Radiotherapy treatment planning for pelvic radiotherapy

Hi Dramalady

Welcome to the Online Community here at Macmillan. I hope you find it a helpful place to access support and ask questions. My name is Vanessa and I am one of the information nurses.

I see from your profile that you have joined our womb cancer forum.  I hope that support from others in a similar situation is reassuring to have.

Radiotherapy is often used to treat womb cancer.

There are two types of radiotherapy used: internal and external radiotherapy. I’m not sure which type of radiotherapy you are having so will include information about planning for both.

Planning for external radiotherapy is done before you start treatment and normally takes up to around 30 minutes. This appointment allows the radiotherapy team to work out exactly where they need to target the radiotherapy and the dose required. You will normally have a CT scan as part of planning and may require an injection of contrast into a vein to help show up body tissues more clearly. The radiotherapy team may make small marks on your skin, these are used to ensure you are in the correct position for each radiotherapy treatment. There is normally a gap of days or weeks between the planning appointment and starting treatment.

Internal radiotherapy is different and requires the insertion of applicators into the vagina and cervix. Once these applicators are in place, their position is checked, a treatment plan is formulated, and the applicators are connected to the radiotherapy machine. Treatment is then given for several hours before the applicators are removed, and you are able to return home.

At your planning appointment you should also be told what to expect during treatment, potential side effects and who to contact should you develop any problems during treatment.

I hope you find this information helpful. You can also always call one of our nurses directly if you want to talk over your concerns or require any further support.

Take care

Vanessa G, Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref VG/ KA

Hello...thank you so much for this but it looks like I’ll have to miss the internal radiotherapy.  I have a consultation at Christie’s on Friday and one of the questions I was going to ask is could I have the treatment under general anaesthetic because I’ve only ever had one internal examination when I was 20 years old (shamefully 41 years ago). I passed out and was dizzy and sick for 2 days.  When I spoke to my consultants secretary this morning to ask what the consultation entails she said it would include an examination to see what size applicator they would need to use.  I explained why I couldn’t have that done and she was lovely because apparently her mum is the same as me.  She doesn’t think I’ll be able to have the treatment under general anaesthetic but she will ask my consultant then ring me back.  I’m not sure what the implications will be if I miss that part of the treatment.  I have been told they managed to get all my cancer during my hysterectomy and the treatment is to just mop up.  23 sessions of external radiotherapy which starts on the 26th august followed by what was going to be 3 sessions of internal radiotherapy then 4 rounds of chemotherapy... I have my fingers crossed that I receive some positive news ... I can but hope... having hope is good xx

Hi Dramalady

My name is Gail and I’m a Cancer Information Nurse Specialist here at Macmillan Cancer Support. I’m glad you got back in touch. It sounds as though the uncertainty surrounding your treatment plan is causing you more concern. It can be challenging when trying to prepare yourself for treatment and so it’s important you feel supported during this time.

Joining the forum and sharing your experience with others can sometimes help.

I’m glad to hear your consultant’s secretary was understanding. You did the right thing in sharing your concerns. We’re all different and so although there are guidelines to ensure everyone has equal access to effective treatments, it’s not uncommon for these to be adapted for each person’s specific needs.

Your consultant will likely discuss if there is anything that can be done, to help you feel more at ease about the internal radiotherapy, such as a general anaesthetic or a spinal anaesthetic.

During this discussion, it’s important to be open and honest with your consultant and to let them know if they’ve helped ease your concerns. Remember, this is only part of your treatment plan. They are there to help you understand the reasons this treatment plan is being recommended for you. The evidence indicates there are benefits to internal radiotherapy but they are also there to discuss what other treatments may be available, to help you make the decision that is right for you. The important thing is having the right information for you to make an informed choice.

I hope you find this information helpful. You can also always call one of our nurses directly if you want to talk over your concerns or require any further support.

Thank you so much for your quick reply.  My consultants secretary phoned me back to say she had spoken to my consultant and unfortunately I can’t be given general anaesthetic for the internal radiotrapy... I have been asked to attend my appointment on Friday so that the consultant can explain the treatment to me and in return I can ask questions.  I see little point because it is a 5 hour round trip for me but I will attend and see if there is anything they can do seeing as there is no chance I can put myself through that treatment  This is exactly why I am such a drama Queen xx