Chemotherapy for vulvar cancer

Chemotherapy uses drugs to destroy cancer cells. These drugs target rapidly dividing cells throughout the whole body. This means that chemotherapy kills cancer cells but it can also damage healthy cells.

With most types of chemotherapy, the drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic therapy.

Chemotherapy is sometimes used to treat vulvar cancer. If you have chemotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

Chemotherapy may be the only treatment you have or it may be used along with other cancer treatments. You may have chemotherapy to:

• shrink a tumour before other treatments such as surgery or radiation therapy (called neoadjuvant chemotherapy)
• relieve pain or control the symptoms of advanced vulvar cancer (called palliative chemotherapy)
• treat advanced vulvar cancer when surgery can’t be done
• destroy cancer cells left behind after surgery to reduce the risk that the cancer will come back (recur) (called adjuvant therapy)

Chemotherapy is most often given with radiation therapy during the same time period to treat vulvar cancer. This is called chemoradiation. Some chemotherapy drugs can help make radiation work better by making cancer cells more sensitive to radiation. Combining chemotherapy and radiation therapy can be more effective than either treatment on its own.

Most chemotherapy for vulvar cancer is given through a needle into a vein (intravenously, or by IV) or directly into the abdomen through a small, flexible catheter (called intraperitoneal chemotherapy). Some chemotherapy drugs can be applied to the skin as in a cream or ointment (called topical chemotherapy).

The most common chemotherapy drug combinations used in chemotherapy and chemoradiation for vulvar cancer are:

• cisplatin and paclitaxel
• carboplatin and paclitaxel

In some cases, cisplatin may be given on its own in chemoradiation. But it is less common.

Side effects of chemotherapy will depend mainly on the drug, the dose, how it’s given and your overall health. Tell your healthcare team if you have side effects that you think are from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Side effects of chemotherapy drugs used for vulvar cancer include:

• low blood cell counts
• nausea and vomiting
• sore mouth and throat
• loss of appetite
• diarrhea
• fatigue
• skin problems
• hair loss
• peripheral neuropathy
• fertility problems

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.