Radical hysterectomy vs Chemoradiation

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Hoping for some advice, I've had staging today and I'm 1b2 but the tumour is 3.9cm according to MRI so consultant suggested he thinks surgery okay but as cut off 4cm may need chemo/radiation and reluctant to do both. I spoke with CNS and she says I can have some input given uncertainty between two. I wonder has anyone had surgery and tumour bigger so then need radiation/chemo?

Many thanks:)

  • Hi  

    It’s difficult when there is some doubt about what the best plan is-makes things harder for you when they don’t just tell you “this is definitely what we’re going to do”.

    I had a different situation since I couldn’t have the radical hysterectomy at my stage of 2b, even though my tumour was just slightly smaller than yours,  so chemoradiation was the only option for me.

    However there are ladies in the group who had the hysterectomy and then chemoradiation after. 

    Did your consultant give you the reason why he was reluctant for you to have both surgery and chemoradiation? 

    What I would say is that it is easier to have chemoradiation after surgery rather than before it in my experience, because radiotherapy can cause your organs to stick together inside which can make future surgery difficult. My surgeon did attempt a hysterectomy when my cancer recurred, but I had to be stapled up again without it being done as my radiotherapy damage was too great. 

    I hope some of the other ladies who’ve been in the same situation will come along and share their experiences with you. Do you personally have a preference on what you would like to happen?

    Sarah xx

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  • Hi Keyowni

    I can very much relate to your situation.  2017 I was staged 1B1 (new Figo 1B2) tumour size 3.8cm following MRI and PET scans. 

    My surgeon held a strong view that he wanted to avoid his patients ending up having both surgery and chemo-radiotherapy because of co-morbidities (side effects from more than one type of treatment). With that in mind, and because he said he was 90% sure he could get a surgical cure, I agreed to a radical hysterectomy. Post op histology results revealed lympho-vascular space invasion (LVSI), peri-neural invasion (PNI) plus a close margin and I was restaged to 2A1.  I was then robustly advised that I should have chemo-radiotherapy which I also agreed to. 

    My medical team were very clear with their advice about which treatments I should have so I went along with it despite having misgivings. Afterwards I beat myself up wondering if I should have asked more questions especially as I unluckily ended up with fairly profound side effects from both he RH and chemo-radio. It didn't help that I later found out that the decision to offer me chemo-radiotherapy wasn't unanimous and I felt short changed that I hadn't been given a choice. But then there's no way of knowing what the outcome might have been with a different course of treatment; I'm now 6+ years post treatment: NED (no evidence of disease).

    I was diagnosed with stage 2A squamous cell cervical cancer (node negative) in 2017 following symptoms: persistent, watery, yellow vaginal discharge then post-menopuasal bleeding.  My treatment was a radical hysterectomy followed by chemo-radiotherapy.  My long term side effects include lymphoedema and urinary retention which I manage with intermittent self catheterisation.
  • Hi Beth2

    Thank you so much for sharing your experience with me, it does sound like I'm in a similar situation as yourself. I've since been told there is up to a 50% chance I will require chemo/radio post radical hysterectomy so I'm concerned. I'm so sorry you've suffered from Lymphodema and urinary retention post treatment and I appreciate your honesty. I think I will discuss my situation further with the team.

    Many thanks x