Did anyone have sedation for vaginal brachytherapy?

@cmc1 Blood on toilet paper is certainly frightening. Thank goodness you have continued with your cancer follow-up appointments and were seen to evaluate this new symptom.

Are you back at Mayo Rochester? I had radiation therapy, both external and internal (brachytherapy) at Mayo Rochester after a recurrence in 2021. Sedation was never mentioned for brachytherapy. My radiation therapy at Mayo Rochester was almost 5 years ago so perhaps the protocol has changed? Since one cannot have radiation therapy at the same location I am thinking your brachytherapy will target a different spot than what you had in 2023.

When is the brachytherapy scheduled? I would ask the radiation oncologist who will perform this why sedation is recommended. You are the patient and can certainly say you do not want sedation. Just as an example when I have a colonoscopy I have sedation. My husband prefers to be awake and opts out of sedation. The doctors tell him that it is his choice.

Hi cmc1...I had stage 1a uterine serous carcinoma in April 2021. After a complete hysterectomy i had three 4 minute brachytherapy sessions. I was told that if my cancer returned it would be in the vagina....the brachytherapy sessions were completely painless with no side effects and no sedation....Unfortunately my cancer did return in October of 2022 in my omentum....after 6 sessions of chemo with herceptin ( her2+ ) cancer , my scans were NED...currently on enhertu for maintenance...I would definitely ask why sedation is needed for brachytherapy !!

@naturegirl5 According to the radiology oncology nurse, when I have the brachy therapy, a shield of some sort, will be placed on the top and upper part of the vaginal cylinder, to eliminate radiation to the area of my vagina that previously received brachy radiation. The new lesion is very low in my vagina, just beneath where the 2023 radiation stopped. It was originally suggested that I would be having "targeted radiation", but for some reason that changed and I was not given an explanation. The information that I have been given has been inconsistent and that concerns me. I will have the brachy at Rochester. I am having the external at another Mayo hospital. Near the end of the external, I will have brachy one day and external the next x three brachy treatments. I was originally told I would have the brachy at the completion of the external and that changed with no explanation.

@cmc1 The shield makes sense so I'm relieved that the radiation oncology nurse explained that to you. What questions might you ask if you have the opportunity prior to the brachytherapy sessions? And what questions do you have about sedation vs. no sedation? I wonder why the schedule of external and brachy has changed?

Is there a nurse navigator at this radiation oncology practice whom you could call? Maybe they could get your questions answered for you. Write down exactly what you want to ask - as
well as the answers - and try not to just accept what’s said without getting clarifications you need and answers that make sense. (I’m still working on this myself!)

i was offered sedation for my treatment due a history of sexual assault and a man was going to be present for the treatments. after much discuss and my refusal to take sedation they were able to bring in a female so the man never had to be present.

if you don't want the sedation let them know and they'll figure something out

In May 2017 I was diagnosed with Serous papillary carcinoma endometrial it was first staged at 1a then I went to Moffett in Tampa and they said stage 2 since it was creeping in the cervix. I discovered it when I was staining a weird salmon color and my gyno was spot on in diagnosing it with an ultrasound and d and c. I had 6 chemo treatments-taxol and carboplatin and I had 3 or 4 brachy treatments. Was awake - no big deal. I also had a radical hysterectomy and had my omentum removed as well. Now I am suffering from lymphedema in my legs and feet. But other than that no recurrence. I had the brachy on the vaginal cuff. Cmc1 did you have chemo originally? Hope all goes well with you.

@bocabird Have never had chemo. My cancer was very early stage Figo grade 1. In 2023, I had surgery and had everything removed and then had high dose, outpatient, vaginal brachytherapy (Cylinder in vagina), 3 sessions as there was a suspicion of LVSI "low", so the surgeon wanted me to have the brachytherapy to be on the safe side. The radiation oncologist said it would be "curative". No such luck. Cancer came back, in the vagina 2.5 years later, just below where the radiation to my vagina stopped (that's what I was told). When I have this second round of vaginal radiation, the top and sides of the cylinder will be covered with a shield to protect the area of my vagina that already received brachy radiation in 2023. The new lesion is near the opening of the vagina. I was originally told I would be having targeted radiation, to the lesion, but then no further mention of it. I will get a chance this week to see a dr and I will insist that he tell me why the radiation oncologist wants to "put me to sleep" for the brachytherapy. I was wide awake for it the first time and although it wasn't pleasant, I tolerated it. I don't know what to expect for side effects after I'm finished with all of this.

@cmc1 What type of endometrial cancer is it? Mine was very aggressive and recurrent. Did you have genetic testing? My cousin had brca and had ovarian cancer. Mine was very similar to ovarian cancer. Genetic testing showed chek2 low grade so don't think this was cause of it. However, in the 60's I used "Shower to Shower" talc all the time in that area and they are saying ovarian and endometrial cancers could have occurred using that. Who knows? There may be a valid reason why they want to sedate you- can't they do a twilight on you? Did they do the brachy on the vaginal cuff the last time? Where are you located? I am in South Florida. I always get second opinions.

Stage 1 grade 1 slow growing endometrial cancer is what I was told. I had genetic testing and it was negative. I never used any kind of body powder (they never asked me if I did). I was menopausal for many years and I started spotting. Yes, they did brachy to the vaginal cuff in 2023 after a hysterectomy with tubes, ovaries and cervix removed. I am currently in the middle of 25 external radiation treatments. The brachy is going to be "aimed" mainly at the lesion just inside the opening of my vagina. Apparently the 2023 brachy missed that area. The upper portion and top of the cylinder will be covered with a shield to protect the rest of the vagina from the radiation. I live in southern Minnesota and have been going to Mayo in Rochester, MN, about an hour from where I live. I started in my hometown and was sent to Rochester by a doctor here. The radiation doctor where I am having the external (about 30 minutes from my home, at another Mayo facility) said that brachy goes better when the patient is relaxed and it is easier for the doctor who is performing the brachy treatment. He is all for sedation. I did not have sedation withe the 2023 brachy and I was very tense, but I got through it without too much of a problem, despite having a cold and seemingly uncaring radiation dr. I do not have him this time.