Radiation treatment treats cancer by using radiation (energy) to destroy cancer cells. The radiation is targeted to cancer sites in your body. Treatment is also carefully planned to do as little harm as possible to your normal body tissues.
Radiation treatment may be advised:
as your main treatment option
to have after surgery
with, before or after chemotherapy
if you are not well enough for a major operation or if the cancer returns after surgery
as an additional therapy (this is called adjuvant treatment).
Radiation treatment can be delivered:
using a source placed internally (inside you) or
as an invisible beam of energy directly from a machine (outside you).
Since they can work in different ways, it is possible that you could have both forms of radiation treatment. Your radiation oncologist will advise which radiation treatment is best for you.
Brachytherapy (radiation treatment from inside)
Brachytherapy is a type of radiation treatment where a hollow instrument is inserted into the vagina and placed close to the cancer or where the cancer was.
A tiny radioactive source (smaller than a grain of rice) on the end of a long wire is inserted into the instrument, so the source of radiation is very close to what needs to be treated. This tiny radioactive source is programmed to stay at each site for periods of time before being moved to the next site in order to give the correct dose. In New Zealand this treatment is likely to be high dose brachytherapy which means the dose is delivered over a short time (5 to 15 minutes) for each treatment.
Many women will have brachytherapy (radiation treatment from the inside), after surgery (adjuvant treatment). This means there is no known cancer left after the surgery but it is given to reduce the risk of the cancer coming back in the top of the vagina after surgery.
Your cancer doctors will advise the best form of treatment, based on your cancer and medical history.
This treatment is given only to women who have a higher risk of the cancer coming back. This treatment may be given with external beam irradiation. You will have internal radiation treatment as two to five short treatments. Most people can have their treatment as an outpatient but you may need to stay in hospital overnight.
Each treatment time can be as little as 5 to 10 minutes. Your doctors will tell you how many treatments you need.
External radiation treatment (or radiation from a machine that is outside the body, usually called a Linear Accelerator or LINAC)
Radiation treatment uses high energy radiation to destroy cancer cells or prevent them from reproducing. Radiation treatment only affects the part of the body at which the beam(s) are aimed. For cancer of the uterus, the lower abdomen area and pelvis are treated but if the cancer has spread this can be extended to include other areas.
The radiation therapist will explain your treatment to you.
You usually have external radiation treatment as an outpatient, five days a week for five to six weeks. The actual treatment takes a few minutes. You will be in the room for, approximately, 15 minutes as you are positioned and other checks are done.
Radiation treatment does not cause pain or discomfort as it is being given. Radiation treatment involves careful measurement and planning so the treatment is delivered to where it is needed, avoiding as much normal tissue as possible. However, you will develop some symptoms and notice some changes from the treatment – called side effects.
Side effects of radiation treatment
Radiation treatment may cause a number of side effects, which are temporary and can be treated. Side effects may include tiredness, loss of appetite, diarrhoea, pain when passing urine and passing urine more than usual. There may also be skin problems, and the skin between your buttocks may look and feel as if it has been sunburnt. Sometimes this effect occurs after radiation treatment has finished. Use creams recommended by your treatment team to relieve this burning feeling.
There may be some hair loss in the area where radiation treatment has been targeted. This means that your pubic hair may become thinner. It may grow back after the treatment is finished; this could take a number of months.
Radiation treatment will make the vagina inflamed at first but later can make the vagina narrower and drier. This can make sex uncomfortable. Using lubricating gel may be helpful.
A vaginal dilator may be recommended to try to reduce the likelihood of vaginal narrowing/shortening, and to make follow-up examinations easier. See the information on dilators in the section ‘Sexuality and cancer’ and for more information talk to your cancer care team.
Sometimes, side effects do not occur for some time after the end of treatment. These late side effects can be long term and for some women they will be permanent. The effects can include inflammation of the bowel and the bladder. Bladder inflammation is called radiation cystitis. Inflammation of the rectum is called radiation proctitis. Speak to your doctor or nurse about how to manage any side effects.
The Cancer Society has a booklet titled Radiation Treatment/Haumanu Iraruke: A guide for people having radiation treatment. You can receive a copy by phoning our cancer information nurses on the Cancer Information Helpline 0800 CANCER (226 237), or by visiting your local Cancer Society. You can also read and download a copy of the booklet from the Cancer Society of New Zealand’s website.