Radiation Oncology for Gynecologic Cancer

If you have cervical, endometrial, or vaginal cancer, your doctor may recommend radiation therapy. Radiation treatment means using high-energy x-rays to kill cancer cells.

Oncologists (cancer doctors) may use radiation alone or with other treatments. It’s an effective way to treat different forms of gynecologic cancer.

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What Is Radiation Oncology for Gynecologic Cancer?  

You may have heard several similar terms — radiation treatment, radiation oncology, radiotherapy — and you’re wondering exactly what radiation is.

Broadly, radiation means energy that travels in the form of waves or particles. It occurs naturally in our environment (sunlight, radon gas, uranium).

Radiation can also be man-made. Experts use man-made radiation in medicine, industry, and research.

The four types of radiation are:

• Alpha
• Beta
• Gamma
• Neutron

When it comes to treating cancer, radiation treatment uses targeted energy to destroy cancer cells. It's best for treating one specific area, rather than the whole body like chemotherapy does.

Doctors may also use the terms radiation therapy, radiotherapy, or x-ray therapy to describe the treatment.

Doctors use radiation therapy to:

• Cure or shrink early-stage cancer.
• Stop cancer from coming back in another part of the body.
• Treat cancer that has come back.
• Treat symptoms of advanced cancer.

Radiation oncology is a medical specialty that includes diagnosing and treating people who have cancer with radiotherapy. A radiation oncologist is a medical doctor who treats cancer using radiation therapy. 

What Gynecologic Cancer Conditions Do We Treat with Radiation Therapy?

At UPMC, we treat the following types of cancers with radiotherapy:

• Cervical cancer — Providers may use radiotherapy along with chemotherapy. Or they may use it to treat cervical cancer that has come back or spread to other organs after treatment.
• Endometrial cancer —Providers most often use radiation after surgery to treat endometrial cancer. Radiation can kill any cancer cells that remain in the treated area. And if you’re not healthy enough for surgery, radiation may be the main treatment.
• Vaginal cancer — Radiation therapy is the most common treatment. Providers may use a combination of internal and external radiation, with or without low doses of chemotherapy.

Less often, we may use radiation therapy to treat localized, very specific cases of vulvar and ovarian cancers.

What Gynecologic Cancer Radiation Treatments Do We Offer?

There are two main types of radiation treatment for gynecologic cancers. Your doctor may use a combination of the two or recommend radiation therapy after cancer surgery or chemotherapy. It depends where your cancer is and what stage it’s reached.

External beam radiation therapy (EBRT)

With this method, providers use a machine to focus beams of radiation at the tumor. It’s like having an x-ray. Some forms of EBRT include:

• 3D conformal radiation — Uses CT or MRI scans to take a 3D image of the tumor and a computer to design radiation beams to fit the tumor's shape. A machine then delivers high-dose radiation beams to the tumor’s exact dimensions. This minimizes damage to nearby healthy tissue.
• Image-guided radiation therapy (IGRT) — Uses advanced imaging to monitor changes in your anatomy and the tumor's size and shape throughout treatment. Your care team can then adapt your treatment to these changes, leading to more precision.
• Intensity-modulated radiation therapy (IMRT) — Radiation beams change strength depending on where they hit the tumor. IMRT allows your doctor to direct radiation to cancer cells while sparing surrounding tissue.
• Stereotactic body radiation therapy (SBRT) — For small tumors, particularly those that have recurred following radiation, this type of treatment may be performed. This treatment typically involves fewer treatments than IMRT delivered every other day to small areas.

Brachytherapy

In this method, doctors place radioactive material into (intracavitary) or near (interstitial) the cancer. They use MRI and CT scans to help find the right place for the radioactive seeds. The two types of brachytherapy are:

Low dose rate (LDR) brachytherapy

This type of radiation treatment takes place over the course of a few days. You need to stay in bed in the hospital, with instruments holding the radioactive material in place.

High-dose rate (HDR) brachytherapy

High-dose rate (HDR) brachytherapy is an outpatient procedure where you have several treatments at least a week apart. For gynecologic cancers, your doctor implants a small tube with highly radioactive material into the vagina or uterus. They remove it after a few minutes, and you can go home the same day.   

What Can I Expect from Radiation Treatment?  

The kind of radiation treatment you have depends on where the cancer is and how advanced it has become. Some radiation treatments happen in the doctor’s office, and you go home afterwards. Others require a hospital stay.  

We may use advanced imaging before and during treatment. This helps to precisely target your tumor and spare healthy tissue. Imaging methods include:

• CT scan — A noninvasive imaging test that uses x-ray technology to create pictures of the inside of your body.
• CT simulation — CT simulation is part of the pre-treatment process. Your care team will place you in the same position where you'll be during treatment. CT imaging confirms the target areas for radiation, and your care team may mark your skin in the areas where radiation will be targeted. This helps your team develop your individual radiation treatment plan.
• MRI — A noninvasive imaging test that uses magnetic waves to take pictures of the inside of your body.
• PET scan — An imaging test that uses a radioactive tracer injected into the body. A specialized scanner picks up the signals from the tracer and displays them on the screen. It can detect where cancer is in the body because cancer cells display brighter.
• PET-CT scan — Combines PET and CT technologies to help doctors pinpoint tumors. It makes it easier to get a tissue sample (biopsy).
• Respiratory gating — A tracking device “watches” the tumor’s position. It briefly shuts off treatment when the tumor moves, due to breathing or other involuntary movements.

Side effects of radiation therapy on your body

Radiation therapy for gynecologic cancer can cause some side effects.  Before your treatment begins, your doctor will discuss how radiation might affect you.

Side effects from radiation therapy may include:

• Diarrhea.
• Irritation to the bladder that causes discomfort or problems urinating.
• Low blood counts.  
• Lowered sexual desire.
• Menstrual changes.
• Nausea and vomiting.
• Rectal irritation.
• Red, peeling skin.
• Tiredness that gets worse a couple weeks after treatment begins.
• Upset stomach.
• Vaginal pain or scarring.

Many of these side effects are temporary and subside in time after your treatment is over. Your provider will go over the potential side effects of radiation therapy with you before treatment.

Why Choose UPMC Radiation Oncology for Gynecologic Cancer? 

UPMC is a national and international leader in gynecologic cancer care. Here are some of the reasons to trust us for radiation treatment:

• Advanced care — We offer the latest cancer treatments available. We also take part in cutting-edge research and offer patients the opportunity to participate in clinical trials. Some of our experts are also researching strategies for treating gynecologic cancers using radiation therapy.
• A team approach — Sometimes, the best care option is a combination of treatments. We work closely with colleagues in surgical oncology (gynecologic cancer surgery) for a team approach to treating gynecologic cancers. Your cancer care team may include experts in many different medical specialties
• Care close to home — We provide gynecologic cancer care throughout the regions we serve. You won’t have to travel far for advanced cancer treatment.

By UPMC Editorial Staff. Last reviewed on 2026-08-06.