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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 45933
Experience:  Board Certified Physician
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I am half way through 25 sessions of daily radiotherapy ...I

Resolved Question:

I am half way through 25 sessions of daily radiotherapy ...I had stage 2 non tumour in womb and had total hysterectomy....we are now looking at two sessions of Brachy therapy and I am very reluctant to have this as its so invasive with many side issues inc bowel and bladder problems and vaginal wall collapse and having to use dilatory etc.....
Any advice
Submitted: 11 months ago.
Category: Medical
Customer: replied 11 months ago.
Really looking for some evidence that the BT will reduce the chance of a recurrent .....but researching myself I can't fin many pro brachytherapy as the side effects can outweigh the low risk of recuurrence
Customer: replied 11 months ago.
I am half way through a 25 daily radiotherapy course and already having bowel problems and cystiti
Customer: replied 11 months ago.
No response yer
Expert:  Dr. David replied 11 months ago.

This is Dr. David

I am a radiation oncology doctor

what stage was your uterine cancer?

what size was it and grade?

any spread to lymph nodes?

do you have this information?

Customer: replied 11 months ago.
I have sent replies to your queries
Expert:  Dr. David replied 11 months ago.

I didn't get your replies.

Customer: replied 11 months ago.
Weird I sent twice,,,,let's hope this gets to you,,, I had post menopausal slight bleed which a smear sent me to have scans etc...I had CT and hysteroscopy and pretty much every health professional said it was contained in womb and a radical has would be curative. He took everything inc cervix and had a good loo at lymphs and said they were perfect. It was both a shock to him and us when the histology came back that it had spread into cervix ,,,,it was classed as stage one grade two and they said although I didn't have any Cancer in my body at that it would be usual to do twenty five daily radiotherapy and two sessions of brachytherapy. We have researched and asked forums etc re the pro and con of the BT and we can't see any definitive reason for having such an invasive treatment which then leads on to using dilatory and problems within the vaginal vault walls etc
Customer: replied 11 months ago.
Please tell me you got reply now otherwise I am giving up...I am pressing SEND so surely it must be going
Expert:  Dr. David replied 11 months ago.

yes, I got it

Customer: replied 11 months ago.
Yay......will await your replies thank you
Expert:  Dr. David replied 11 months ago.

I am a radiation oncology doctor

if your uterine cancer spread to your cervix, this would be stage II uterine cancer

vaginal cuff brachytherapy is actually the least toxic of the radiation treatments, and gives a smaller area radiation compared to the whole pelvis radiation for 25 treatments which treats your uterine tumor bed, pelvic lymph nodes as well as your upper vaginal cuff.

the number 1 place for uterine cancer recurrence is the vaginal cuff, where your uterus was removed and the upper vagina is sown together.

the vaginal brachytherapy is radiation only to 0.5cm depth to the vaginal wall in the upper 2/3 of the vaginal canal.

yes, woman do have risks for vaginal adhesions after this procedure

but this can be prevented with regular vaginal intercourse every week for 4-6 months

or use of a vaginal dilator for 5 minutes a day, 4-5 days a week for 4-6 months.

scar tissue from radiation forms in the first 4-6 months and can be prevented with these prevention methods

to allow for future intercourse and future vaginal gyn examinations to be easier to do.

I would hate for your uterine cancer to come back on your vaginal cuff, cause bleeding and require you to do more surgery and more radiation at that point and lower your chance of cure if your uterine cancer came back.

most radiation doctors would have recommended just the vaginal cuff brachytherapy over the 25 whole pelvic radiation as being more important if they had to pick one radiation treatment for you.

let me know if you have other questions.

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you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

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Customer: replied 11 months ago.
Thank you for the info....it's so confusing as so many different viewpoints from both oncology teams and women who have had BT or mixture etc......couple of points if you don't mind me asking ...
It wasn't a tumour as such but a spread of cells in lining of womb which had slightly spread into cervix and finally as a couple in our mid sixties who still enjoy some initmacy and intercourse it certainly wouldn't be once a week for four to six months nor would I be happy using dilatorrsAnd secondly are you able to give me statistics about recurrence etc.....
And finally although we still have an intimate life in our 43 year old marriage it certainly wouldn't be
Expert:  Dr. David replied 11 months ago.

Following standard surgery treatment for stage II uterine cancer with a hysterectomy, 20-40% of patients will experience recurrence of their cancer.

with the addition of pelvic radiation therapy and vaginal cuff brachytherapy, that percentage can be brought down to less than 7% recurrence rates.

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