Roll Call for External Radiation After Chemo

I haven't been through radiation yet, but am getting ready to start external radiation in a week or two. That will be followed by several internal radiation treatments and then three more rounds of chemo. Like you, I am stage 3(c), grade 3. My tumors were mixed serous and endometrioid, and I had quite a bit of lymph node involvement in the pelvic and para-aortic areas. I had a positive wash at surgery (cancer cells present) but no sign of cancer outside those regions. The serous dx and lymph node involvement are the reasons for the rather aggressive use of radiation treatment in my case (following the sandwich regimen rather than waiting until after chemo). I've had PET & CT scans recently and there was no sign of cancer elsewhere, so the radiation is really all about zapping the lymph nodes and reducing the chance of recurrence. It will be a form of IMRT and very carefully targeted/individualized. It's my understanding that the brachytherapy to the vaginal cuff is even more common than external radiation for advanced-stage endometrial cancer, because that's a common site for recurrence.

My biggest concern about having the radiation is lymphedema, which is something that is not discussed much on this board. Radiation does increase the risk of that, though it would be a concern for me in any case because of the number of lymph nodes they removed. I dread that a lot, though I'm managing not to worry about it until the time comes. But that is not enough to keep me from having the radiation. I want very much to be in the 47% of my cohort who survive to five years.

I am curious about why they are having you go back for a second pelvic wash. Does that mean abdominal surgery, or can that be done laparascopically?

Sorry that I can't offer feedback on side effects, etc. I will know more in a few weeks!

I had 28 external radiation session in Feb. 2013 plus to of the internal as part of the sandwich treatment.  I was much more afraid of the radiation than I was of the chemo, mostly because of personal reasons.  My father had radiation 55 ago for,lymphoma and it burned a quarter size hole in his groin that never healed.  We are lucky that cancer treatment has gotten more humane over the years.

My side effects during radiation were not to bad, mostly fatigue.  My treatment was scheduled for late afternoon so I could get in most of my school day.  I did have some problems with diahria but I was able to control it with Imodium.  Luckily my classroom was close to the bathroom.  The doctor did have me on a low fiber diet, no fresh fruit or vegetables and no whole grain.  

I was hit with radiation in nine different places and the whole thing lasted for about 20 minutes.  It was my understanding that they radiated the places where the surgeon had sliced and diced.  The hardest thing for me was holding still for that long and I was afraid that I would fall asleep and roll of the rather narrow table.  I never even got a red mark on me.  My energy came back pretty quick after I was done.

i do have lingering side effects from the radiation, all involving the bones in my pelvis.  My bones are just plain weaker.  I have a stress fracture in my left side and I have had a lot of trouble with my blood counts after chemo since radiation. Both atributed to the radiation.

Hugs and prayers, Lou Ann

beccabtown said:

Lymphedema?

Lou Ann, thanks for sharing. It is sobering to hear that even though you thought the side effects were not severe you still have lasting effects. It sounds like lymphedema has not been a problem, but did anyone ever talk to you about it? Thanks. 

I didn't lose any lymph nodes during surgery, so I shouldn't have a problem with that.  All in all,I have been very blessed.

Lou Ann

MAbound said:

What issues with your blood counts?

Is it your immune system impacted or your red blood cells as far as your blood count issues? It makes some sense since there's a lot of marrow in your hip bones. Did you have bone scans prior to or after radiation? Have you had to take any osteoporosis drugs?

My red blood cells and platelet dropped very low.  My white,blood cells stayed pretty good because I had the Neulasta shot. my platelets came back enough to go ahead with the next chemo treatment if we waited an extra week. My doctor also had to lower the dosage of the chemo drug several times The red cells dropped low enough that I had to have two blood transfusions.  Biggest problems came with Taxol.  Since I am off of chemo and on immunotherapy my blood counts have all come back to almost nornmal.  I have not had any bone scans only CT scans and an MRI.  The CT scan showed the stress fracture and weakening in my spine and pelvic bones. I don't know if it had anything to,do with the problem that I am having with my SI joint in my right hip, but I do wonder.

Lou Ann

I'm curious: Who continued working during radiation? Who found that they needed to take time off?

Thanks for the lymphedema link, MAB. I don't have any symptoms yet, but have already seen a physical therapist for baseline measurements and an early discussion. The good news is that compression stockings now come in all kinds of colors and patterns--won't have to wear the thick fleshtone ones if it comes to that.

I too had 28 external radiation treatments after I completed my chemo in April.  Like kvdyson my rad-onc told me that because of specific targeting, even with a higher dose radiation, she expected no long-term side effects and only mild short-term ones. My short-term ones were primarily diarrhea, nausea, and mangbeing tired.  My treatments were first thing in the morning and I went to work immediately there after.  I did find that I was exhausted by 3:30 or 4:00 and often napped for an hour to an hour and a half upon getting home each evening in addition to going to bed earlier than normal.

I did have a episode of bloating and quite a bit of pain in my lower abdominal area a couple weeks ago.  A CT showed it was a bit of inflamation of the intestinal lining, likely from the radiation. It was easily treated with a bit of pain medication and an anti-inflamatory (Naproxin).