Brachytherapy for Endometrial Cancer

Brachytherapy is a form of internal radiation in which a radioactive source is placed in your body, in or near the cancer. Endometrial cancer patients often require treatment to their “vaginal cuff.”  The vaginal cuff is defined as the proximal/top third or half of your vagina. A cylindrically-shaped instrument is inserted into the vagina, and this is called a “vaginal cylinder.” It acts as a conduit or holder for the radioactive source.

Vaginal cylinders come in many different sizes. A cylinder size will be chosen based on your vagina's size. A proper cylinder size should not be too big or too small. When the cylinder is inserted, you will likely feel pressure but some rapid, short-lived discomfort.

You will be receiving what is called “High Dose Rate” (HDR) brachytherapy. The radiation source is left inside the cylinder for an average of 10 minutes and then removed. You may have treatment every other day or every 2-3 days for 2-6 treatments. You will not feel, smell, or taste the radiation during the treatment. The radiation is being precisely delivered to your vaginal cuff with minimal-to-no exposure to your surrounding organs.

Before the procedure:

• No prep is necessary 😀

• Arrive 15 minutes before your appointment and wear loose, comfortable clothing. You will be given a gown and asked to undress from the waist down.

• You MAY drive yourself and carry on normal daily activities while undergoing this treatment.

During the procedure:

• We will try to position you comfortably on our CT table

• The doctor will insert the cylinder

• The cylinder will then be held in place by a clamp attached to a board under your bottom. You don’t have to squeeze to keep it in place. Once inserted and clamped, it will not move, but you can relax your pelvis and legs.

• You will then use our CT scan to take two X-rays of the cylinder to confirm it is in the proper position.

• The rod at the cylinder's end will be outside your body. It will be attached to the radioactive source machine via a long, thin rubber catheter.

  • The radioactive source is a tiny seed embedded in a long, extremely thin wire coiled inside a machine called a “remote afterloader.” The machine is made of lead, protecting us from the radioactive seed.

• The doctor and staff will leave the room during your treatment. You will not feel anything. You will hear machine sounds or coiling and uncoiling sounds as the machine sends a wire in and out of the cylinder.

• It is important to lie still during your treatment so the cylinder does not move.

• Your treatment team can see on a monitor and hear you through an intercom at all times.

• Once the treatment is completed, your treatment team will return and disconnect the cylinder from the machine and remove the cylinder from inside of you.

**Pictures of a “remote afterloader” (zoomed in and zoomed out)

After the procedure:

• Please empty your bladder even if you do not feel like you have to urinate.

• Please drink at least 3 Liters of fluid daily while undergoing these treatments (i.e., stay well-hydrated.

• You will feel normal after the procedure, and driving will be perfectly safe. You may go home, but it is also safe to return to work, run errands, etc.

• You may notice some pink, clear, or yellow vaginal discharge during or shortly after the procedure.

• You may notice a feeling of pressure or discomfort when you urinate or when you have a bowel movement.

• You may experience mild vaginal irritation.

• You may feel tired several hours after the procedure or the following day.

***The above side effects should be temporary