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Brachytherapy versus radiotherapy and bowel and bladder issues

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I had a hysterectomy 2 weeks ago for endometrial cancer. Stage 1 b grade 2. I have been offered a choice between radiotherapy and brachytherapy. The oncologist told me this is a new treatment for endometrial cancer which was driven by covid concerns over corona virus over whelming hospitals, so brachytherapy is only four days and it’s less risk to patient. She explained, brachytherapy targets top of vagina which is usually where cancer is if it were to reoccur whereas radiotherapy targets whole of pelvis. She said they feel confident in brachytherapy as a treatment, it works in other parts but they have no data for womb. 

I have researched and online recourses seem to suggest this is a normal option. I feel conflicted by what oncologist said and what I read. Has it been used for some time in pelvis for endometrial? She definitely said that was a decision at the outset of covid. My son was at the meeting and he agrees. It just seems odd to me.

i know there can be bowel and bladder problems and I understand you can’t feel me how mine will be but I wonder ( excluding needing an op in bowel or bladder) how serious, life debilitating  these can be?

thank you so much 

Alison P - Macmillan

Hi Endo2,

Thank you for getting in touch with us, and welcome to our online community.

I hope you are recovering well from your surgery. You’ve been through such a lot already, and now having to make decisions about your next treatment. It can be quite overwhelming.

Radiotherapy for endometrial cancer can be given in different ways. External-beam is usually the more common method, but Internal (brachytherapy) radiotherapy can also be given. It is a conventional treatment for endometrial cancer after surgery. It might be that it is not normal protocol for the hospital you are at as not every centre is able to do brachytherapy.

With brachytherapy, it can target a more specific area, rather than the whole pelvis. This means that the side effects to the bladder and bowel tend to be less and don’t last as long. However, it usually means that your vagina could become painful during and after your treatment. You can take painkillers for this or have some topical ointments to help with the discomfort. Side effects from these treatments are usually manageable and begin to fade around 4-6 weeks post treatment.

You might find it helpful to talk to someone who has been through brachytherapy. Our online community has a womb cancer group where women can share their experiences of treatment, and often find friendship and support.

Making treatment decisions can be difficult, especially as the treatment plan has changed. Sometimes it helps to write down the benefits of each treatment and how potential side-effects would make you feel. It’s also worth asking your consultant more questions about the treatment if you feel that you need more answers.

I hope this information has been useful, but please don’t hesitate to get back in touch if we can be of further help.

Best wishes


Alison P

Cancer Information Nurse