Uterine cancer, also known as endometrial cancer, originates in the lining of the uterus, called the endometrium. When diagnosed at Stage 1, the cancer is localized, meaning it is confined to the uterus. Radiation therapy is a common and effective treatment option for Stage 1 uterine cancer, aiming to eliminate cancer cells and reduce the risk of recurrence.
Why Radiation for Stage 1 Uterine Cancer?
Radiation therapy for Stage 1 uterine cancer is often used as an adjuvant treatment. This means it is given after initial surgery, such as a hysterectomy, to destroy any microscopic cancer cells that might remain in the pelvic area. The goal is to reduce the risk of cancer recurrence in the pelvis, which can be around two-thirds lower with radiation compared to surgery alone.
In some cases, radiation might be the primary treatment if a person cannot undergo surgery due to other health conditions or if the cancer has specific high-risk features. Radiation therapy delivers high-energy rays directly to the affected area. This focused approach aims to destroy cancer cells while minimizing damage to surrounding healthy tissues.
Types of Radiation Therapy
Two main types of radiation therapy are used for uterine cancer: external beam radiation therapy (EBRT) and brachytherapy. One or both types may be used, depending on the specific case and diagnostic information, including the cancer’s grade and depth of uterine invasion.
External Beam Radiation Therapy (EBRT)
EBRT involves a machine outside the body that directs high-energy X-rays to the pelvic region. Patients receive daily treatments, five days a week, for several weeks, often around 25 treatments over five weeks. EBRT aims to treat a larger area, reducing the chance of recurrence in the pelvis.
Brachytherapy
Brachytherapy, also known as internal radiation, involves placing a radioactive source directly inside the body, typically in the vagina, near where the cancer was located. This method delivers a high dose of radiation to a localized area, limiting exposure to nearby organs like the bladder and rectum. High-Dose Rate (HDR) brachytherapy delivers radiation in short, intense bursts over a few minutes, often in 3 weekly treatments, while Low-Dose Rate (LDR) brachytherapy involves a continuous, lower dose over a longer period.
The Radiation Treatment Journey
The radiation treatment journey begins with a consultation with a radiation oncologist. This is followed by a planning phase, often called simulation. During simulation, a CT scan creates detailed images of the treatment area, allowing the medical team to map out radiation fields and determine doses to target the cancer effectively.
Treatment sessions are generally short, lasting only a few minutes. During each session, the patient lies still on a treatment table while the radiation machine moves around them. The procedure is painless, and patients are typically alone in the treatment room, though monitored by the care team from an adjacent room.
Attending all scheduled appointments is important to ensure the full prescribed dose of radiation is delivered. This consistency helps maximize the treatment’s effectiveness in eradicating cancer cells and minimizing the risk of recurrence.
Managing Treatment Effects
Patients undergoing radiation therapy for uterine cancer may experience various treatment effects, both short-term and long-term. Short-term effects typically emerge during or shortly after treatment and include fatigue, which can range from mild to severe. Skin irritation in the treated pelvic area, resembling a sunburn, may also occur.
Bowel changes, such as diarrhea and abdominal cramping, are common as radiation can affect the intestines. Bladder changes, including frequent urination or discomfort, can also arise due to the bladder’s proximity to the treatment area. Vaginal soreness or discharge may also be noticed. These immediate effects usually subside within weeks or a few months after treatment concludes.
Less common but possible long-term effects include vaginal stenosis (a narrowing or shortening of the vagina), chronic bowel changes, and lymphedema (swelling caused by fluid buildup). Managing these effects involves:
- Adequate rest
- Staying hydrated
- Making dietary adjustments to ease bowel and bladder symptoms
- Practicing gentle skin care
- Open communication with the care team to address discomfort and receive support and medication.
Recovery and Outlook
After completing radiation therapy for Stage 1 uterine cancer, the body begins a recovery process where side effects gradually lessen over several weeks or months. The lingering fatigue and localized discomfort tend to improve steadily as healthy cells repair themselves. The medical team provides guidance on managing any persistent symptoms during this period.
Regular follow-up appointments with the oncology team are a routine part of post-treatment care. These appointments typically include physical examinations, imaging scans like CT or MRI, and blood tests to monitor overall health and check for any signs of recurrence. The frequency of these visits decreases over time as the recovery progresses.
The prognosis for Stage 1 uterine cancer, when treated effectively with surgery and radiation, is generally positive, with a high chance of successful outcomes. Most patients experience a good recovery and can return to their usual activities. Maintaining a healthy lifestyle, including a balanced diet and regular physical activity, can further support long-term health and well-being.