Radiation therapy for endometrial cancer

Radiation therapy is treatment with high energy rays (such as x-rays) to kill cancer cells or shrink tumors. The radiation may come from outside the body (external radiation). Or it can come from radioactive materials placed near the tumor. (This is called brachytherapy.) In some cases, both types of radiation treatment are used.

How much of the pelvis needs to have radiation treatment depends on how far the cancer has spread.

Vaginal brachytherapy

With this method, radioactive pellets or seeds are put into place for a short time. They are put into a small tube that is placed in the vagina. This is most often used to treat the upper part of the vagina after surgery. With brachytherapy there is little effect on nearby structures such as the bladder or rectum.

This treatment is given in the radiation suite of the hospital or care center, often starting about 4 to 6 weeks after surgery. In one form of brachytherapy, the pellets stay in place for days at a time, and the patient stays in the hospital (in bed) until they are removed. More than one treatment may be needed.

In the other form of brachytherapy, the pellets stay in place for less than an hour at a time. This treatment is often given weekly or even daily for at least 3 doses.

External radiation

This method of giving radiation is like a regular x-ray but it takes longer. It is most often given 5 days a week for 4 to 6 weeks. While treatment itself takes less than a half-hour, the daily trips may be tiring.

Side effects of radiation treatment

• Tiredness (fatigue)
• Upset stomach
• Loose bowels (diarrhea)
• Nausea and vomiting
• Skin changes like redness and soreness
• Problems passing urine
• The vagina may become dry, or shorter, or more narrow (this is called vaginal stenosis), causing pain during sex (this is more common after brachytherapy)
• Early menopause (But this is not an issue for most women who are being treated for endometrial cancer because they have already gone through menopause, either naturally or as a result of surgery to treat the cancer)
• Problems with the bladder or the bowel
• Weakened bones in the pelvis and hips

Radiation can also irritate the vagina, leading to discomfort and drainage (a discharge). When this problem is severe, there can be open sores in the vagina. Your doctor can help with treatments for these problems.

Radiation can lead to low blood counts, causing low red blood cells and low white blood cells. The blood counts usually return to normal after radiation is stopped.

Pelvic radiation can also lead to a blockage of the fluid draining from the leg. This can cause severe swelling known as lymphedema, a long-term side effect that doesn't go away after radiation is stopped. In fact, it may not start until several months or even years after treatment ends. This side effect is more common if pelvic lymph nodes were removed during the surgery to remove the cancer.

If you are having side effects from radiation, talk to your doctor. There are often things you can do to get relief from these problems or prevent them from happening.