How Do You Decide If I Need Radiation Therapy?

As we mention in Question 40, the decision to treat with radiation therapy is made on the basis of risk factors found at the time of surgery. These include the grade of the tumor, the depth of invasion into the uterine muscle, the presence of tumor in vascular spaces within the muscle, the presence of tumor in the cervix, and the status of the lymph nodes if removed.

Women with tumor that is considered “high risk” should have post-operative radiation. Women with “intermediate risk” tumors may or may not benefit from radiation treatment and should discuss treatment with their doctors. They may decide to be treated only with vaginal radiation. Table 2 gives criteria of what defines risk in endometrial adenocarcinoma.

Risk Groups and Endometrial Cancer

Risk group
Low Stage I Grade 1-2
Intermediate Stage I Grade 3
Stage II Grade 1-2
Alternatively: deeply invasive OR lymphovascular
invasion OR Grade 2-3:
Age 70 or over: 1/3 present
Age 50–69: 2/3 present
Age 50: 3/3 present
High Stage II Grade 3
Uterine Papillary serous cancers
Clear cell cancers
Stage III-IV

Joan said:

I read about and asked about IMRT radiation therapy There are fewer side effects—well, at least they tend to be less severe. I talked with both of the radiology oncologists I met with about this type of radiation therapy. I didn’t want to demand the treatment if it did not meet the needs of my diagnosis.

This is where trusting your doctors comes in—working as a team for your best care. It was agreed that this therapy would work well and it would cause less severe side effects and possibly cause less long-term problems.