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Radiotherapy uses x-rays to kill cancer cells or injure them so they cannot multiply. The radiation can be targeted at cancer sites in your body. Treatment is carefully planned to do as little harm as possible to your healthy body tissues.

Radiotherapy may be recommended if you are not well enough for a major operation. It is also commonly used as an additional therapy, which is called adjuvant therapy.

There are two ways radiotherapy is administered:

  • From outside the body (external). A machine directs radiation at the cancer and surrounding tissue.
  • From inside the body (internal). Radioactive material is put in thin tubes and inserted into your body on or near the cancer.

Since internal and external radiotherapy have slightly different purposes, it is possible to have both types of treatment. Your gynaecologic oncologist and radiation oncologist will advise the best form of treatment, based on your situation.

Internal radiotherapy (brachytherapy)

Internal radiotherapy, also called brachytherapy, is a type of radiotherapy where the radiation source is placed close to the cancer. If you need to have radiotherapy for cancer of the uterus, you will probably have brachytherapy. You may also have brachytherapy after a hysterectomy.

A radioactive implant will be inserted through the vagina or the tissues around the vagina using special applicators.

Internal radiotherapy can be done in two ways: either continuously for up to 30 hours as a low-dose rate treatment or, more commonly, as high-dose rate treatment given in several short sessions. Your choice of treatment may depend on your location. For example, high-dose rate brachytherapy may require several treatment appointments, which can be difficult for a woman living in a rural area.

  • Low-dose rate treatment: If you are having low-dose rate treatment, you will go to hospital to have an implant put in. You will usually not be anaesthetised if your doctor is able to slide the implant, which is shaped like a cylinder, into your vagina. However, some women may require a general anaesthetic when the implant is inserted.
    Because the implant is radioactive, you will need to stay in a room on your own while the implant is in place. You may not be allowed to have visitors during this time.
    Your radiation oncologist and the nursing staff will explain the precautions associated with low-dose rate brachytherapy, which vary from hospital to hospital depending on the equipment used. These safety measures may make you feel isolated and frightened at a time when you would like people around you. Talking on the phone, reading or sharing your feelings with nurses may help pass the time.
  • High-dose rate treatment: You may not need to stay in hospital for high-dose rate brachytherapy, but you will have four to eight outpatient treatment sessions. Each brachytherapy session may last only five to 10 minutes.

External radiotherapy

In external radiotherapy, x-rays from a large machine are directed at the part of the body needing treatment. For uterine sarcoma, the lower abdominal area and pelvis are treated, but if the cancer has spread (metastasised), this can be extended to include other areas.

You will probably have radiotherapy treatment from Monday to Friday for four to six weeks. You can usually receive this treatment as an outpatient (at a radiotherapy centre) and you will not need to stay in hospital.

The actual treatment only takes a few minutes each time, but it can take several hours to undergo a simulator session (work out where the treatment needs to be given), set up the machine, see the doctor and have any other necessary tests, such as blood tests.

External radiotherapy does not make you radioactive. It is safe to be with other people in the period when you are having treatment and afterwards. You will not hear or see the rays.