Preventative Treatment

Hi Martha24 and welcome to our group.

It’s always good to be optimistic, so I don’t think that’s naive of you, but it can be hard waiting for all the diagnostic tests to be completed so that you know what’s next.

The tests could give a range of potential outcomes depending on a number of factors. First, it will depend on whether clear margins were achieved in your LLETZ procedure. What this means is that all the area of cancer has been removed with an area of tissue around it which is normal tissue.

Any treatment will depend on collating all results-biopsies, mri etc. These results are put to an MDT meeting (multidisciplinary team meeting) where the medical professionals-oncologists, pathologists, radiologists etc consider a number of patients at each meeting to decide the next steps. These meetings typically happen once a week at most hospitals, and then you get an appointment to find out what has been decided.

Treatment will depend primarily on the stage of the cancer. Early stage cancer (for example stage 1) might be treated by a hysterectomy and need no further treatment, but some ladies may have to have chemo and radiation even after a hysterectomy.

A cancer which is early Stage 2a may also be eligible for surgery, but with any cancer at stage 2b or above, surgery would not be possible at all and patients would have chemotherapy, followed by a combination of chemo and radiotherapy and internal radiation called brachytherapy or just chemoradiation (chemo and radiotherapy given concurrently) with brachytherapy at the end of this treatment.

Several ladies in the group have had a hysterectomy and required no further treatment of any kind, others have had the hysterectomy followed by chemoradiation.

It would not be usual to have chemoradiation first and then surgery as radiotherapy can damage your organs and make surgery more difficult. 

You should still be monitored afterwards if you had a hysterectomy as you would still need cervical screening for example and abnormal cells or cancer can recur even after a hysterectomy. 

I hope this might be  helpful for you, and that others will come along and post their experiences too. Feel free to ask any questions in the group-we have experience in the group of a range of different treatments and stages of cancer, and keep us posted with how you’re getting on.

Sarah xx

Thank you Sarah. 
Yeah the MDT is Friday. 
The hysterectomy is the “best” outcome I figured at the moment when they talk preventative rather than treatment so just trying to find out everything I can about what happens afterwards monitoring wise really. 

Sorry! Also in relation to the LLETZ the consultant said she’d gotten it all when I asked the basic question do I have cancer she said “you did have”.  She didn’t mention margins but I think she’s happy it’s all gone. 
Is that probable or will it still not be clear until all of the results? 

Hope you’ll hear soon after the mdt meets so you know what’s next. There are different types of hysterectomy, so I should have said that future cervical screening would depend on the type of hysterectomy performed if you do have this surgery. 

In terms of monitoring afterwards, I had stage 2b cervical cancer so I was monitored every three months after my treatment ended. This involved a discussion with my consultant and internal examination. I had my first check up 6 weeks after treatment finished. 

There were no follow up scans for me, and this seems typical for others. We are told to report any unusual symptoms and if that happens, the consultant would be likely to order a scan then. 

Sarah xx

The only thing that can confirm that, even though the consultant said she got it all, is the results from the tissue removed being analysed by the lab. Sometimes the lab results can differ from what the consultant thinks. 

Sarah xx

Thank you. I assumed the lab analysis has been done with what was removed? 
I’ve not had anything else removed so don’t think Im waiting for any other lab results.

also sorry for not being clear, regarding follow up you said every three months but for how long a period of time in total? 

The tissue removed in the LLETZ is sent away to analysed by the lab, and you said the consultant had said it was cancer but you didn’t say you’d received the lab results? 

At my stage of cancer I would have had follow ups every 3 months at least for the first year, with the frequency decreasing each year thereafter for 5 years.

Unfortunately my cancer recurred 9 months after treatment so I never got to more than 3 follow up appointments,

The stage of the cancer should determine how often follow ups are but as I didn’t have a hysterectomy as my first line of treatment, I hope some of the other members in the group might be able to give you an idea of their follow up schedule if you have a hysterectomy,

Sarah xc

Well no, I assumed she was telling me what the lab results were. Would that not have been the case? 

I’m not sure, but if she had the lab results I would have expected her to say that clear margins had been obtained or not because that’s an important factor. 

Often very small cancer can be fully removed in a LLETZ, with clear margins, and there might be no need for further treatment in the form of a hysterectomy. But you’d need to be told the stage of the cancer removed and the results of your mri etc.

Sarah xx

Thank you.  I’ll definitely write that down as a question if they don’t give me that information on Friday. 
The hysterectomy was suggested as the preventative measure not treatment, again as I think she’s confident it’s all gone. 

Thank you for your time Sarah, very helpful.