Radiation Therapy

Radiation can be used to kill cancer cells and cure patients with endometrial cancer. There are two ways of targeting endometrial cancer cells: external radiation therapy and internal radiation therapy.

1. External radiation therapy uses a machine to focus radiation from outside the body onto the cancer cells inside the pelvis.

   External beam radiation therapy may be used after surgery:

• if the cancer has spread through more than half the myometrial (the uterine muscle) thickness and lymphatic channels have cancer cells in them
• if cancer was found in the lymph nodes after being removed
• for certain types of uterine cancer

The number of treatments given varies, but external beam radiation therapy is usually given daily, Monday through Friday, for four or five weeks.

2. Brachytherapy (or internal radiation therapy) involves placing radioactive devices, such as tubes or catheters which have radioactive seeds sealed inside them, inside the body. These are placed temporarily in the uterus (if done before surgery) or the vagina (if done after surgery).
   
   

   Brachytherapy may be given without external treatment or after the external treatment is finished.  It is usually used if cancer cells were found in the cervix as well as the body of the uterus.

Most commonly, radiation of any kind is given after surgery. On rare occasions, radiation therapy may be used before surgery if the cervix is also affected by the cancer.

Side Effects

There can be side effects from radiation treatment. Most will go away. The skin in the treated area may look sunburned and then tanned, but will return to normal within six to 12 months.

Other side effects during treatment include:

• fatigue
• diarrhea, which is usually controlled with medication
• urinary frequency or burning with urination, also often alleviated with medication
• nausea and vomiting (rare)
• changes in appetite (rare)

Brachytherapy is minimally uncomfortable when the device is inserted into the vagina but otherwise, has few side effects.

Long-Term Consequences

The potential long-term consequences of radiation therapy include:

• permanent change in bowel habits, with increased tendency to diarrhea (uncommon)
• damage to the bowel, which requires surgery (very rare)
• narrowing of the vagina (called vaginal stenosis), which can make sexual intercourse difficult or painful, but there are strategies to prevent this from happening
• increased risk for fracturing a pelvic bone

Talk to your doctor about any side effects. There are treatments and medications that can help alleviate some of these effects.

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