Radiation or not after surgery for endometrial cancer?

@dlgbb Thanks for coming back and letting me know about your follow-up exam. There is a Discussion that I started in our Gynecological Support Group on radiation therapy that you might like to read through. You'll get various perspectives including side effects, if any. Personally, when I had radiation therapy (external and internal) after a recurrence in the vaginal cuff I had very few side effects. I experienced a little fatigue, occasional diarrhea, and that's really all. I continued weightlifting and balance training and went for daily walks. I went for 5 days/week for 5 weeks for external and then 2 treatments of brachytherapy (internal). I met with the radiation oncology nurse and the radiation oncologist weekly to monitor my progress and to discuss any problems I was having.

Discussion: What kind of radiation therapy did you get for your gynecological cancer?

-- https://connect.mayoclinic.org/discussion/types-of-radiation-treatments-for-gynecological-cancers/

@naturegirl5 @val64

I had my follow-up today in Calgary, and now I have to make a decision. No chemo is required. Standard of care is to do radiation, but a clinical trial is being offered where there is no radiation because of the POLE mutation - they just observe every three months, and then treat if there is a recurrence. I guess the choice is between being proactive and preventative, or reactive and treating cancer again if it comes back. I am leaning towards doing the radiation. I would rather stop it in its tracks than have to try and get rid of it again. It will be 5 weeks of 5 days a week, 25 treatments - external only.

Diaz,
I have yet to see my Dr post hysterectomy but am interested in radiation and its side effects.
A quick questions for you: What is the dilator you use to prevent scarring after radiation? Is it placed up the rectum and do you still have control of your anus opening? How much longer will you have to use the dilator?
Thanks for any insight you can share:)

I sure will. I am 58, and until this past fall, a picture of health and fitness! This is all so bizarre.

@dlgbb I hope your 6 week follow-up goes well. Do you have some questions written that you can ask your oncologist? You have good questions here that you can start with and in your place these are questions I would be asking. I'd also ask about the mitral valve prolapse and if that is something to be considered in your cancer care treatment. I'm 73-years-old and it seems like every time I'm ahead something new shows up to address. And I need to see yet another specialist. Sound familiar?

Will you please come back here and let me know what you learn at your appointment tomorrow?

Tomorrow is my 6 week surgical follow-up after total hysterectomy, removal of fallopian tubes, ovaries, and lymph node testing. I have not spoken to my oncologist yet about results, but have been able to see them online. I am so nervous about what follow up is going to be, because of results that are both good and bad. I have a grade 3 endometrioid carcinoma. Only minimal spread to myometrial wall (11%), but substantial lymphovascular invasion. I know both those thing are indicators for recurrence and poor prognosis. On the other hand, I have tested positive pathogentic POLE mutation, which is great news! I am just wondering if the "good" compensates for the "bad", and if there will be follow-up, like radiation. I have read that with POLEmut, the recommendation is to back off further treatment. I am just anxious and want to move on, but also feel nervous about potentially doing nothing further. Yesterday I also had a echocardiogram to check for what looks like a flailing mitro valve prolapse. Everytime there is light at the end of the tunnel, something else. Geesh.

i am sorry for what have been through.

When I was diagnosed with endometrial cancer Grade 3, I had a complete hysterectomy. After the surgery, in my follow up appointment with my GYN-Oncologist, I was informed that chemotherapy followed by brachytherapy was the recommended course of treatment for me. I wanted to know, if I found chemotherapy to be too difficult could I stop. I was told Yes, but that I should have the brachytherapy.
I thought about it and it made sense to me to have the brachytherapy since it was through that area that the uterus was removed. I also felt that I would be second guessing myself if I did not have the brachytherapy and the cancer came back.
I completed both the chemotherapy and the brachytherapy in December 2023 and do have to use a dilator to prevent scarring.
It has been 14 months since I completed all treatment and I have follow up appointments, with a CA125 blood test and a physical examination, every three months. All appointments to date show no evidence of disease.
I hope you make an informed decision based on good medical advice and what you feel is best for you.

Go for the radiation! Although I don't know much about brachytherapy, I do know that it is better than external beam radiation: less chance of killing off healthy surrounding tissues. Just wondering why you wouldn't be getting chemo as well.
As for diet and healthy lifestyle, while everyone should follow the regime the effects on cancer may be minimal. Cancer is complicated, operating at the DNA level, so I don't imagine that eating cruciferous veggies and other purported cancer-antagonistic foods would be potent enough to mitigate the course of the disease.
Having said that, there are natural foods and supplements (like pectin) that can ameliorate the effects of radiation.
Hope this helps.

I had three brachytherapy sessions, and there were no side effects. I was diagnosed with aggressive endometrial cancer, and I wanted to do everything to prevent it from recurring. I wish you a good recovery, but do discuss it more with your doctors.