External or Internal Radiation Therapy for Endometrial Cancer
Radiation therapy for uterine cancer is mostly used as an adjuvant therapy after surgery, but in some cases it may also be used as a primary therapy. The goal of radiotherapy is to ensure that any remaining cancer cells that may not have been removed by surgery are destroyed by radiation. Radiation therapy involves the use of high energy X-ray beams or other forms of radiation that is focused on the affected tissue of the uterus.
Radiation for endometrial cancer may be performed as an external beam radiation therapy or internal radiotherapy. External radiation therapy makes use of a machine to focus radiation on the cancerous portion of the uterus. Internal radiation therapy places the radioactive material directly into or close to the tumor, with an aim to minimize exposure to surrounding healthy tissue. The choice of radiation therapy procedure depends on the size, location and type of uterine cancer.
What Should the Patient Expect during Radiotherapy
Radiation therapy for uterine cancer is usually administered to prevent the spread or recurrence of the disease. However, in some cases where the patient cannot undergo surgery, radiotherapy may be used as a primary treatment option. External beam radiation therapy is generally performed as an outpatient procedure over a few weeks, with five sessions per week. During the course of treatment, the patient may have to avoid sexual intercourse because of the discomfort involved. Internal radiation therapy or brachytherapy, on the other hand, may be performed in the hospital over a period of two to three days.
Radiation Therapy in Different Stages of Endometrial Cancer
Radiation therapy may become necessary at different junctures during the treatment, depending on the stage of the endometrial cancer. During Stage I of the cancer, radiotherapy is usually not required if the location of the tumor is convenient for surgical removal. But if the tumor is embedded deep into the uterine muscle, it may be necessary to give radiation of the pelvis. At Stage II, if the cancer is found in the cervix, post-surgery radiation therapy may be required.
In Stage III of endometrial cancer, radiation therapy is a standard part of the treatment. If surgery cannot be performed, radiation therapy alone may be used. During Stage IV, if the cancer has metastasized beyond the uterus to distant parts of the body, it may not be useful to give radiotherapy. However, it may still help to relieve the symptoms and discomfort. Radiation is more helpful if the tumor is confined to the pelvic area.
Side Effects of Radiation Therapy
Radiation therapy for endometrial cancer may cause a number of side effects, depending on the extent of radiation. The patient may experience tiredness and fatigue, loss of appetite, poor bowel control, bowel obstruction, abdominal cramping, vaginal scars and chronic bladder irritation.
There may be a burning sensation or itching, squeezing and dryness in the vagina. Patients may find difficulty in urinating and the frequency may increase. Most of the superficial side effects subside gradually after the treatment is over. However, radiation to the pelvis area may lead to permanent sterility. Patients should be aware of the expected side effects before the treatment.
National Cancer Institute: https://www.cancer.gov/cancertopics/pdq/treatment/endometrial/Patient/page4#Keypoint16