Hello (Apologies if this has been discussed before). Basically I’m Grade 3 3C1 recently diagnosed and 3 weeks post radical Hysto. They are keen to get started on the treatment. I went to see the Chemo Dr today and the plan is 6 Weeks Chemo (Paclitaxel and Carboplatin), 5 Weeks Radio on pelvic lymph’s and 1 week Bracheo. This all sounds rather standard from browsing through this excellent resourse. I have a couple of questions:
1. The Dr said that was the best combination of chemo drugs from last century's research (Has there not been any research / trials done with Chemo in the last 20 years for womb cancer?)
2. I’ve read a lot about Immuotherapy e.g Dostarlimbad - I didn’t really get a clear answer why these are not deployed sooner as they seem more effective.
I think that’s about it for now … but any links or tips on choices are most welcome
Hi Rachart
From my understanding and experience the treatment you are being offered is the standard first line of treatment. It's being used because it has a good track record for working and although as with all treatments there are side effects these can usually be well managed/tolerated. So the benefits outweigh the negatives.
The chemo combination is a standard one and it is basically trying to stop rapidly dividing cells by destroying them. Healthy cells (such as hair follicles etc) can recover but the cancerous ones do not. Its a systemic treatment so it affects the whole of your body so it is used where there are chances that the cancer could spread further afield. Although your cancer is locally advanced the chemo is trying to sort it in pelvic area but also trying to mop up any cells that may have got into the blood/lymphatic system or spread further afield.
External radiotherapy is aimed at destroying any cancerous cells in the pelvic area (including lymph nodes) and it does this by altering the DNA and stopping the fast division of cells. So its similar to chemo but works in a bit of a different way. So its trying to get rid of any cancer specifically in the pelvis before it gets a chance to go further afield,
Brachytherapy is used to treat the area local to the top of the vagina and where the cervix was. This can be an area where cancer can return.
So combined the three treatments are working on whole body, the pelvic area and the area where recurrence is most likely to begin with. So it pretty much covers it all and gives extra treatment in the local area.
With immunotherapy the effect is a bit different and from my understanding it is teaching the body to recognise the cancer cells and to use the immune system to deal with them. So it seems to be offered as a second line treatment as it can take longer to have an effect. So the chemo starts to work more quickly. There have been trials where some chemo and immunotherapy is used together but from what I know these are still at an earlier stage and they are used for advanced cancer and there are different criteria that need to be met before they are approved. Because of the way the treatment works the genetic factors will come into play. It is not suitable for everyone. With immunotherapy there can also be different side effects that can be challenging so its back to the positives vs negatives.
When I had my own discussions with my oncologist about treatments it was explained that the first line treatments are chosen as they are likely to be best tolerated with the best outcomes. Sometimes as well it is about the timing of treatment. Some treatments eg radiotherapy can only be given to the pelvis once so for some people it is best they are done earlier whereas for others its best to keep them banked in case of recurrence. It does seem to involve a lot of different factors. I asked what would happen if I had a recurrence and was told if it was small and local then surgery might be an option, if not then chemo. The chemo would likely be the same one as that had been effective before. If it wasn't then they would look at different chemo. Immunotherapy would be looked into only if the chemo stopped working.
Hope this helps. I wish you well with your treatment
Jane
Hi Hop5
I understand and get that you get worked up about your appointment then when you get there it's all information that we don't really take it in, if possible take somebody with you to listen. I took my daughter as she would understand better than my husband and she would think of questions to ask. I'm glad I did as when we relayed back the information given, I had missed bits that had been said by the consultant as I was thinking about the previous item discussed. I had my chemo as belt and braces approach in 2022, I've received excellent treatments and so grateful to the NHS.
Just thinking if they don't want to punish your body too much now and save other treatments available if you need them in the future? (Hopefully not)
I did read that a lady was similar grade and stage to you and she's had no recurrence since first line treatments, found info on cancer research site, if I find the item will copy and paste it for you on here.
Hopefully all goes well for you. Here's a screenshot of post from cancer research forum x
