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Radiation Therapy for Uterine (Endometrial) Cancer

Radiation Therapy for Uterine (Endometrial) Cancer

Radiation therapy is the use of penetrating beams of high-energy waves or streams of particles called radiation to treat disease. Radiation therapy destroys the ability of cancer cells to grow and divide.
Radiation therapy may be used alone or in addition to surgery. Radiation is tailored to your needs and situation. Treatment with both internal and external radiation may be used for patients who are not candidates for surgery due to poor health or those who refuse surgery. Radiation may be combined with hormone therapy. This treatment may also be used for advanced disease to control bleeding, pain, and other symptoms.

Types of Radiation Therapy Used for Uterine Cancer

Internal (intracavitary) and external radiotherapy are used in the treatment of uterine cancer. Internal irradiation involves the insertion of radioactive seeds into the uterus, near the tumor. The radioactive material is inserted through the vagina and left in place for two to three days while you remain in the hospital. During your stay, limitations will be placed on visitors and contact with staff to limit exposure to the radiation. Once the implants are removed, casual contact with others is safe.
Effectiveness
This group consists of patients with grade 1 or 2 tumors that invade through less than one half of the muscle wall of the uterus, or grade 3 tumors that do not invade the muscle at all, with no spread to lymph nodes or invasion of blood vessels or lymphatic channels. These patients are usually treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO), which is the surgical removal of the entire uterus and both ovaries. In women who have other medical problems that would make such surgery risky or more difficult than usual, radiotherapy is an option. The cure rates with radiotherapy are slightly lower than with surgery.
This group consists of patients with grade 1 or 2 tumors that invade through more than one half of the muscle wall of the uterus or invade the cervix, with no invasion of blood vessels or lymphatic channels and no spread to other parts of the body. These patients are usually treated with surgery (TAH-BSO) and removal of the lymph nodes in the pelvis. Radiotherapy is often recommended after surgery for these patients, since it has been shown to reduce the risk of the cancer coming back in the pelvis. However, the chances of survival do not appear to be improved by the use of radiation therapy after surgery.
This group consists of patients with grade 3 tumors with any degree of invasion of the muscle wall of the uterus, spread to the tissues around the uterus or elsewhere in the pelvis, grade 2 tumors with invasion through more than one half of the muscle wall of the uterus or into the cervix, or tumors that invade blood vessels or lymphatic channels. These patients are usually treated with surgery (TAH-BSO) to remove as much of the cancer as possible. Their risk of the cancer coming back is high, however, so radiotherapy is often recommended after surgery.
Side Effects and Possible Complications of Radiotherapy
  • Bladder irritation
  • Vaginal itching, burning, dryness, or menstrual cessation
  • Reduction of sexual desire
  • Fistula formation, which occurs when a hole forms between the bladder, intestines, and vagina
  • Nausea
  • Fatigue
  • Diarrhea

References

Abeloff M. Clinical Oncology. 2nd ed. Orlando, FL: Churchill Livingstone, Inc; 2000: 1987-2008.

American Cancer Society website. Available at: http://www.cancer.org/ .

Bast R, Kufe D, Pollock R, et al, eds. Cancer Medicine. 5th ed. Hamilton, Ontario: BC Decker Inc; 2000.

National Cancer Institute website. Available at: http://www.nci.nih.gov/ .

Rakel R. Bope E, ed. Conn's Current Therapy. 54th ed. St. Louis, MO: WB Saunders; 2002: 1094-1096.

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