Hi everyone,
I am trying to decide whether to go ahead with adjuvant localised pelvic radiotherapy to lymph nodes using VMAT, and I would really appreciate hearing from anyone who has had adjuvant pelvic radiotherapy, especially about short-term and long-term side effects and how you coped with them.
For context, this would be after a radical hysterectomy for stage 1B2 cervical cancer. The tumour was fully excised at LLETZ with clean margins and no LVSI, but isolated tumour cells were found in one sentinel node on ultrastaging, which puts me in a grey area where further treatment is optional (I am still stage 1B2). The MDT recommends treatment to reduce the risk of nodal recurrence by 50% (they mentioned current risk at 15% if there were any cells left behind, which they don’t know).
The plan would be external radiotherapy only, no brachytherapy, using VMAT, targeting one side of the pelvis and the central area near where the cervix was.
I would be very grateful for any experiences or tips you are willing to share that can help going through the treatment.
Thank you!
Hi Kamuka1e94e2
it can be difficult to make decisions when you’re faced with a choice to go ahead with a particular course of treatment.
Most ladies in the group who have had radiotherapy have had EBRT (external beam radiotherapy) and I haven’t seen VMAT radiotherapy specifically mentioned here before. As it is a very targeted type of radiotherapy, there may be less potential side effects, but if someone has had this specifically, then they may come along and share their experience.
Speaking from my own experience of actually having had a recurrence, and knowing how difficult that made things for me, I would personally want to take any further treatment which reduced that risk, especially when cells have been found in a sentinel node. My cancer recurred when cells were still there after treatment but were too small to be seen on a scan. There is never a guarantee that every single cell has been removed by treatment, whether by surgery or other treatment, and I did not have cancer cells in any nodes that could be seen, but it still grew again.
Side effects from pelvic radiotherapy don’t happen for everyone, but may typically affect the bladder and bowel. My side effects kicked in when I was 3 weeks into treatment, and involved radiation cystitis and diarrhoea. I was given cream and tablets to help with these and they all disappeared soon after treatment ended. Everything went completely back to normal and I had no long term effects at all. I did feel very tired as the treatment went on, but again this was a short term effect.
Treatment itself is short for each session and painless. It took me much longer to actually travel to the hospital and get set up on the table than it did to have radiotherapy itself.
It’s a personal decision to go ahead when adjuvant treatment is offered, but cancer can be a sneaky beast, and being present in the nodes does give an extra risk, even when it’s small, of spreading through the lymphatic system. You may feel happy to live with that risk and decline further treatment, but the MDT is recommending it to further reduce the chances of it happening because it can be harder to treat once that’s occurred.
Hopefully you can come to a decision you’re happy with, and it will be the right one for you in your own particular circumstances,
Sarah xx
