Radiation therapy for uterine cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is usually used to treat uterine cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.

Radiation therapy is sometimes combined with chemotherapy to treat some types of uterine cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Radiation therapy is given for different reasons. You may have radiation therapy or chemoradiation to:

• destroy the cancer cells in the body
• shrink a tumour before other treatments such as surgery or chemotherapy (called neoadjuvant therapy)
• destroy cancer cells left behind after surgery or chemotherapy to reduce the risk of the cancer coming back, or recurring (called adjuvant therapy)
• relieve pain or control the symptoms of advanced uterine cancer (called palliative therapy)

Radiation therapy for uterine cancer can be given as external beam radiation therapy or brachytherapy (internal radiation). Both methods may be used based on surgical staging results.

During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it. Treatments are given once a day, 5 days per week, for 4–6 weeks.

Brachytherapy is internal radiation therapy. It uses a radioactive material called a radioactive isotope. It is placed right into, or very close to, the tumour. Radioactive materials can also be placed in the area from where the tumour was removed. The radiation kills the cancer cells over time.

For uterine cancer, brachytherapy may be given as intracavitary radiation or interstitial radiation.

Intracavitary radiation uses a radioactive material in a special applicator or cylinder that is placed in the vagina.

Interstitial radiation places thin radioactive tubes directly into the tumour and surrounding tissue. These implants can be temporary or permanent. Temporary implants are removed after the desired dose of radiation is delivered. Permanent implants (such as radioactive seeds) are not removed. They slowly deliver their dose of radiation over a period of weeks or months.

Either low-dose-rate (LDR) or high-dose-rate (HDR) brachytherapy will be given.

LDR brachytherapy delivers continuous, low doses of radiation. The implant often stays in for 1–4 days, and then the healthcare team removes it. More than one treatment may be needed. You will need to stay in the hospital while receiving treatment. Special radiation safety precautions are followed to make sure other people aren't exposed to radiation. Once the implant is removed, you are not radioactive and can be around people. LDR is not commonly used anymore.

HDR brachytherapy delivers high doses of radiation over a very short period of time, often in less than an hour. The radioactive material is given from a special high-dose-rate machine that is attached to catheters or needles placed in the tumour. The treatment is often given weekly or daily, for at least 3 doses.

Find out more about brachytherapy.

Side effects can happen with any type of treatment for uterine cancer, but everyone's experience is different. Some women have many side effects. Other women have few or none at all.

During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. Side effects can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Some common side effects of radiation therapy used for uterine cancer are:

• fatigue
• skin problems
• diarrhea
• bladder problems, including discomfort, urge to urinate often and bleeding
• nausea and vomiting
• bowel obstruction
• lymphedema in the legs
• sexual problems including vaginal dryness and painful intercourse

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

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