How to pick the right treatment route

Hi Sssss and welcome to our group.

I would agree with your consultant to focus on the word curative! I haven’t seen anyone else in the group (that I can recall) being offered a radical hysterectomy at stage 2b as it is usually only offered for cancer which is stage 1, or occasionally stage 2a. I was diagnosed with stage 2b, and was only offered chemoradiation, as were many of the ladies in the group. Are you in the UK?

I’d recommend writing a list of the pros and cons of each proposed treatment as you see them for you and your life and situation.

A radical hysterectomy is a major surgery, and there can be no guarantees that you wouldn’t need chemoradiation afterwards if there are any cells remaking after surgery. Everything which is removed in surgery is analysed by pathology and to see whether clear margins have been obtained in what was taken out, and further treatment might still be needed, depending on the results.

With chemoradiation, the treatment is intense over a fairly short period of weeks but is usually very successful. You need to be warned of all the potential side effects in order to give informed consent to treatment, as you do for surgery. Not everyone will have any or all of the possible side effects, but you can’t predict in advance which may affect you. Usually at stage 2b you would expect to have around 5 weekly sessions of chemotherapy which helps the radiation do its work. 

You would need to ask your doctor about egg freezing, as obviously the hysterectomy would remove the chance of having a baby naturally, and radiation treatment would usually put you into a surgical menopause. I don’t think any of us in the group would be able to advise you on this as we are just patients ourselves and not medical professionals. 

I think we can all worry about the potential loss of dignity during any treatment in this particular area of our bodies, but I’ve always found staff to be very respectful, and mindful of this. To undergo pelvic radiation you don’t need to undress, you are only required to pull your clothes down a little, and are covered by the nurses as you’re prepared for each treatment. 

I’d recommend making a list of questions for your doctor about the potential outcomes of surgery versus chemoradiation, and potential egg freezing, but ultimately when you are given a choice like this, you will have to make the decision on which way to go. I’m not sure you will find anyone else in the group who has been offered this choice at stage 2b, so it might be difficult to find others to connect with in the same situation. However we do have many ladies who have had either the radical hysterectomy for a lower stage, or chemoradiation as their first line of treatment at stage 2b and above.

Sarah xx

From what they have seen on the MRI it is only just 2b and not spread very far. This is why they are considering both routes. 
it’s the internal radiotherapy that has really freaked me out having tubes inserted for that. 

Stage 2b means that it has spread a little, but not far-it’s classed as “locally advanced” cervical cancer, as mine was. But this put a radical hysterectomy completely off the table for me based on my mri scan. 

I wasn’t able to have brachytherapy, so I don’t have experience of it, but most of the ladies in the group did have this as the last bit of treatment and I think everyone found the thought pretty daunting-I know I did when I assumed I would be going through it. However, I looked on it as the last thing to blast any cancer remaining and I was devastated to find out I couldn’t have it. Hopefully others may read your post and be able to comment with their experiences. 

Sarah xx

Hi Ssss

My situation had some resemblance to yours so thought I'd share my experience.

I was intially diagnosed with grade 2 1B1 (1B2 new Figo) squamous cc in 2017 and was advised to have a radical hysterectomy - the surgeon said it gave me a 90% chance of a cure. Unfortunately my post op histology showed the cancer was bigger than first thought and was restaged to 2A1. On account of lympho-vascular invasion, perineural invasion and a close margin (all revealed by the post op histology) I was advised to have chemo-radiotherapy as well. So ironically I ended up having more treatment than other ladies with a higher stage initial diagnosis!

I don't have any experience of egg freezing but I would ask - I wouldn't want to look back and wonder.  As for the dignity side of it; all the staff I interacted with were very respectful of my dignity at all times and I quickly became relaxed, and almost blase, about being examined etc.

Although I was advised, and accepted, which treatments to have I can understand your angst about making a decision. Something you cannot know is how your body will cope the treatments in terms of short and long term effects. It's good you are putting a lot into making your decision because, whatever the outcome, at least you can look back and know you did the best you could given the circumstances.

Thank you for sharing your experience with me x

Thank you x