Endometrial/Uterine Cancer

Endometrial/Uterine Cancer

Endometrial cancer starts when cells in the inner lining of the uterus (endometrium) begin to grow out of control.

Signs and symptoms

  • Abnormal vaginal bleeding such as a change in periods or bleeding after menopause.
  • Pain in the pelvis
  • Feeling a mass (tumor)
  • Weight loss

At this time, there are no screening tests or exams to find endometrial cancer early in women who are at a risk and have no symptoms.

Risk Factors

  • Hormone factors
  • Age
  • Obesity
  • Diabetes
  • Family history
  • Breast or ovarian cancer
  • Endometrial hyperplasia
  • Prior pelvic radiation therapy

Brachytherapy for Endometrial/Uterine Cancers

The main treatment options for most women with endometrial cancer include surgery, radiation therapy, hormone therapy and chemotherapy.  In certain situations, a combination of these treatments may be used.

Surgery is the primary treatment for endometrial cancer.

If you have had surgery, radiation treatment may be used afterwards to help reduce the risk of recurrence in the upper vaginal or pelvis.  If brachytherapy is recommended, a treatment device called a vaginal cylinder is utilized to deliver the treatment.  It is similar to a large tampon with a central channel.  The cylinder is placed into the vaginal area then connected to the HDR treatment machine via a tube where the radioactive source is located.  Once the source has been connected, the radioactive source will travel quickly into the central channel of the cylinder to deliver a high dose of radiation to the top of the vagina.  After completed, the vaginal cylinder is disconnected and removed from the patient.  The number of treatments will be determined by your doctor although it is usually 3-5 treatments total.  The patient does not leave the department with any radioactive material in place, therefore does not place others at risk to radiation exposure.

Where surgery is not possible at all, radiation therapy may be used as the ‘main’ treatment for uterine cancer.  In cases where the cancer is advanced, brachytherapy can be used to deliver a high dose of radiation to the tumor to control bleeding.

At UVA, we use the Y-applicator (Rotte applicator).  With this procedure, you will be placed under anesthesia and positioned on a CT bed in lithotomy position.  The Y- applicator is then inserted by the radiation oncologist.  The Y-shape applicator helps cover a larger uterine width.  Once everything is placed, a CT scan is performed to ensure proper placement and coverage of the applicator.  The applicator is then connected to a machine that automatically loads a radiation source into the applicator for a predetermined time.  Once the time is up, the machine removes the source and the applicator is removed from your vaginal area.  Again, your radiation oncology physician will determine the number of treatments you will receive.

What to expect after treatment

  • General feeling of fatigue
  • Slight vaginal discharge or bleeding
  • Cramping
  • Discomfort at the implant site
  • Diarrhea

Although everyone is different, these side effects usually resolve within a few days to weeks following the treatment