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Long-term Side Effects Of Radiation For Uterine Cancer

How To Care For Yourself During Treatment

What Are the Side Effects of Radiation Treatment?

During treatment, there are ways to help your body stay strong:

  • Get plenty of rest, dont push yourself too hard.

  • Eat a healthy diet and drink plenty of fluids.

  • Treat your skin in the treatment area with care. Clean the area with warm water and mild soap, avoid hot or cold packs, and check with your care team before using lotions or ointments.

  • Talk to your doctor about any medications or supplements you are taking to make sure they are safe to use during treatment.

  • Follow your doctors orders and dont be afraid to ask questions.

  • Find a support group or seek out help to cope with the stress of your cancer diagnosis and treatment.

Being a cancer survivor has helped me be a better radiation therapist and a source of tips for patients in managing side effects. Ive learned gratitude from my patients and from my own journey. I dont take anything for granted, I dont procrastinate on going for my goals anymore, and Im thankful every day.

How Uterine Cancer Is Treated

In cancer care, different types of doctors, together called a multidisciplinary team, often work together to create a patients overall treatment plan. Your health care team should include a gynecologic oncologist, which is a doctor who specializes in the cancers of the female reproductive system. In addition to physicians, cancer care teams often include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

The common types of treatments used for uterine cancer are described below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, your overall health, your age, and your personal preferences. This includes whether or how treatment will affect your ability to have children, called fertility. Uterine cancer is treated by 1 or a combination of treatments, including surgery, radiation therapy, and medications. Combinations of these cancer treatments are often recommended, but they depend on the stage and characteristics of the cancer.

What Side Effects May Occur As A Result Of Brachytherapy

Side effects of brachytherapy can include swelling, bruising, bleeding, or pain and discomfort at the spot where the radiation was delivered. Brachytherapy used for gynecologic cancers or prostate cancer can lead to short-term urinary symptoms, including incontinence or pain on urination. Brachytherapy for these cancers can also lead to diarrhea, constipation and some rectal bleeding. Prostate brachytherapy can occasionally cause erectile dysfunction.

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Mouth And Throat Changes

Radiation therapy to the head and neck can cause mouth changes. Radiation not only kills cancer cells but can also harm healthy cells in the glands that make saliva and the moist lining of your mouth. You may have:

  • Loss/change in taste
  • Thickened saliva

Some problems, like mouth sores, may go away after treatment ends. Others, such as taste changes, may last for months or even years. Some problems, such as dry mouth, may get better but never go away.

Mouth Care After Radiation

Your Throat

Radiation therapy to the neck or chest can cause the lining of your throat to become swollen and sore. Your risk for throat changes depends on how much radiation you are getting, whether you are also having chemotherapy, and whether you use tobacco and alcohol while getting radiation therapy. You may notice throat changes in 23 weeks after starting radiation. These will likely get better 46 weeks after you have finished treatment.

Nutrition During Head, Neck or Chest Radiation

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Possible Late Effects Of Radiotherapy

Cancers

Radiotherapy to the pelvic area can sometimes cause problems months or years after treatment. These are called late effects. Some of these may be permanent, but there are lots of ways to manage or treat them.

It is always important to tell your GP or cancer doctor about any new symptoms that develop a long time after treatment. They need to be checked, as they may not be caused by radiotherapy.

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What Is The Success Rate Of Radiation Therapy For Prostate Cancer

Radiation therapy is highly effective for treating prostate cancer. In a 2017 , researchers compared the effectiveness of brachytherapy and external beam radiation in men with high-risk prostate cancer. Five years after treatment, 89% of men given brachytherapy and 84% of men given external beam radiation had no signs of cancer.

Disclosure Of Potential Conflicts Of Interest

M. W. Dewhirst reports receiving commercial research grants from Biomimetix and is a coinventor for the use of BMX-001 for oncology applications . Duke University holds the patent for BMX-001, a redox-active Mn porphyrin, discussed in this paper. No potential conflicts of interest were disclosed by the other authors.

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Volumetric Modulated Arc Radiation Therapy

This type of therapy allows the linear accelerator to move around you in one or several 360-degree rotations during each treatment. This means radiation can be given from almost any angle, allowing doctors to target the tumor while avoiding healthy tissue. Physicians are also able to adjust the angle and intensity of the radiation beams without stopping treatment.

Because this radiation therapy is given without interruption, treatment sessions may be shorter than with other types of external beam radiation therapy. Sessions are given once daily, five days a week, over the course of several weeks.

Mroadvanced Radiation Therapy Thats Close To Home

What to Expect When Receiving Radiation Therapy Treatment

About 3.5% of all new cancer cases in the U.S. are uterine cancer, according to statistics from The National Institute of Health.

At Minneapolis Radiation Oncology, we understand the uncertainty that comes with a uterine cancer diagnosis and the impact it can have on your life, your fertility, and the psychological health of you and your family.

