Radiation or not after surgery for endometrial cancer?

Excellent decision. My family member did not have radiation the first time around and had a reoccurrence at the 5 year mark. She had general radiation and several MRI guided linac treatments plus low dose chemotherapy the second time around and has been fine for 3 years so far.
Her follow up now includes an annual PET scan to ensure anything emerging can be caught early and treated promptly. So far so good!

I was diagnosed with endometrial cancer, grade 3, June 2023. I underwent a total hysterectomy that was followed by 6 chemo treatments and then 4 brachytherapy treatments. My gynecologist oncologist felt strongly that I should have the brachytherapy and after much thinking, I decided that if I didn't follow her advice and the cancer came back I would always wonder if having the radiation could have prevented a recurrence.
The only side effect from brachytherapy was tiredness. The one thing that I was not expecting was having to use a dilator "for the rest of my life". If this is not done, scar tissue would create a problem for being able to have follow up gynecological exams. It has now been a year since I finished the entire treatment protocol, my CA125 went from 259 to 10 and I keep my fingers crossed that all is well.

@blancheruth This is so distressing that you needed care at a rehab/nursing home after one round of chemotherapy. I did not have chemotherapy when I was diagnosed with endometrial cancer (endometrial adenocarcinoma) in 2019 and had a recurrence in 2021. I did have radiation therapy, both external (pelvic) and internal (brachytherapy) which I realize now is so much easier on the body then chemotherapy.

My understanding is that everyone reacts a little different to chemotherapy infusions. It's difficult to share information without knowing more about why you are on hospice. Are you still at the rehab/nursing home? Did you talk with your oncologist about other options? What did your oncologist recommend and suggest?

Back in 8/22 had hysterectomy for endometrial adenocarcinoma, no fallopian tube, no ovary, or tube involvement. However, there were 2 tears on back of uterus for some reason, so was told needed to have chemo, 2 runs of chemo 3 weeks apart between 5 weeks of external radiation, and 2 brachytherapy because adenocarcinoma cells were found in peritoneum wash. Was originally told would only need 3 brachytherapy. I recommend the brachytherapy so you should not have any problems in the future. Have read many times if you do nothing 2 years later there are issues on the vaginal cuff. I wish the brachy was all I was requested to have needed.

Why are you on Hodpice?
What insurance do you have?

I am new to the effect of my endometrial cancer. I had one round of chemotherapy, which made me very sick and dehydrated. I currently am on Hospice care b/c of events which occurred when I went to a rehab/nursing home after the chemotherapy. I am looking for support and knowledge about should I be on Hospice care or still seeing my oncologist.

My family member had some issues with diarrhea after the third week and some mild pain in the area for a few weeks after the treatment was completed but nothing after that. Still in remission and doing very well three years later. But she had an expert team at MD Anderson who monitored her carefully, ensured that her bladder was full before every session and recalculated everything midway through the treatment as she was responding so well to the treatment plan. Radiation therapy is an exact science and a fine art. They have a saying there: “where you go first matters” as they often have patients who have had less than optimal care elsewhere and now have a reoccurrence. Do your research and go to the best facility in your region. It is worth choosing carefully.

When a person has GI problems and diarrhea after radiation therapy then this something to talk with the radiation oncologist about. In my case I had radiation therapy over two years ago. I had 25 external pelvic treatments and 2 treatments of brachytherapy. I know that the amount of the radiation used to target my recurrence of endometrial cancer was carefully figured out and planned with a radiation oncology physicist and my radiation oncologist. I had loose stools and fatigue for a few weeks after the radiation therapy ended but nothing since then. I wonder if those of us who have lasting effects such as diarrhea had higher levels of radiation? I don't know enough about this to answer that question.

If radiation therapy is recommended then it would warrant a discussion with the radiation oncologist about all of this.

Here is information about this from Mayo Clinic:

Radiation Enteritis:

-- https://www.mayoclinic.org/diseases-conditions/radiation-enteritis/symptoms-causes/syc-20355409

I had thefour radiation treatments after the surgery. I found that I had loose stools after the treatments. Still months later have some problems. Other than that, no problems.

I do not recommend any radiation for uterine cancer treatment. I would take my chances with Immunotherapy if the cancer returned.
My quality of life has suffered since radiation therapy for uterine cancer. I have been diagnosed with radiation enteritis and small bowel obstructions resulting in 2 small bowel resection surgeries. The radiation fried my intestines and I had to have an appendectomy at age 67! I had 4 surgeries in 2 years, including total hysterectomy and malignant lymph node removal. I am no longer able to eat and will be on TPN for the rest of my life. It has been a long 4 years and the only good news is that my cancer has not metastasized. PTL!!