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Radiation therapy for cancer of the uterus
Also known as radiotherapy, radiation therapy uses a controlled dose of radiation to kill or damage cancer cells so they cannot grow, multiply or spread. The radiation is usually in the form of x-ray beams. Treatment is carefully planned to limit damage to the surrounding healthy tissues.
Learn more about:
- Overview
- Internal radiation therapy (brachytherapy)
- External beam radiation therapy
- Chemoradiation
- Side effects of radiation therapy
- Video: What is radiation therapy?
Overview
For cancer of the uterus, radiation therapy is commonly used as an additional treatment after surgery to reduce the chance of the disease coming back. This is called adjuvant therapy.
In some cases, radiation therapy may be recommended as the main treatment if other health conditions mean you are not well enough for a major operation.
There are two main ways of delivering radiation therapy: internally or externally. Some people are treated with both types of radiation therapy. Your radiation oncologist will recommend the course of treatment most suitable for you.
Internal radiation therapy (brachytherapy)
Internal radiation therapy may be used after a hysterectomy to deliver radiation directly to the top of the vagina (vaginal vault) from inside your body. This is known as vaginal vault brachytherapy.
During each treatment session, a plastic cylinder (the applicator) is inserted into the vagina. The applicator is connected by plastic tubes to a machine that contains radioactive material in the form of a small metal seed. Next, this seed is moved from the machine through the tubes into your body. After a few minutes, the seed is returned to the machine. The applicator is taken out after each session.
This type of brachytherapy does not need any anaesthetic. Each treatment session usually takes only 20–30 minutes. You are likely to have 3–6 treatment sessions as an outpatient over 1–2 weeks.
If you are having radiation therapy as the main treatment and haven’t had a hysterectomy, the internal radiation therapy may involve placing an applicator inside the uterus. This is done under anaesthetic or sedation, and may require a short hospital stay.
External beam radiation therapy
External beam radiation therapy (EBRT) directs the radiation at the cancer and surrounding tissue from outside the body. For cancer of the uterus, the lower abdominal area and pelvis are treated, but if the cancer has spread (metastasised), other areas may also be treated.
Planning for EBRT may involve a number of visits to your doctor to have more tests, such as blood tests and scans. You will also be told about any special bladder or bowel preparations you have to take before each treatment.
Each EBRT session lasts about 30 minutes, with the treatment itself taking only a few minutes. You will lie on a treatment table under a large machine known as a linear accelerator, which delivers the radiation. The treatment is painless (like having an x-ray), but may cause side effects.
You will probably have EBRT as daily treatments, Monday to Friday, for 4–6 weeks as an outpatient. It’s very important that you attend all of your scheduled sessions to ensure you receive enough radiation to make the treatment effective.
Learn more about radiation therapy.
Chemoradiation
High-risk endometrial cancer is often treated with EBRT in combination with chemotherapy to reduce the chance of the cancer coming back after treatment is over.
When radiation therapy is combined with chemotherapy, it is known as chemoradiation. The chemotherapy drugs make the cancer cells more sensitive to radiation therapy. If you have chemoradiation, you will usually receive chemotherapy once a week a few hours before some radiation therapy sessions.
Once the radiation therapy is over, you may have another four cycles of chemotherapy on its own.
Side effects of chemoradiation include fatigue; diarrhoea; needing to pass urine more often or in a hurry; cystitis; dry and itchy skin in the treatment area; numbness and tingling in the hands and feet (peripheral neuropathy); and low blood counts. Low numbers of blood cells may cause anaemia, infections or bleeding problems.
Talk to your treatment team about ways to manage any side effects.
Video: What is radiation therapy?
Watch this short video to learn more about radiation therapy.
Podcast: Making Treatment Decisions
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More resources
A/Prof Jim Nicklin, Director, Gynaecological Oncology, Royal Brisbane and Women’s Hospital, and Associate Professor Gynaecologic Oncology, The University of Queensland, QLD; Dr Robyn Cheuk, Senior Radiation Oncologist, Royal Brisbane and Women’s Hospital, QLD; Prof Michael Friedlander, Medical Oncologist, The Prince of Wales Hospital and Conjoint Professor of Medicine, The University of NSW, NSW; Kim Hobbs, Clinical Specialist Social Worker, Gynaecological Cancer, Westmead Hospital, NSW; Adele Hudson, Statewide Clinical Nurse Consultant, Gynaecological Oncology Service, Royal Hobart Hospital, TAS; Dr Anthony Richards, Gynaecological Oncologist, The Royal Women’s Hospital and Joan Kirner Women’s and Children’s Hospital, VIC; Georgina Richter, Gynaecological Oncology Clinical Nurse Consultant, Royal Adelaide Hospital, SA; Deb Roffe, 13 11 20 Consultant, Cancer Council SA.
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