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Endometrial
Treatments - Internal Radiation - Vault Selectron
What is Endometrial Cancer?
The uterus or womb is a muscular pear shaped organ, which at its narrower end is closed by the neck of the womb, the cervix. The cervix is at the top of the vagina. The lining of the uterus is called the endometrium and it is from here that a cancer of the uterus usually starts hence the name endometrial cancer.
Situated near the uterus are small glands called lymph nodes, these make up part of the body’s lymphatic system, which is a network of small glands that act as the body’s defence system.
The exact cause of endometrial cancer is not yet known although women who have taken the contraceptive pill have a reduced risk and women who have taken HRT for a long time have a slightly increased risk of developing endometrial cancer.
Endometrial cancer is most common in women between the ages of 50-64. It is rare under the age of 50.
Treatments - General
Your treatment will be individually planned and discussed with you by your Consultant and Specialist Nurse. Your Consultant will plan your treatment with you taking into account a number of factors including the type and size of tumour, stage of cancer, your age and general health. Your partner or a close family member or friend are welcome to attend consultations and may like to make notes on your behalf.
To assist in planning your treatment it may be necessary to have some further investigations including blood tests, chest x-rays, vaginal ultrasound, hysteroscopy, biopsy and MRI scan.
For an early endometrial cancer where there is no evidence that the disease has spread then surgery (hysterectomy) will be recommended. Radiotherapy may be given following this if the histology suggests there is a risk of the disease coming back at a later date. If the disease has spread and cannot be removed surgically or if you are physically unfit for surgery then radiotherapy will be recommended.
In some cases hormone treatment may be recommended and in a few cases chemotherapy may also be considered.
Treatments - Internal Radiation - Vault Selectron
Internal radiotherapy is a method of treating gynaecological cancer with radiation. This enables the treatment to be given directly to the diseased area reducing the exposure to healthy surrounding tissue. The exact dose and length of treatment will be calculated individually prior to you commencing treatment.
Where will I go for my treatment?You will be admitted to a single room on Tyneham Ward for your treatment. The room is specially designed to ensure that radiation does not leak into the surrounding area. This prevents unnecessary exposure to staff and visitors. There is an intercom to allow you to talk to the staff or your family without interrupting the treatment.
How is treatment given?In order to treat the area your Consultant will insert an applicator (it will feel like a large tampon) into the vagina. A catheter will be placed in your bladder so that the applicator is not dislodged when you pass water. This procedure will be carried out in the privacy of your single room while you are on the ward.
What happens when treatment starts?During treatment you will need to lie down and remain in bed. A flexible tube will connect the applicator to a radiotherapy machine, although the machine is in the room next door you may still find it a little noisy. For safety reasons it is not possible for anyone to enter the room while the machine is running. Your treatment will however be interrupted for short periods throughout the day and night so that the nursing staff can attend to your needs. You can use the intercom to speak to the nurses and there is a pre-pay telephone to enable you to contact family and friends at home.
Can I have visitors?The treatment is continuous but can be interrupted for visitors to enter your room for a short period, however please remember that this will extend the course of the treatment and is therefore not encouraged. Relatives may use the intercom briefly but are discouraged from waiting outside the room for their own safety.
What can I eat?Please select food that you can eat when lying down and choose a low fibre food that will not stimulate a bowel action (do not select high fibre food marked with a * on the menu). You will be given something to prevent a bowel action during treatment.
Treatments - Vaginal Dilation
Some treatments given for your type of Cancer can cause scar tissue to form in the vagina. This can lead to a reduction in the elasticity of the vagina and may lead to painful sexual intercourse. It is very important to maintain a healthy vagina for your general health and well-being. This is important not just for those who wish to resume sexual intercourse.
Vaginal dilation is recommended in order to:
- Keep a healthy supple vagina and increase natural vaginal moisture.
- Enable those who wish to do so to comfortably resume sexual intercourse (sex).
- Allow a more comfortable and effective physical examination at your regular check ups, to enable the doctor to clearly see how you’re responding to treatment and its effectiveness.
Vaginal dilation means stretching and opening the vagina. This can be achieved by:
- Vaginal massage
- Sexual intercourse
- Use of vaginal dilators
- Use of a vibrator
- The combination of using a dilator and sexual intercourse.
The vaginal dilators are smooth plastic tubes, which are available in four sizes and have a handle. Using the dilators will reduce scar tissue and adhesions and stretch and maintain the elasticity of the vagina; this will help to maintain a healthy vagina, especially if you are not having regular intercourse.
You will be advised to begin the use of your dilators about four weeks after the end of radiotherapy treatment. The dilators should be used regularly, although if you have intercourse twice a week you will not need to use the dilators in that week.
How to use the dilators
It is important to be relaxed, so ensure that the room is warm and private before you start. You may like some relaxing music playing. The following steps will help you to use the dilators correctly.
- Fit the universal handle to the recommended sized dilator.
- Wash your hands and place a small quantity of the lubricant supplied on the rounded end of the dilator. Relax and get into a comfortable position lying with legs apart and knees raised. You may like to do this in a warm bath.
- Gently insert the rounded end of the dilator into your vagina and insert the dilator as far as is comfortable. You cannot lose the dilator as the top of your vagina is closed.
- Insert and withdraw the dilator a couple of times and then hold it in place for three to five minutes. Try to use your pelvic floor muscles to grip the dilator firmly.
- Do not use force when inserting the dilator, if you have any difficulty revert to the smaller size. You may notice some tightness while using the dilator, if this is the case use the dilator more frequently for a while. To prevent scar tissue forming you may need to use the dilators regularly whilst you are sexually active.
- Withdraw the dilator and wash it in warm soapy water using a small brush to clean the inside. Ensure that the dilator is completely dry before storing.
- Use of the dilators on a regular basis can help reduce your anxiety about having intercourse and does not detract from the enjoyment of lovemaking.
Slight bleeding or ‘spotting’ following the use of dilators for the first few times is not unusual. If you have fresh heavy bleeding, pain or soreness you should contact your Doctor or the Gynaecological Nurse Specialist.