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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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Radiotherapy| treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.
Radiotherapy can be given after surgery| (adjuvant radiotherapy), if your doctor feels that there is a risk of the cancer coming back. It can be used instead of surgery if you are not well enough to have surgery or if the cancer has spread to the area surrounding the womb. It can also be used if the cancer comes back in the pelvic area at a later date. Radiotherapy for womb cancer can be given externally or internally, and often as a combination of the two.
Our section on understanding radiotherapy| has more information about the treatment and its side effects.
This is given by directing high-energy rays at the area of the cancer. It is usually done at a hospital outpatient clinic each weekday, with a rest at the weekend. The type and length of your treatment will depend on the size and position of the cancer, but it may last a few weeks.
To make sure that the radiotherapy is as effective as possible, it has to be carefully planned. Planning ensures the radiotherapy rays are aimed precisely at the cancer and cause the least possible damage to the surrounding healthy tissues. The treatment is planned by a specialist doctor known as a clinical oncologist. Planning is important and may take a few visits.
Marks may be drawn on your skin to help the radiographer, who gives you your treatment, to position you accurately and to show where the rays are to be directed. These marks must stay visible throughout your treatment, but they can be washed off once your course of treatment is over. At the beginning of your radiotherapy you’ll be told how to look after the skin in the area to be treated.
Before each session of radiotherapy, the radiographer will position you carefully on the couch and make sure you are comfortable. During your treatment, which only takes a few minutes, you’ll be left alone in the room but you can talk to the radiographer, who will watch you carefully from the next room.
Your skin may become sore in the area being treated. Perfumed soaps, creams or deodorants may irritate the skin and shouldn’t be used during the treatment. Your radiographer or nurse can advise you on skin care during this time.
Internal radiotherapy, often called brachytherapy, is a way of giving radiation directly to the scar at the top of the vagina, where the womb has been removed, and the area close by.
It is usually used after surgery| if there is a chance that the cancer may come back. It is also sometimes used as an alternative treatment for women who can’t have surgery. Internal radiotherapy can be used on its own or in combination with external radiotherapy.
Internal radiotherapy gives a high dose of radiation to the top of the vagina, but only a low dose to tissues and organs more than a few centimetres away. The treatment is given by a machine that delivers radioactive sources (small radioactive wires or metal balls) into hollow plastic or metal tubes (applicators) that are placed into the top of the vagina. The tubes are usually put in position without anaesthetic or under light sedation.
The treatment can be given using either a high dose-rate system or a low dose-rate system. High dose treatment is sometimes known as ‘fast’ treatment and low dose treatment as ‘slow’ treatment. Both high dose-rate and low dose-rate treatments seem to be equally effective.
HDR treatment is the most common internal treatment for womb cancer and is usually given after surgery or following external radiotherapy. Each treatment only lasts a few minutes but is repeated more than once on different days. There is usually no need for an anaesthetic or painkillers.
The most common type of HDR is vaginal or vault brachytherapy. This is when a hollow plastic cylinder is placed at the top of the vagina. The cylinder is attached by a flexible tube to a machine called a microselectron. The machine delivers a radioactive source (usually a wire) into the hollow cylinder. The treatment is usually well tolerated and is given as an outpatient.
Occasionally, women who are not able to have surgery and still have their womb may be offered a slightly different type of internal treatment. This involves placing different applicators (plastic or metal tubes) at the top of the vagina as well as the womb. The tubes are usually put in position under an anaesthetic to ensure that the internal part of your womb is reached with minimal discomfort. This may mean that you need to have a short hospital stay to complete the treatment.
You will be given painkillers and occasionally sedation or gas and air (entonox) before the tubes are removed to make the removal easier for you.
LDR treatment is less commonly used than HDR. Treatment is given through the same applicators as described above but delivered much more slowly, usually over several hours or days by a machine called a Selectron.
During the treatment you will need to stay in hospital for a few days. You’ll be asked to stay in bed while the applicators are in place, to make sure that they stay in the correct position.
You will probably need to stay in a separate room, set apart from the main ward and often behind lead shields. Some women feel isolated or worried during this treatment, but you can still have visitors for short periods. It may also be helpful to take in plenty of reading material, a radio and other things to keep you occupied. Pregnant women or children aren’t encouraged to visit if you are having this treatment.
At the end of treatment the applicator will be removed by one of the doctors, nurses or radiographers on the ward/department. This is not usually painful but may be uncomfortable if you have applicators into the womb. You will be given painkillers and occasionally sedation or gas and air (entonox) before the tubes are removed to make the removal easier for you.
It’s not unusual to have slight vaginal discharge once radiotherapy treatment has finished. If it continues or becomes heavy, let your clinical oncologist or specialist nurse know. Some women find that their vagina becomes drier than usual.
Radiotherapy to the pelvic area can cause side effects such as tiredness|, diarrhoea,| needing to pass urine more often, and a burning sensation when passing urine. These side effects can be mild or more troublesome, depending on the strength of the radiotherapy dose and the length of your treatment. Your clinical oncologist, specialist nurse or radiographer will be able to tell you what to expect.
Most of these side effects can be treated quite easily. Any side effects should gradually disappear a few weeks after your treatment is over.
It’s important to drink plenty of fluids and maintain a healthy diet during your treatment. You may feel slightly sick but this is not common. If you don’t feel like eating you can replace meals with nutritious, high-calorie drinks, which are available from most chemists and can be prescribed by your GP.
During your treatment it’s helpful to get as much rest as you can, especially if you have to travel a long way each day.
We have more information about the possible side effects of pelvic radiotherapy during treatment|.
Radiotherapy to the pelvic area can sometimes cause long-term side effects. However, improved planning and treatment techniques have made long-term effects much less likely.
A small number of women will find their bowel or bladder are permanently affected by the radiotherapy. If this happens, the increased bowel motions and diarrhoea may continue, or you may need to pass urine more often than before.
The blood vessels in the bowel and bladder can become more fragile after radiotherapy treatment and this can make blood appear in the urine or bowel movements.
These side effects can take many months or years to happen.
If you notice any bleeding, let your doctor know so that tests can be carried out and appropriate treatment given.
Radiotherapy can cause a narrowing of the vagina, which can make sexual intercourse uncomfortable. Some women become less interested in sex and notice that their vagina is dry. We have more information on coping with the effects on your sex life|.
Some women also find that the radiotherapy affects the lymph glands in the pelvic area and can cause swelling of the legs. This is known as lymphoedema| and it is an uncommon side effect.
These possible late side effects are discussed in detail in our section on pelvic radiotherapy in women: possible long-term side effects|.|
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