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Adjuvant radiotherapy for endometrial cancer

Patient information A-Z

The operation that you have had has successfully removed your endometrial (womb) cancer. However, there may be a few undetectable cancer cells which can cause the cancer to return at a later date. Having radiotherapy treatment at this stage may reduce the chance of the cancer returning.

This leaflet explains the benefits, risks and alternatives to undergoing radiotherapy following your surgery. We want you to be informed about your choices to help you be fully involved in making decisions about your treatment.

Please ask about anything you do not understand or wish to have explained in more detail.

About Adjuvant Radiotherapy

The operation that you have had has completely removed your cancer. With no further treatment your chance of being cured (the cancer never returning) is around ………%. On the next page is a diagram showing you the areas where the cancer may return and the how the different treatment options may affect the chance of the cancer returning.

Current evidence suggests that radiotherapy for cancer of the womb decreases the risk of local recurrence but does not improve survival.

Diagram of the female reproductive system showing the womb, ovaries, vagina, and nearby lymph nodes, with text noting cancer spread and recurrence risk under different radiotherapy options.
Image showing % chance of cancer returning to each area

Your choice of treatment

It is often difficult to make a decision about which treatment option you should have. It is important that you discuss any concerns you have regarding your decision with your doctor or radiographer. The table below summarises the benefits and risks of each treatment to help you make a decision.

Your choice of treatment - Benefits and risks
Active surveillance Brachytherapy
(internal radiotherapy)
External and Internal radiotherapy
Process Follow up will be with the surgical team responsible for your operation.

The follow up schedule will be determined in conjunction with your surgeon
One outpatient treatment a week for three weeks.

Vaginal applicator inserted for 10 minutes.

Treatment painless

Follow up schedule: Three monthly for one year then six monthly for two years.
CT planning scan

Three tattoos

25 outpatient treatments, every day (Mon-Fri) for five weeks. This may or may not be followed by one internal treatment.

Follow-up schedule:
Appointments at 3 months, 9 months and eighteen months
Benefits No side effects

Radiotherapy is only given if your cancer returns in the pelvis. At least 50% chance of cure if radiotherapy is given at this point.
Risk of vaginal recurrence reduced to less than 5%

No significant side effects
Risk of vaginal and pelvic recurrence reduced to less than 5 %
Risks Cancer may come back in your pelvis or vagina. This might have been prevented with early radiotherapy.

Cancer may come back somewhere else in your body.

No improvement in survival.
Vaginal stenosis (shortening and narrowing of the vagina) - this may be prevented with regular use of vaginal dilators

Cancer may still come back in your vagina despite radiotherapy.

Cancer may come back in your pelvic lymph nodes that may have been prevented with external radiotherapy.

Cancer may come back somewhere else in your body.

No improvement in survival.
Significant risk of side effects:
Acute (during treatment and up to six weeks after treatment completed)
 Diarrhoea
 Cystitis - frequency, urgency, pain
 Abdominal (tummy) cramps
 Skin reaction (in area being treated)
 Fatigue
Long term (six months to many years after treatment completed)
 Bowel change - diarrhoea, urgency, abdominal pain, incontinence
 Recurrent cystitis
 Bleeding from the bowel or bladder
 Vaginal stenosis
 Pelvic bone pain
 5-10% chance of permanent serious bowel or bladder side effects that may require you to have an operation.

Cancer may come back in the pelvis or vagina despite radiotherapy.

Cancer may come back somewhere else in your body.

No improvement in survival.

We are smoke-free

Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.

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Contact us

Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
CB2 0QQ

Telephone +44 (0)1223 245151
https://www.cuh.nhs.uk/contact-us/contact-enquiries/