, to enable the doctor to clearly see how you’re responding to treatment and its effectiveness.
Vaginal dilation means stretching and opening the vagina. This can be achieved by:
- Vaginal massage
- Sexual intercourse
- Use of vaginal dilators
- Use of a vibrator
- The combination of using a dilator and sexual intercourse.
The vaginal dilators are smooth plastic tubes, which are available in four sizes and have a handle. Using the dilators will reduce scar tissue and adhesions and stretch and maintain the elasticity of the vagina; this will help to maintain a healthy vagina, especially if you are not having regular intercourse.
You will be advised to begin the use of your dilators about four weeks after the end of radiotherapy treatment. The dilators should be used regularly, although if you have intercourse twice a week you will not need to use the dilators in that week.
How to use the dilators
It is important to be relaxed, so ensure that the room is warm and private before you start. You may like some relaxing music playing. The following steps will help you to use the dilators correctly.
- Fit the universal handle to the recommended sized dilator.
- Wash your hands and place a small quantity of the lubricant supplied on the rounded end of the dilator. Relax and get into a comfortable position lying with legs apart and knees raised. You may like to do this in a warm bath.
- Gently insert the rounded end of the dilator into your vagina and insert the dilator as far as is comfortable. You cannot lose the dilator as the top of your vagina is closed.
- Insert and withdraw the dilator a couple of times and then hold it in place for three to five minutes. Try to use your pelvic floor muscles to grip the dilator firmly.
- Do not use force when inserting the dilator, if you have any difficulty revert to the smaller size. You may notice some tightness while using the dilator, if this is the case use the dilator more frequently for a while. To prevent scar tissue forming you may need to use the dilators regularly whilst you are sexually active.
- Withdraw the dilator and wash it in warm soapy water using a small brush to clean the inside. Ensure that the dilator is completely dry before storing.
- Use of the dilators on a regular basis can help reduce your anxiety about having intercourse and does not detract from the enjoyment of lovemaking.
Slight bleeding or ‘spotting’ following the use of dilators for the first few times is not unusual. If you have fresh heavy bleeding, pain or soreness you should contact your Doctor or the Gynaecological Nurse Specialist.
Lymphoedema - Information and Advice
What is it?
Lymph, a colourless fluid, forms in the tissues of the body. Under normal circumstances it drains back into the circulating blood through the body’s network of lymph vessels and nodes collectively termed the ‘lymphatic system’. The nodes act as filters to remove bacteria and abnormal or dead cells thus defending the body against infection.
If the lymph nodes or vessels are damaged by inflammation, infection, tumour, surgery or radiation this may result in a swelling of the soft tissue below the skin. This is known as lymphoedema.
If you notice any of the following changes in your legs:
- Swelling
- Heaviness
- Flushing or hot skin
- Skin rash
Please contact us, as treatment of the lymphoedema is easier in the early stages.
What preventative measures can I take?
If you have had treatment that might affect your lymph drainage, you may be at risk of developing swelling (lymphoedema). There are several measures you can take to minimize this. Skin care is particularly important:
- Wash and dry your legs very carefully using a simple soap.
- Apply aqueous cream or another moisturizing cream at night.
- Try to avoid cuts, scratches and insect bites.
- Attend to any cuts, scratches or insect bites promptly by cleaning well and applying antiseptic cream.
- Use an electric razor for hair removal.
- Avoid sunburn by using a high factor sun-block.
- Exercise as normally as possible as movement helps to drain the lymph.
What treatment is there for lymphoedema?
There is no curative treatment for lymphoedema, however it is possible to control the symptoms and move the excess fluid to where the lymph vessels and nodes are working normally by using special:
- Massage
- Exercise
- Skin care
- Hosiery
Where can I get help?
If you are currently receiving treatment for gynaecological cancer or have received treatment in the past and are concerned about swelling in your legs please inform your Consultant or contact Jan Barclay.