@dianavl I don't have a medical degree and so I don't know how the amount of radiation is calculated and how it's targeted. Like you, I had external beam radiation therapy (EBRT) and I didn't experience any effects that you did. I've heard from others here about burns from radiation.

Here is what I experienced as a patient who had a recurrence of endometrial cancer. I had EBRT for 25 sessions. When I went in for the simulation my radiation oncologist was present as was the medical physicist. My radiation oncologist told me that the work of the medical physicist is to work out those very delicate calculations needed for radiation therapy.

After the 25 sessions of EBRT I had 2 sessions of vaginal brachytherapy (VB). My radiation oncologist worked with me to determine the size of the device that was most comfortable for me and so I didn't experience pain during the VB. Again, I don't know how the radiation was calculated, only that the radiation oncologist was present during the entire procedure both times.

Before the VB, the radiation oncology nurse spent about 30 minutes with me discussing what I needed to do to lessen vaginal atrophy. She gave me dilators and lubricant and showed me how to use them.

I'm very mystified why your cancer care team did not talk with you about the use of dilators after radiation. The radiation oncology nurse told me that sometimes the scarring of the vagina after pelvic radiation and especially after VB will make it difficult for vaginal exams after radiation. I do have some scarring at the vaginal cuff from the VB and shortening of the vagina from the hysterectomy because my cervix was removed. My nurse practitioner who does my follow-up exams said that she is able to use the speculum she used prior to radiation therapy.

Anyway that's a long story of my experience.