Minneapolis Radiation Oncology is the Twin Cities leading provider of advanced radiation therapy for cancer. Our MRO radiation oncologistsprovide a level of expertise that comes only from working with cancer patients and radiation cancer treatments every day. And weve established a reputation as trusted allies in the fight against cancer. Since 1981, MRO clinics have treated over 100,000 patients more than any other clinics in Minnesota.

We bring advanced radiation therapy close to home, with 11 locations across the Twin Cities, Brainerd Lakes Area, and Western Wisconsin. Count on the cancer specialists at MRO to be here for you, with care, precision, and compassion.

I am a firm believer in the power of technology and radiation therapyto give patients their best options for fighting cancer.Charles Shideman, MDMRO | Regions

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Radiotherapy For Womb Cancer

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Radiotherapy treats cancer by using high-energy x-rays. It destroys cancer cells in the area where the radiotherapy is given.

Radiotherapy for womb cancer can be given in different ways:

  • External-beam radiotherapy radiotherapy is given from outside the body from a radiotherapy machine.
  • Internal radiotherapy radiotherapy is given from inside the body
  • A combination of both.

Sometimes you have radiotherapy with chemotherapy. This is called chemoradiation. Your cancer specialist will discuss your treatments with you.

  • after surgery, to reduce the risk of the cancer coming back
  • instead of surgery, if a general anaesthetic or an operation is not suitable for you
  • to try to cure a cancer that has come back after surgery
  • to treat cancer that was not completely removed with surgery.

Before your radiotherapy, your radiotherapy team will explain what your treatment involves and how it may affect you.

We have more information about what happens before and after radiotherapy, and questions you may want to ask.

Changes To The Pelvic Bones

Radiotherapy can cause thinning of the bones in the pelvis. Often this does not have any symptoms, but is seen on scans. Sometimes it may cause fractures in the pelvis called insufficiency fractures. These can cause pain in the lower back or pelvis. If this happens, your doctor can give you painkillers to help. You may also be referred to a physiotherapist.

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Radiation Technology Is Proven Effective

At MRO, we use radiation, or radiotherapy, to destroy cancer cells with radiation. Using state-of-the-art imaging technologies such as MRI, CT, and PET, your MRO care teamcan pinpoint radiation doses down to the millimeter.

The way the radiation therapy is given depends on the type and stage of the cancer being treated. But each treatment directs precise doses of radiation at cancer cells, which are more susceptible to radiation than healthy cells. Like an x-ray, radiation therapy is painless. For patients who receive external beam radiation therapy, theres no fear of becoming radioactive during or after treatment.

Remission And The Chance Of Recurrence

Caring for Yourself During Radiation Therapy

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning.

If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place . Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. A key goal of follow-up care is to watch for a recurrence and to manage possible late effects and long-term side effects from treatment. Learn more about coping with the fear of recurrence.

Some symptoms of recurrent cancer are similar to those experienced when the disease was first diagnosed:

  • Vaginal bleeding or discharge

  • Pain in the pelvic area, abdomen, or back of the legs

  • Difficulty or pain when urinating

  • Persistent cough/shortness of breath

People with recurrent cancer sometimes experience emotions such as disbelief or fear. You are encouraged to talk with your health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

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What Are The Symptoms Of Uterine Cancer

Signs of uterine cancer can resemble those of many conditions. Thats especially true of other conditions affecting reproductive organs. If you notice unusual pain, leaking or bleeding, talk to your healthcare provider. An accurate diagnosis is important so you can get the proper treatment.

Symptoms of endometrial cancer or uterine sarcoma include:

  • Vaginal bleeding between periods before menopause.
  • Vaginal bleeding or spotting postmenopause, even a slight amount.
  • Lower abdominal pain or cramping in your pelvis, just below your belly.
  • Thin white or clear vaginal discharge if youre postmenopausal.
  • Extremely prolonged, heavy or frequent vaginal bleeding if youre older than 40.

Bowel Or Bladder Changes

After radiotherapy, you may develop changes to the bowel or bladder. It is common to have some mild changes, but much less common to have severe side effects that affect your quality of life. If this happens, symptoms may develop months, or sometimes years, after radiotherapy treatment.

If your bowel is affected, you may have to go to the toilet more often or more urgently than usual, or you may have diarrhoea.

If your bladder is affected, you may need to pass urine more often or more urgently.

The blood vessels in the bowel and bladder can become more fragile. This can cause blood in your urine or stools. If you have bleeding, always tell your cancer doctor or GP so it can be checked.

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Radiotherapy To Control Symptoms

If the cancer has spread, you may have external beam radiotherapy to shrink the cancer or to control the symptoms. For example, you may have this treatment if the cancer has spread in the pelvic area, or to other parts of your body such as the bones. This is called palliative radiotherapy. It is planned carefully so that you have as few side effects as possible.

Types Of Radiation Therapy

Radiation Treatment: Managing Your Side Effects

Two types of radiation treatments might used for uterine sarcoma:

  • External beam radiation therapy
  • Internal radiation therapy or brachytherapy

Sometimes brachytherapy and external beam radiation therapy are used together. How much of the pelvis needs to be exposed to radiation therapy and the type of radiation used depend on the extent of the disease.

