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Radiation therapy uses high-energy rays or particles to kill cancer cells. It is sometimes used to help treat uterine sarcoma.

When is radiation therapy used for uterine sarcoma?

Radiation might be used to treat uterine sarcoma:

• Instead of surgery, alone or with chemo, as the main treatment if surgery can't be done
• After surgery (adjuvant radiation), to lower the chance of cancer coming back in the pelvis or treat spread to the lymph nodes
• To manage symptoms, like pain or swelling caused by a tumor pressing on nearby nerves and blood vessels

Radiation therapy seems to help keep some uterine sarcomas from coming back after surgery, but there is not enough information to know if it can help someone live longer.

Types of radiation therapy

Two types of radiation treatments might be used for uterine sarcoma:

• External beam radiation therapy
• Internal radiation therapy or brachytherapy

Sometimes brachytherapy and external beam radiation therapy are used together. How much of the pelvis needs to be exposed to radiation therapy and the type(s) of radiation used depend on the extent of the disease.

Side effects of radiation therapy

The side effects of radiation therapy depend on the dose of radiation and where the radiation is given.

• Short-term side effects happen during or shortly after treatment.
• Long-term side effects can last for months or years after treatment.
• Late effects can take months or years to develop after treatment.

Almost all side effects can be treated with medicines, and many go away over time after treatment ends. If you're having any side effects from radiation, discuss what you can do to get relief from these symptoms or prevent them with your cancer care team.

Short-term side effects

This same kind of damage that can happen to the skin from EBRT can happen with vaginal brachytherapy.

Side effects in the weeks during and after treatment might include:

• Fatigue
• Hair loss in the area receiving radiation
• Red, tender, or dry skin in the area receiving radiation, like a sunburn
• Low blood counts, which are more common when radiation is combined with chemo or other drugs
• Nausea, vomiting, cramps, and diarrhea
• Bladder irritation (radiation cystitis), bleeding, or damage, which might cause pain or problems when passing urine
• Blood or pain when passing stool (radiation proctitis)

As long as there is not a lot of bleeding, a person can continue to have sex during radiation therapy. But the outer genitals and vagina might become sore and tender to touch, and many choose to stop having sex for a while to let the area heal.

Long-term or late effects of radiation

Long-term and late effects of radiation therapy depend on where it was given. Some of these effects can last many years after treatment.

Altered sexual function: Radiation to the vaginal walls can cause scar tissue to form, which can cause the vaginal canal to narrow and become dry, making sex painful. Vaginal dilators (a plastic or rubber tube used to stretch the vagina) and lubricants can help with symptoms. However, pain with sex can be a long-term problem after radiation.

Changes in bowel or bladder habits: Radiation scarring can cause bleeding from the bladder or rectum, and might lead to problems like frequent or painful urination, or constipation. This can begin months or years after treatment.

Swelling (lymphedema): Radiation to the pelvis can block fluid drainage from the legs, leading to swelling (lymphedema) in the legs. It's more common in those who had lymph nodes removed during surgery.

Bone health problems: Pelvic radiation can also weaken bones, leading to fractures of the hips or pelvic bones. Low estrogen levels, either from surgery to remove the ovaries or radiation to the ovaries, can also increase the risk of fractures.

Risk of a second cancer: Because radiation works by breaking DNA, it can also increase the risk of a second cancer many years later.