Radiation or not after surgery for endometrial cancer?

@marceyw First, welcome to our Support Group. You’ll get kindness and support here from those of us who have had gynecological cancer.

I was diagnosed with endometrial cancer (endometrioid adenocarcinoma, Stage 1a, FIGO 1) in 2019. I had recurrence in late 2021 and had pelvic external beam radiation and two sessions of brachytherapy. I can tell you that the brachytherapy was easier than I thought it would be and I was able to get up and walk out of the clinic with no after effects. My nurse practitioner who I see for my cancer surveillance appointments does a pelvic exam at each appointment. She tells me that there is some scarring at the site of the brachytherapy.

Since you are on the fence about where to go from here would you like to get another opinion? You could ask your primary care provider to refer you to another gyn-oncology practice. Or, if you are interested in getting another opinion at Mayo Clinic you could request an appointment at one of the 3 locations of Mayo Clinic using this link:

Request an appointment at Mayo Clinic:
http://mayocl.in/1mtmR63

Radiation worked very well for a family member but it helps to have it done where they really know how to administer it effectively. Side effects were very manageable for the most part.

Hello @marceyw

Maybe we can help each other.

My grandmother (age 88) stage 2 endometrial carcinosarcoma with spread to cervix just completed 3 brachytherapy treatments and 5 weeks of radiation. Other than gas and diarrhea, she did not have any other side effects. One of the brachytherapy treatments was uncomfortable for her (the removal of the applicator) as she was awake and refused pain medication. Following that, she did request medication and they ended up just sedating her briefly to remove.

She is scheduled for a hysterectomy on Tuesday and would really like your input on the recovery. Her surgeon did NoT want to operate first- hence why she did RT before surgery.

I had 5 sessions of brachytherapy (for stage 1b figo 1 endometriod
adenocarcinoma), and had no problems at all either during the course of treatments, nor any side effects afterward. (They do recommend dilator use several times a week for 10 min forever afterward to prevent vaginal scar tissue which can occur). I too had been worried about any possible side effects, but knew that I would never forgive myself if the cancer came back and I had not done everything possible to reduce the odds…

I also had 3 treatments with brachytherapy and think that it is worth doing. It is somewhat uncomfortable and very undignified for 10-15 min each time. I had no immediate side effects. After a month or so you need to either start using a vaginal dilator or engage in sexual activity to avoid long term issues.

If there are stray cancer cells in your body, diet and lifestyle probably won't do much to prevent recurrence.

If your cancer was Grade 1 or 2, a recurrence would probably still be curable, but that's still really worth avoiding if possible.

Thank you so much - this will help me to ask the right questions at my first appt with the radiologist. I went to my GP this week to get their input as well.

After your recurrence, are you doing well? My doctor said I had a gene that would qualify me for immunotherapy if I have a recurrence. I’m trying to research the best diet changes to help avoid a recurrence and praying for wisdom.

I should know more after my appt with the radiologist on the 20th. She comes highly recommended. I’m trying to write down all of my questions. Thank you for responding.

I had the complete hysterectomy and several nodes removed on 1/9. I am feeling remarkably well. Since it was done robotically through 5 small incisions and removed vaginally, I didn’t take pain medication for more than 4 days. Then I moved to Tylenol for another 3-4 days. I haven’t had to have anything else. There is still a lot of fatigue and my other organs trying to sort themselves out to their new spots when I cough or laugh. I still have to restrict heavy lifting for a couple of weeks. However, I’ve been able to return to running our business and cooking meals. I can drive again. I’d say fatigue and moving or stretching wrong causes the most discomfort. Prayers that your Grandmother does well.

I haven’t heard of the dilator but that is a good thing to ask about at my first appt to discuss this on the 20th. It is such a relief to hear that you did not have any major side effects. I’m praying for wisdom and I’m like you - wanting to do all I can. My Mom died in her 50s of pancreatic cancer and I’m scheduled for genetic testing.

I’m researching diet changes to help prevent recurrence.

Thank you for this information.

I absolutely would like to avoid any recurrence so am leaning toward the brachytherapy. Thank you!