Radiotherapy treats cancer by using high-energy rays which destroy the cancer cells while doing as little harm as possible to normal cells.

Radiotherapy may be given after surgery, if your doctor feels that there is a risk of the cancer coming back. Radiotherapy may be used instead of surgery if you are not fit enough to have surgery or if the cancer has spread to the area surrounding the womb. It can also be used if the cancer comes back in the pelvic area at a later date. Radiotherapy for womb cancer can be given externally or internally, and often as a combination of the two.

Your clinical oncologist, who plans your treatment, will be able to help you with any problems or concerns you may have.

Our section on radiotherapy provides detailed information about this treatment and its side effects.

This is given by directing high-energy rays at the area of the cancer. It is usually done at a hospital outpatient clinic each weekday, with a rest at the weekend. The type and length of your treatment will depend on the size and position of the cancer, but it may last a few weeks.

To make the radiotherapy as effective as possible, it has to be carefully planned. On your first few visits to the radiotherapy department you will be asked to lie under a large machine called a simulator, which takes CT scans of the area to be treated.

Planning may take a few visits. Marks will be made on your skin to show the radiographer, who gives you your treatment, where the rays are to be directed. Sometimes a few permanent marks may be made on the skin instead of pen marks. These marks are tiny and will be made only with your permission. 

Before each session of radiotherapy, the radiographer will position you carefully on the couch and make sure you are comfortable. During your treatment, which only takes a few minutes, you will be left alone in the room but you will be able to talk to the radiographer, who will be watching you carefully from the next room.

Radiotherapy is not painful but you do have to be still for a few minutes while your treatment is being given. The treatment will not make you radioactive and it is perfectly safe for you to be with other people, including children, after your treatment.

Your skin may become sore in the area being treated. Perfumed soaps, creams or deodorants may irritate the skin and should not be used during the treatment. Your radiographer or nurse can advise you on skin care during this time.

Internal radiotherapy (often called brachytherapy) gives radiation directly to the womb and the area close by. It can be used after surgery if there is a chance that the cancer may come back. For those few women who can’t have surgery it may be used as an alternative treatment. Internal radiotherapy can be used on its own or combined with external radiotherapy.

With this treatment, applicators (hollow plastic or metal tubes) are placed into the top of the vagina. These tubes are usually put in position without anaesthetic or under light sedation. But if you still have your womb you may need a general anaesthetic. 

Internal radiotherapy gives a high dose of radiation to the area close to the applicator, but only a low dose to tissues and organs more than a few centimetres away. The treatment is given by a machine that delivers radioactive sources (small radioactive metal balls) into the applicators.

This treatment can be given at two different speeds – depending on the machine being used. If the machine is a ‘low dose-rate’ machine, treatment will be given once over several hours or even days as an inpatient. This machine may be called a Selectron®, but other names are used sometimes. If the machine is a ‘high dose-rate’ machine, then the treatment is delivered in a few minutes as an outpatient but may have to be repeated more than once. Both low dose-rate and high dose-rate treatments seem to be equally effective.

If a low dose-rate machine is used, you will probably need to be in a separate room, set apart from the main ward and often behind lead shields. You will be asked to stay in bed while the applicator is in place, to make sure that it stays in the correct position. For the same reason, you will have a small tube (catheter) placed into your bladder to drain your urine. If a high dose-rate machine is used, a catheter is not usually needed as the treatment only takes a few minutes.

Visitors may only be allowed to stay for a short time, during which the machine is switched off and the radioactive sources go back into the machine. This is to keep the dose of radioactivity to visitors and hospital staff as low as possible. Children and pregnant women are not encouraged to visit.

You may feel isolated, frightened and possibly depressed at a time when you might want people around you. If you feel like this, you can let the staff looking after you know. It might also be helpful to take in plenty of reading material, a radio and other things to keep you occupied. The isolation only lasts while the applicators are in place. Once they are removed, the radioactivity disappears and it is perfectly safe for you to be with other people.

The applicator will be removed by one of the doctors or nurses on the ward. This can be uncomfortable. You will be given painkillers and occasionally sedation or gas and air (entonox) before the tubes are removed to make the removal easier for you.

It is not unusual to have slight discharge once radiotherapy treatment has finished. If it continues or becomes heavy, let your clinical oncologist or specialist nurse know.

Radiotherapy to the pelvic area can cause side effects such as tiredness, diarrhoea and a burning sensation when passing urine. These side effects can be mild or more troublesome, depending on the strength of the radiotherapy dose and the length of your treatment. Your clinical oncologist, or specialist nurse, will be able to tell you what to expect.

Most of these side effects can be treated quite easily with tablets which your clinical oncologist can prescribe. Any side effects should gradually disappear a few weeks after your treatment is over.

It is important to drink plenty of fluids and maintain a healthy diet during your treatment. You may feel slightly sick but this is not common. If you don’t feel like eating you can replace meals with nutritious, high-calorie drinks, which are available from most chemists and can be prescribed by your GP. Our information on eating well has some helpful hints on how to eat well when you are feeling ill.

During your treatment it is helpful to get as much rest as you can, especially if you have to travel a long way each day. Our coping with fatigue section, has helpful tips on dealing with tiredness.

Sometimes radiotherapy causes a narrowing of the vagina, which can make sexual intercourse uncomfortable. Some women become less interested in sex and notice that their vagina is dry. See the section on the effects on your sex life and fertility.

Our information about the possible side effects of pelvic radiotherapy during treatment may also be useful. 

Radiotherapy to the pelvic area can sometimes cause long-term side effects. However, improved planning and treatment techniques have made these long-term effects much less likely.

A small number of people, the bowel or bladder may be permanently affected by the radiotherapy. If this happens, the increased bowel motions and diarrhoea may continue, or you may need to pass urine more often than before. The blood vessels in the bowel and bladder can become more fragile after radiotherapy treatment and this can make blood appear in the urine or bowel movements. This can take many months or years to happen. If you notice any bleeding, let your doctor know so that tests can be carried out and appropriate treatment given.

Some people also find that the radiotherapy affects the lymph glands in the pelvic area and can cause swelling of the legs. This is known as lymphoedema and is an uncommon side effect.

There is more information about possible long-term side effects in our section on pelvic radiotherapy in women.