Radiotherapy for womb cancer

Radiotherapy uses high-energy rays called radiation to treat cancer. It destroys cancer cells in the area where the radiotherapy is given.

There are 2 ways of having radiotherapy for womb cancer:

• External beam radiotherapy is given from outside the body (externally) using a radiotherapy machine.
• Internal radiotherapy is when a radioactive material is placed inside the body. This is called brachytherapy.

Sometimes radiotherapy is given after chemotherapy. The chemotherapy makes the cancer cells more sensitive to radiotherapy.

External beam radiotherapy is when a radiotherapy machine aims high-energy rays at the area of the body being treated.

Before you start your treatment, it needs to be planned. This is to make sure that the radiotherapy is aimed directly at the cancer. This will also mean it causes the least amount of damage to the surrounding area. Your cancer team will plan your radiotherapy carefully.

You will have a hospital appointment to plan your treatment. You will usually have a CT scan of the area to be treated. During the planning appointment, you may have markings made on your skin. These help the radiographers position you for each treatment.

Side effects do not usually happen straight away. They may develop during treatment or in the days or weeks after treatment finishes. Sometimes side effects get worse for a time during and after you have finished radiotherapy.

Your team will explain what to expect. Always tell them if you have side effects during or after radiotherapy. They can give advice and support to help you cope.

Radiotherapy to the womb and surrounding areas it is known as pelvic radiotherapy. We have more information about the side effects in our information about pelvic radiotherapy.

Radiotherapy often makes people feel tired. Tiredness (fatigue) may get worse as treatment goes on. If you are having radiotherapy alongside other treatments, such as surgery or chemotherapy, you may feel more tired. But there are things you can do to help, such as:

• get plenty of rest
• do some gentle exercise, such as going for short walks
• eat a healthy diet and drink plenty of fluids
• ask for help with everyday tasks, if you have friends or family members who can support you.

After treatment finishes, you may continue to feel tired for weeks or months. If it does not get better, tell your cancer doctor or specialist nurse.

We have more information about coping with tiredness (fatigue).

Diarrhoea is the most common side effect. It usually starts during radiotherapy or after 2 weeks of treatment. If you have diarrhoea, your radiotherapy team may give you tablets to help reduce it. Try to drink at least 2 to 3 litres (8 to 12 glasses) of fluids each day, unless your doctor or nurse tells you something different.

If you have any bowel (poo) incontinence, tell your radiotherapy team. They will give you advice about coping with incontinence and looking after your skin.

It is important to tell your radiotherapy team about any bowel side effects. They may suggest making some changes to your diet during radiotherapy. Or they may suggest treatments to help. Follow their advice carefully. Tell them if your side effects get worse.

We have more information about the bowel side effects of pelvic radiotherapy.

Pelvic radiotherapy can irritate the lining of the bladder. You may need to pee (urinate) more often. You may find it hard to wait when you need to go, or you may leak a bit of urine. You may notice a burning feeling when you pass urine (pee), which feels like having a urine infection. You may also notice blood in your urine (haematuria).

Always tell your radiotherapy team if you have any side effects during or after your treatment. They can give you advice and may recommend medicines to help you feel more comfortable. They may also ask you for a urine sample to check if you have an infection.

We have more information about the bladder side effects of pelvic radiotherapy and coping with bladder changes.

Pelvic radiotherapy can affect the vagina. It may cause changes such as:

• skin reactions
• dryness
• bleeding
• narrowing of the vagina.

Vaginal changes can be uncomfortable. They may make having vaginal sex painful. They may also make it difficult if you need to have internal examinations in the future.

Your doctor, radiographers or nurse can give you advice about preventing or coping with vaginal changes. Try to follow their advice and ask for more help if you need to. It can be hard to talk about these side effects, but your radiotherapy team can usually help.

We have more information about coping with vaginal dryness and preventing narrowing of the vagina when having pelvic radiotherapy.

When you have pelvic radiotherapy, you may lose some of your pubic hair. After treatment, it usually grows back but may be thinner than it was before.

It is not common to have a skin reaction with pelvic radiotherapy, but rarely the skin in the area that is treated may:

• if you have white skin, your skin may redden
• if you have black or brown skin, you skin may darken
• feel sore or itchy.

Your radiographer or specialist nurse will give you advice on taking care of your skin. If your skin becomes sore, itchy or changes colour, tell them straight away. They can give you advice and treatments if needed.

Skin reactions should get better within 4 to 6 weeks of treatment ending.

Internal radiotherapy is also called brachytherapy. It gives a high dose of radiotherapy directly to the top of the vagina, or to the vagina and womb. This depends on whether you had surgery to remove your womb. It also gives a high dose to the area close by. You may have brachytherapy on its own. Or you may have it at the end of your external radiotherapy treatment. You usually have this as an outpatient.

External beam radiotherapy causes more side effects than internal radiotherapy. If you are having brachytherapy only, it is not common to get side effects after treatment. The treatment only affects a very small area. This means is not likely to cause any long-term side effects, for example to your bladder or bowel. But you may notice some effects to the vagina and your sex life after treatment.