Gynecological
cancers

These cancers do not usually produce any symptoms in the earliest stages, which is why it is important to detect them during a gynecological examination and a Pap smear. The most common symptoms are:

• Bleeding after sexual intercourse or outside the menstrual cycle (metrorrhagia)
• Pain during intercourse
• A feeling of heaviness in the pelvis

Your doctor may prescribe several types of treatment, either alone or in combination.

External radiotherapy

This treatment uses X-rays directed through the skin to the area to be treated. These rays are produced by a linear accelerator and gradually destroy the cancer cells.

Your treatment will begin with a scanning session (called virtual simulation) to identify the areas to be treated (target volumes) and the healthy organs around them that must be preserved as much as possible.

Your treatment plan will be tailored to your individual needs (taking into account your specific characteristics and those of your disease) and scheduled over several weeks. Sessions take place from Monday to Friday and last approximately 15 minutes.

The radiation is invisible and painless and does not make you radioactive.

Chemotherapy in combination with radiotherapy

Chemotherapy is a treatment based on drugs that act on the mechanisms of cell division.

It is a general treatment (called systemic treatment) that acts throughout the body. This allows cancer cells to be reached regardless of their location in the body, even if they are isolated and cannot be detected by diagnostic tests.

Chemotherapy drugs are most often administered by infusion, or sometimes orally in tablet form. At Centre François Baclesse, chemotherapy is administered concurrently with radiotherapy. This sensitizes the cells in order to enhance the action of the radiation on the areas to be treated.

Brachytherapy

This is a form of radiotherapy that involves placing a radioactive source in contact with or inside the tumor to destroy nearby tumor cells, delivering only a low dose to neighboring organs. This type of treatment requires the temporary insertion of specific equipment (see section "Stages of treatment > Brachytherapy of the vaginal vault and uterovaginal brachytherapy").

Side effects are predictable but not systematic; each situation is unique and each patient reacts differently. We invite patients to report any adverse effects to their referring physician at the CFB during weekly follow-up consultations. Nowadays, the most common acute side effects are very well managed with symptomatic treatments. These will be prescribed by your radiation oncologist if necessary.

During radiotherapy

The uterus is close to the bladder and rectum. As a result, these organs receive a certain amount of radiation and some side effects may occur.

• Vaginal symptoms: Dryness, vaginal discharge, rarely traces of blood, recurrence in cases of predisposition to herpes outbreaks
• Urinary symptoms: Burning sensation when urinating, frequent and urgent need to urinate, rarely traces of blood (pink urine)
• Digestive symptoms: Urge to have a bowel movement, sometimes mucus or minimal bleeding, diarrhea, abdominal pain such as bloating, rarely nausea or vomiting
• Fatigue: Fatigue is a common side effect but is not necessarily due to the treatment. It is often caused by the daily repetition of the treatment.

During chemotherapy

Side effects will depend on the choice of drugs and the doses required to treat the tumor.

However, it is important to know that a number of chemotherapy drugs do not cause hair loss and that nausea after chemotherapy is increasingly well controlled.

The combination of radiotherapy and chemotherapy can increase side effects such as fatigue and nausea.

During brachytherapy

Local inflammation of the vaginal mucosa may occur. This is usually painless but may cause "whitish" discharge in the days or weeks following treatment. Sometimes a few traces of blood may appear, but this is also nothing to worry about if it is not heavy or prolonged.