Hi Everyone,
Hope you are all enjoying the holiday season as much as possible!
My wife was diagnosed with Stage 4b endometrial carcinosarcoma back in May. Surgery was unsuccessful at first. She has gone through 6 sessions of chemo (which brought the ca-125 number down from approx 500 to 20).
After chemo she underwent a radical hysterectomy which was successful. Scans have revealed no visible cancer, but, CA-125 is back up (after 3 months post chemo) to 55 or so. She has now been scheduled for Radiotherapy (5 weeks.. M-F).
My question is:
I believe the Radiotherapy will have a positive effect. IF/WHEN the number starts to rise again what treatment is next?
In other words, after radiotherapy, are we now out of options? (Note that Immunotherapy has been ruled out by the Oncologist)
Many thanks and take care
Hello JamesYSK
Am sorry to hear about your wife's cancer journey. I had carcinoma sarcoma but at a different stage to your wife.
My treatment was surgery, then chemotherapy and then the external beam radiotherapy.
I found the radiotherapy tiring and I did have some tummy effects but they can offer medication to help with these. I hope that your wife's radiotherapy goes well. It was daunting at first to think of 25 sessions ahead but once they were started they went quicker than I thought. The travelling to and from hospital can be tiring and your wife may well need to adjust her diet to quite bland food. I found that because I had chemo before the radiotherapy that the side effects were somewhat enhanced but it is still very much doable.
You have asked what next and it is hard to predict without knowing all your wife's medical details. As you are probably aware there are quite a few different types of womb cancer and some can respond differently to different treatment.
I asked my oncologist what would happen if mine returned and she said it very much depends where it is and how much it is. If it returned in one area then surgery may be an option. Chemo could be repeated and if one chemo regime did not work then there were several other regimes that could be used. I was told radiotherapy could not be repeated in the same area unless it was to control symptoms or bleeding. With radiotherapy, although they do their best to protect healthy tissue- there can be some damage. When your wife has her radiotherapy it continues to work for some months following treatment. I did not realise this was the case at the time.
You mention immunotherapy and are right in thinking it is not helpful for some cancers. I am not sure for mine if that would be an option.
As I say, it is hard without knowing all the details and we are not medically trained but here are some links that may help. You could perhaps talk with your wife's oncologist to see if these may help in the future. Sometimes treatments that have been previously successful in holding things at bay may be offered again and sometimes it can be a combination of treatments.
Targeted therapy | Macmillan Cancer Support
Hormonal therapies | Macmillan Cancer Support
Cancer clinical trials | Macmillan Cancer Support
I hope this helps a bit. The Support Line will be open again tomorrow at 8am -8pm and it may be worth giving it a call and speaking with one of the nurses. They would be able to talk you through these treatments and may well know of other possibilities.
I wish you both well and hope that your wife's radiotherapy treatment goes well. If there is anything else you need, then please do ask
Jane
Thank you Jane -- helpful 