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Sore Skin In The Treatment Area

Your skin may be sore on the inside and outside of your genitals and the area around your bottom . It can help to use a moisturiser on the outside everyday.

While you are having radiotherapy, do not:

  • use hair removal cream.

If you want to use these products, wait until radiotherapy has finished and your skin is no longer red or sore.

Be extra careful to protect the skin in the area where youve had radiotherapy for at least the first year afterwards. Dont use sunbeds and use high factor sunscreen if part or all of the area will be exposed for example, if you are wearing a bikini.

This sore skin may also cause pain when you wee. Let your healthcare team know about your symptoms as soon as possible, so they can help.

More Information About Radiation Therapy

To learn more about how radiation is used to treat cancer, see Radiation Therapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

Alektiar KM, Abu-Rustum NR, and Fleming GF. Chapter 75- Cancer of the Uterine Body. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenbergs Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins 2019.

Annede P, Gouy S, Mazeron R, et al. Optimizing Local Control in High-Grade Uterine Sarcoma: Adjuvant Vaginal Vault Brachytherapy as Part of a Multimodal Treatment. Oncologist. 2017 22:182-188.

Boggess JF, Kilgore JE, and Tran AQ. Ch. 85 Uterine Cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloffs Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier 2020.

Lee SW, Lee TS, Hong DG, et al. Practice guidelines for management of uterine corpus cancer in Korea: a Korean Society of Gynecologic Oncology Consensus Statement. J Gynecol Oncol. 2017 28:e12.

Liem X, Saad F, Delouya G. A Practical Approach to the Management of Radiation-Induced Hemorrhagic Cystitis. Drugs. 2015 75:1471-1482. doi:10.1007/s40265-015-0443-5.

McKeown DG, Goldstein S. Radiation Proctitis. . In: StatPearls . Treasure Island : StatPearls Publishing 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559295/

Last Revised: September 20, 2022

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How Does Brachytherapy Compare With Other Forms Of Radiation Treatments

When used appropriately, brachytherapy has been shown to be as effective as conventional external beam radiation therapy and surgery for many cancers. It is best used in patients whose cancer has not spread, or metastasized. In many cases, brachytherapy is combined with external-beam radiation therapy, including stereotactic body radiation therapy, to get the best results.

How Fatal Is Uterine Cancer

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Uterine cancer is fatal when it goes undiagnosed and spreads. The survival rate for cancer that hasnt spread outside the uterus is 95%. The survival rate decreases to 17% when cancer spreads to other parts of your body outside your uterus. Early detection and early treatment are key to a favorable prognosis.

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What Causes Uterine Cancer

Researchers arent sure of the exact cause of uterine cancer. Something happens to create changes in cells in your uterus. The mutated cells grow and multiply out of control, which can form a mass called a tumor.

Certain risk factors can increase the chances youll develop uterine cancer. If youre at high risk, talk to your healthcare provider about steps you can take to protect your health.

How To Lower Your Risk

You can do a number of things in addition to the precautions your healthcare provider takes to reduce your risk of long term complications related to radiation therapy.

  • Don’t smoke, as smoking increases the risk of lung cancer after chest radiation.
  • Talk to your practitioner about any new respiratory symptoms that may suggest radiation pneumonitis.
  • Ask about clinical trials designed to reduce the risk of late effects of radiation.
  • If you will be having chest radiation, ask if respiratory gating is available.
  • Ask your healthcare provider about physical therapy if your movements are restricted. Physical therapy can’t rid your body of permanent scarring but can often improve flexibility and mobility.

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Stereotactic Body Radiation Therapy

Stereotactic body radiation therapy delivers a few high doses of carefully targeted radiation beams. This occurs several days a week for a few weeks.

Your doctor may use this approach to treat small endometrial tumors if you are older or too ill to have surgery. Our doctors may also recommend stereotactic body radiation therapy if other types of external beam therapy do not eliminate the cancer.

As with other forms of radiation therapy at NYU Langone, this approach uses computer and image guidance to precisely target the tumor while avoiding healthy tissue.

Who To Tell About Side Effects

IMRT vs SBRT vs Protons vs Brachytherapy | Ask a Prostate Expert, Mark Scholz, MD

It is important to tell your healthcare team know about your symptoms and how you are feeling. This could be your team at the hospital or your GP. They will be able to assess you and possible refer you for specialist support.

If you are struggling with side effects between appointments, it is important to call the hospital or 111 and let them know.

– Jasmine, who with us

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Questions To Ask The Health Care Team

Learn as much as you can about the potential long-term effects of your cancer treatment from your health care team. You may want to schedule a special appointment to review your treatment summary. This document should include information about your cancer, treatment, and follow-up care. The American Society of Clinical Oncology offers cancer treatment summary forms to store this information.

Consider asking your health care team these questions:

  • Can you write down which treatment I received?

  • Am I at risk for specific late effects?

  • Is there anything I can do to help prevent long-term side effects?

  • What other specialists should I see to watch for potential late effects?

  • What signs or symptoms of late effects should I watch for?

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