Goal of Radiation Therapy for Uterine Sarcoma

Radiation is also called radiotherapy. Its goal is to kill or shrink cancer cells. High-energy rays or radioactive material are directed at cancer cells to harm them and stop their growth. The goal of radiation for uterine cancer depends on when you it.

  • When you have radiation after surgery, the goal is to help make sure that all cancer cells in the area treated are killed. The radiation is directed to an area where cancer cells are likely or known to be. These areas include the entire abdomen, the pelvis, or the vagina.
  • If you have radiation before, during, or after chemotherapy or hormone therapy, the goal is to ease symptoms such as stopping bleeding or reducing pain. In some cases radiation is given prior to surgery.

Making the Decision to Have Radiation Therapy for Uterine Sarcoma

Your doctor may suggest radiation treatment if any of these statements is true for you.

  • You are not able to have surgery.
  • You recently had surgery. Having radiation after surgery is called adjuvant therapy. This can help lower the chances of the cancer coming back. It’s the most common reason to have radiation for endometrial cancer.
  • You are getting chemotherapy or hormone therapy, and the doctor thinks radiation may ease your symptoms.

There are 2 main ways of getting radiation.

  • External radiation comes from a machine. The radiation is pointed to the skin over the tumor. This is the most common type used for treating endometrial cancer.
  • Internal radiation involves placing radioactive material inside you, near the location of the tumor. This is also called brachytherapy. It can help lower the risk of the cancer returning without adding the risks associated with radiating your whole pelvis.

You will talk with a doctor who specializes in both cancer and radiation. This kind of doctor is called a radiation oncologist. This doctor decides what your treatment will be and how long it will last. During your visit, ask what you can expect to feel during and after the treatment.

What Happens During External Radiation Therapy for Uterine Sarcoma

Whether you have endometrial cancer or uterine sarcoma, what happens during external radiation is basically the same. Where you get the radiation and its dose depend on the type of tumor. You can get external radiation as an outpatient at a hospital or a clinic. This type of radiation may come from a machine called a linear accelerator.

A special doctor called a radiation oncologist decides where you need radiation and how much you need. Then a specialist called a radiation therapist gives you the radiation.

Preparing for Radiation Treatment

Before your first radiation treatment, you’ll have an appointment to plan exactly where on your body the radiation beam needs to be directed. This process is called simulation. The appointment may take up to 2 hours. Here’s what you can expect to happen during it.

  • You’ll lie still on a table while the radiation therapist uses a machine to mark your treatment field. This field may also be called your port. The field is the exact area on your body where the radiation will be aimed. You may have more than one treatment field if you have cancer in more than one place. The therapist will mark your skin with tiny dots of colored permanent ink or tattoos so that the radiation will be aimed at the same place each time.
  • You may have imaging scans, such as CT scans. These help your radiation therapy team find out exactly where your tumor is so that they can aim the radiation.
  • You may have body molds made. A body mold helps keep you from moving during the treatment.

What Happens During Radiation

On the days you get radiation, you’ll lie on a table while the machine is placed over you. You may have to wear a hospital gown. The experience is a lot like getting an X-ray, only it lasts longer. The whole process lasts about 15 to 30 minutes, with about 1 to 5 minutes spent actually getting the radiation. A radiation therapist may use special shields to cover parts of your body that don’t need to get the radiation. Or the machine itself may have built-in shields to protect you. The therapist will line up the machine exactly with the areas that were marked during the simulation. The therapist will leave the room to turn on the machine. You will be able to talk to the therapist over an intercom. You can’t feel radiation. It is painless. You may hear whirring or clicking noises.

You may get radiation treatments every day for 5 days in a row for about 4 to 6 weeks.

You will not be radioactive afterward, so don’t worry about that.

What to Expect After External Radiation Therapy for Uterine Sarcoma

Radiation damages normal cells as well as cancer cells, so you may have some side effects. Usually, the risk for side effects is far less than the benefit of killing cancer cells. Many people have no side effects at all. If you do have them, they are generally limited to the area that has been treated.

Here are some side effects that are common with radiation treatment, especially to the abdomen and pelvic area.

  • Abdominal cramping, occasionally with nausea
  • Diarrhea
  • Loss of appetite
  • Increased number of bowel movements or urination
  • Fatigue
  • Skin irritation or changes
  • Narrower, less flexible vagina
  • Difficulty or discomfort with sexual intercourse

These side effects can be unpleasant, but they aren’t dangerous. Talk with your doctor or nurse about how to control them with medication and the foods you eat. Many of them usually go away a few weeks after you stop getting treatment. Others may be ongoing.

Ask your doctor if there are any side effects that indicate you should call him or her immediately. For example, you might need to call your doctor if you have one or more of the following signs of infection.

  • Sweating
  • Fever
  • Pain

You may feel better during your treatment if you make an extra effort to take good care of yourself. Get plenty of rest and eat well-balanced meals. A healthful diet includes plenty of lean proteins as well as fruits and vegetables. This helps your body heal more quickly.

What Happens During Internal Radiation Therapy for Uterine Sarcoma

If you have endometrial cancer or uterine sarcoma, your doctor may decide to treat you with internal radiation therapy. It is usually done a month or so after a hysterectomy in a hospital or surgical center. This kind of treatment is also called brachytherapy. This treatment can be done in different ways, depending on where the cancer is.

The radiation therapist inserts the radiation directly to the upper part of your vagina, which is where the tumor is most likely to return. If the cancer is near your vagina, you’ll have the radioactive implant inserted through your vagina. You may have this done as an outpatient or as an inpatient.

As an outpatient, you may get the radiation in a high dose for 3 treatments lasting about 10 minutes each. You will be awake while the radiation therapist places the implant. You are radioactive only while the implant is in place.

As an inpatient, you may get a low dose of radiation for 3 days. You will be given anesthesia to make you sleep while the radiation therapist places the implant. You are radioactive only while the implant is in place.

Doctors are developing new types of radiation. These treatments are tested in clinical trials. Ask your doctor if there is a radiation therapy clinical trial you should check on.

What to Expect After Internal Radiation Therapy for Uterine Sarcoma

There are fewer side effects from internal radiation than from external. Here are some side effects that may occur early in the treatment.

  • Irritation of the vagina
  • Drainage from the vagina
  • Diarrhea
  • Abdominal cramping

Other side effects may occur after the treatment. Here is a list of the side effects that may occur after internal radiation therapy.

  • Shortening of the vagina due to scarring
  • Vaginal dryness
  • Painful intercourse

Your doctor or nurse will show you how to use a dilator after your treatment. Using a dilator or being sexually active for 10 minutes 2 to 3 times a week helps keep your vagina from getting smaller or closing.