Radiotherapy treats cancer using high-energy X-rays that destroy the cancer cells while doing the least possible damage to normal cells.

Radiotherapy can be given:

• to lower the risk of cancer in the pelvic area coming back after surgery (adjuvant radiotherapy)
• in lieu of surgery
• to try to cure cancer that returns to the upper part of the vagina or in the pelvic area after surgery
• to treat any type of cancer that has not bee eliminated through surgery

Radiotherapy for uterine cancer can be given externally or internally or as a combination of both Your cancer specialist can talk to you at length about this treatment.

Adjuvant radiotherapy

Radiotherapy is given after surgery to lower the chances of the cancer returning to the area of the pelvis. Some women with stage-1 uterine cancer are at a higher risk of their cancer returning; in these situations, doctors can suggest radiotherapy to reduce the risk. Most women with uterine cancer in stage 2 or 3 have radiotherapy after surgery.

Adjuvant radiotherapy can be given internally or externally or as a combination of both. In some cases, radiotherapy is given alongside chemotherapy.

Radiotherapy to control symptoms (palliative radiotherapy)

If the cancer has spread throughout the pelvic area or into other areas of the body such as the bones, radiotherapy can be given to reduce the size of the cancer or to control the symptoms

External radiotherapy

External radiotherapy is normally given on an outpatient basis. High-energy X-rays are emitted by a machine, called a linear accelerator, to the area where the cancer is located.

Radiation Therapy Planning

Radiotherapy must be carefully planned in order to ensure that it is as effective as possible.

On your first visit to the radiotherapy department, you will have a CT scan done or you will lie down below a machine that will take x-rays of the area to be treated.

You may have small marks made on your skin (tattoos) to help the technician find the position more precisely so that the rays can be directed to this area. These marks must remain visible throughout the treatment. These are extremely small permanent marks, and you won't have these done without your consent.

Treatment sessions

At the beginning of each session, the technician will carefully place you so that you are comfortable, as you must remain still during the treatment. Radiotherapy isn't painful. During the treatment you will stay in the room alone, though you can talk to the technician monitoring you from an adjacent room.

Internal radiotherapy

Internal radiotherapy (also called brachytherapy) administers radiation directly to the upper part of the vagina (uterus) and the nearby areas.

The treatment is given by placing hollow tubes (applicators) in the vagina. A machine operated by a radiation therapist delivers radiation through the tubes to the exact spot of the tumor. The machine is programmed to give the exact dose your cancer specialist has prescribed for you.

You can have internal radiotherapy alone or after external radiotherapy. When radiation is given in several short bursts, it is called high-dose rate treatment. On the other hand, low-dose rate treatment is the name for radiation administered slowly.

High-dose rate treatment

This is the commonly used method of internal radiotherapy given after surgery. This can be done on an outpatient basis. An applicator is inserted in the vagina and the a CT scan or X-ray is done to check the position of the applicators. After this, the applicator is connected to the machine so that the radioactive source can be administered. The treatment takes only a few minutes.

Low-dose rate treatment

This type of treatment is not as common and is the same as high-dose treatment, but only slower. It can be given over 12-24 hours or over several days.

The treatment is usually given to patients who are in an individual room so that no one else is unnecessarily exposed to radiation. The procedure requires that patients remain lying down still so that the source of radiation stays in the proper spot. You will be fitted with a urinary catheter so you do not have to get up to go to the bathroom during the procedure.