Vaginal cuff brachytherapy is a treatment that can help prevent endometrial cancer from spreading to the upper part of your vagina. It involves inserting a radioactive cylinder into your vagina to destroy cancer cells.
Radiation therapy is one of the main treatments for cancers that start in or spread to your vagina or uterus. It involves using intense beams of energy to destroy cancer cells.
Healthcare professionals can provide radiation therapy in two ways:
- Brachytherapy: The radiation comes from a device that’s placed in your body.
- External beam radiation therapy: The radiation comes from a machine outside your body.
Doctors often combine vaginal cuff brachytherapy with other treatments, such as external beam radiation therapy or chemotherapy, to treat endometrial cancer. Endometrial cancer starts in your uterus and is also called uterine cancer.
A 2022 research review suggests that in people who have a higher risk of vaginal cancer recurrence, a boost of vaginal cuff brachytherapy after external beam therapy may help prevent cancer from spreading and improve survival.
In this article, we examine how doctors use vaginal cuff brachytherapy to treat cancer and when they might recommend it.
Brachytherapy is an important treatment tool for gynecological cancers (cancers that develop in the female reproductive tract). Brachytherapy is usually performed 6 to 12 weeks after a hysterectomy.
During this procedure, a healthcare professional places a radioactive material into a cylinder and then inserts the cylinder into your vagina. It may feel like a
Healthcare professionals often use 3D imaging to help them guide the cylinder into the right place. Proper placement helps maximize the amount of radiation that reaches cancer cells and minimize the amount that’s delivered to healthy tissues.
Endometrial cancer is often treated with a hysterectomy (a procedure to remove your uterus).
Even after surgery, the cancer may recur (come back) if cancer cells remain undetected. The most common place for the cancer to recur is at the closure doctors make in place of your cervix after a hysterectomy. This area is called the vaginal cuff.
Vaginal cuff brachytherapy can help
Before your procedure, healthcare professionals may ask you to use the bathroom to empty urine from your bladder, or they may insert a tube called a catheter to remove urine.
During vaginal cuff brachytherapy, a healthcare professional will insert a cylinder called an applicator into your vagina. The applicator will then release radiation to the upper part of your vagina.
There are two types of brachytherapy that differ based on how long the applicator stays in your vagina:
- Low dose rate brachytherapy: The applicator stays in place for
1 to 4 days . You’ll usually need to stay in the hospital during treatment because you need to stay immobile. This form is not commonly used in the United States due to a risk of blood clots. - High dose rate brachytherapy: You receive a higher dose of radiation for only 10 to 20 minutes. You’ll usually receive at least 3 doses, either weekly or daily. You’ll likely be able to go home on the same day as each of your procedures. High dose rate brachytherapy is usually completed over the course of 7 to 8 weeks.
You usually don’t need to do anything in particular to prepare for vaginal cuff brachytherapy. You can eat and drink normally before the procedure because you won’t need to receive general anesthesia to put you to sleep.
Vaginal cuff brachytherapy has been consistently shown to decrease the risk of endometrial cancer recurrence in the part of the vagina closest to the uterus, with a minimal risk of serious complications.
Brachytherapy and chemotherapy are commonly used in treating early stage uterine serous carcinoma (a specific type of uterine cancer).
According to a 2022 research review, in people who have a higher risk of a vaginal recurrence, receiving vaginal cuff brachytherapy after external beam therapy may help control the spread of cancer and improve survival.
The most common complication of vaginal cuff brachytherapy is radiation vaginitis, which involves changes to the lining of the vagina. Other possible complications include:
- fatigue
- pelvic pain
- bowel-related side effects such as diarrhea, which are usually mild if they occur
- bladder irritation
- vaginal discharge or bleeding
Serious complications are rare, but they can occur. In a 2023 article, researchers reported three cases of potentially serious misplacement of the radiation applicator that had been found through CT scans.
You’ll have follow-up appointments after your procedure to monitor the effectiveness of the treatment and see how you’re recovering. You have the highest chance of recurrence in the first year after the treatment.
Many people recover well from vaginal cuff brachytherapy and don’t have any other complications. But some people might experience a recurrence of their cancer.
In a
The overall survival rates were 95.5% after 2 years and 77% after 5 years. The addition of external beam radiation therapy was not associated with an improvement in vaginal recurrence-free survival.
How successful is brachytherapy for endometrial cancer?
Research consistently suggests that vaginal cuff brachytherapy decreases the risk of vaginal recurrence of endometrial cancer.
Is brachytherapy necessary after a hysterectomy for uterine cancer?
Vaginal cuff brachytherapy may reduce the risk of recurrence when performed after a hysterectomy. It’s usually performed 6 to 12 weeks after surgery.
Vaginal cuff brachytherapy is a procedure that’s often performed after a hysterectomy to prevent endometrial cancer from spreading to the vagina. It involves placing a radioactive cylinder in your vagina to destroy any cancer cells that might still be present after surgery.
Research consistently shows that receiving vaginal cuff brachytherapy after a hysterectomy reduces the risk of cancer recurrence. Serious side effects are rare but possible.
Your cancer care team can help you decide whether you might benefit from adding vaginal cuff brachytherapy to your treatment plan.