Internal radiation therapy, also known as vaginal brachytherapy, is a common treatment for endometrial cancer (EC). It is most often used following surgery to reduce the risk of tumor recurrence.
What is internal radiation therapy?
Internal radiation therapy uses a radioactive “seed” to kill any leftover cancer cells. Unlike external radiation, which travels through the skin, internal radiation places radiation inside the body. This allows for more precision and limits damage to nearby organs, such as the bladder. It can be used:
- Before surgery to shrink the tumor.
- After surgery to kill any remaining cancer cells and prevent the tumor from recurring.
- In some cases, surgery isn’t possible due to health concerns and internal radiation therapy is the primary treatment.
- It may also be used in combination with chemotherapy.
How does internal radiation therapy work?
In internal radiation therapy a tube about the size of a tampon (called an applicator) is inserted in the vagina and placed close to the tumor. Radiation travels through the cylinder to target the tumor or where the tumor was located before surgery, namely the “vaginal cuff” where the uterus connected to the vagina prior to its removal. Local anesthetic is often used to reduce discomfort.
Internal radiation therapy is performed on an out-patient basis. Treatment lasts only 10-20 minutes at a time and may be given weekly or every few days. The number of treatments you receive will depend on the size of your tumor and how you respond, but patients generally need between three and five visits. In cases of large or recurrent tumors, vaginal brachytherapy may be combined with external beam radiation therapy.
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What are the side effects of internal radiation therapy?
As with external radiation, you may experience side effects from internal radiation therapy, though this is not always the case. Side effects may vary from person to person in terms of severity and duration, and often resolve when treatment finishes. If radiation is combined with chemotherapy, side effects may be worse.
The main short-term side effects include:
- Nausea.
- Fatigue.
- Feeling weak.
- Irritation, dryness or redness of the vagina.
- Urinary tract infections.
- Bowel irritation.
There are some potential long-term side effects that may occur months or years following internal radiation therapy. These may include weakening of the hip and pelvic bones, bowel and bladder problems or vaginal scarring. If your ovaries weren’t removed during surgery, you may also develop menopause as a result of internal radiation therapy. Ask your healthcare team for more information.
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