Is brachytherapy necessary to reduce recurrence of endometrial cancer?

I received three sessions of Brachy therapy without anesthesia. There was a physicist present to adjust the dosage. I had no side effects. I do use a dilator twice weekly after the sessions completed.

i'm not an expert but my understanding of brachytherapy is there are many types, doses, and duration.

the big difference in type is intracavity (wand inserted in a body cavity) and interstitial implantation (inserts needles into the tissue).

since my cancer was caught early a radical hysterectomy and intracavity brachytherapy is sufficient for me. i only need to lay still for 5 minutes for my brachytherapy and i do not have any issues with my vaginal cavity that would prevent the proper insertion and holding in place of the brachytherapy wand. i do not experience any discomfort from the wand or the radiation as it is being delivered.

if you doctor feels your anatomy would have pain by having the brachytherapy wand inserted they might think it's best to sedate you on some level.

if the length of the treatment needs to be long due to later stage or grade it might be best to have a level of sedation because you need to lay still and that might be hard to do for a long period of time.

interstitial vaginal brachytherapy involves a needle or multiple needles. i do not personally know anyone who has had this type of treatment but in my little understanding this is more common when the cancer has moved beyond the uterus like the cervix, vaginal canal, the tissue between the vagina and anus, etc.

my understanding of interstitial brachytherapy, it is always done with some form of sedation since it would be very hard for anyone to be still long enough so the needles do not shift in any way. twilight sedation would not be sufficient because with twilight (typically used for colonoscopy) many people can actually move their arms and do try to swat the scope - the nurse that is present during a colonoscopy is able to hold the arm so you can't swat the scope.

when you have radiation you are left completely alone is the room. the staff can not be exposed to endless radiation. they can see you on a camera and if you're awake communication with them.

given that, if the doctor knows before hand that you will experience discomfort that would make you move about or to try to take the equipment out of your body you'll have to be sedated completely.

ask you doctor why you would have to be sedated - i'm sure they would be happy to discuss and that your doctor feels it's the best option in your situation. just explain that you've in a cancer support group and the typical is without sedation.

Thank you for your kind response. The doctor told me the wand will go in my uterus because the surgeon stopped doing the hysterectomy because of adhesions from a prior surgery.

Is your brachytherapy lie ir high dose? The low dose can involve a ring and tandem being left in place for an extended time frame. There is also another that involves a Schmitt sleeve . I had stage 3 endometrial cancer and had chemo external beam and 3 high dose brachytherapy treatments. The brachytherapy was easy. Uncomfortable but not painful. Had no anesthesia no pain meds and none were needed. It was over on a matter of minutes

i'm so sorry your hysterectomy had complications and the surgery had to stop. it makes sense, entering the uterus would be painful if you were awake.

Kelly, thanks for such a wonderful and thoughtful response to my concerns. I am still researching and have found studies I hope will help me make a truly fact based and educated decision. My husband and I have talked about each one and will both be interested in hearing what my gynecology oncologist and the radiation oncologist have to say about our questions and concerns. We both want honesty and facts, not just “best guesses”.
I am praying for you daily and know the Lord will be with you during these last two treatments. I’ll see my GO this Friday and I will let you know what he says. Hopefully I am healed enough at this 6 week point to move forward with whatever decision we make.
You sister in Christ,
Barb
P.s. I love the Chris Brown song! Added it to my playlist!

I had three brachytherapy treatments and did not have anesthesia or need any pain pills. Was “easy “ a little uncomfortable but not painful. Take care

I wish I was offered sedation! I begged for it and called other treatment centers to find one that would offer sedation and couldn't find any. Mine was extremely painful until finally the doctor ordered me Percocet and Xanax to take prior to the next procedure plus they gave me some morphine at the clinic then I was fine. I had 4 more after that.

@riverland889 I had the same experience as @aardvark2018 with my brachytherapy sessions. It was a little uncomfortable but the radiation oncology physician and team did a lot to try to help me to feel comfortable.

I've seen different experiences here on Mayo Clinic Connect with brachytherapy for gynecological cancers. Some people have had the painful experience that you've described. I'm sure there are variations in the devices that are used and I wondered if maybe the cylinder applicator that was used for your sessions was overly too large for you? Or are you referring to when the radiation was administered through the device?

I'm glad that your doctor listened to you and order pain meds for you to take.

I'm going to ask for some expert advice from radiation oncology at Mayo Clinic about this.

No, the actual radiation did not hurt at all and yes, one of the things they modified to help me feel better was they used a smaller cylinder. I had forgotten that. Thank you so much for responding and of course all your support. I’m still on my immunotherapy every six weeks so far so good, but we never know about the future. I take it one blessed day at a time.