my wife had histerectomy for grade 1 stage 1a ( probably) at three week post operation review they told us it was boarderline 1b or 3a as had grown nearly all the way through the womb wall. Now about to start 27 days radio therapy with 2 additional chemo days- this is middle option between do nothing or full radio and full chemo.
Very strange that they can't say if any cells have escaped the womb- no test, no scan unless something grows to 2-3mm on a ct.
Hello RoRho
Welcome to the Online Community and the Womb group.
I am sorry to hear of your wife's womb cancer and subsequent hysterectomy. It must be a worrying time for you both. I hope that she is recovering well from the surgery.
With womb cancer the doctors can give a provisional stage and grade before surgery but this may sometimes change with the more detailed pathology that is done post op.
So your wife's provisional grade 1, stage 1A was what they felt it was before the hysterectomy. Grade 1 means it is lower grade and that the cancer cells have only changed a little from normal cells- so that is good. Stage 1A is when they believe the cells are contained within the womb and have not grown more than 50% into the muscle of the womb. I expect your wife would also have had an MRI or CT scan to confirm that the cancer was contained.
After surgery it sounds as if the grade was as expected. But that the cancer had grown further into the muscle of the womb than first thought. This is sometimes difficult to see on scans and the extent can only be confirmed post op. 1b means that the cancer had gone more than 50% through into the muscle. 3a means that some cancer cells have possibly reached the outside layer of the muscle. Once there it is possible that some tiny cancer cells may have escaped and in some ladies, in some circumstances and in time set up elsewhere.
Follow up treatment is then suggested as a way of mopping up any potentially escaped cells as it is easier to deal with them at a microscopic level rather than wait until they are big enough to be seen on a scan.
It can be hard when you expect the surgery to sort out the cancer and then to be told you need further treatment. I remember it well and it can be hard when you see the treatment out ahead of you. I had both chemotherapy and radiotherapy. It wasn't easy at times but it is doable and for me the thought of it was worse than my experiences. Yes there are side effects but most were controllable with medication and support from my team. I am sure your wife will be well looked after.
If you click on my name, my profile will come up with some timings of the treatment, but I am almost 2 years post treatment now and on 12 weekly check ups.
It is tough to watch someone you care about going through such a diagnosis and the treatments that follow so if you feel like talking things through would help, then please do give the Support Line a call. The details are below.
If you have any questions about the treatments or anything else that would help, then please do ask. There are many ladies on here who are happy to share their experiences and offer support.
I will also pop a link to the Family and Friends forum as I wonder if this may be of help to you.
(+) Family and friends of people with cancer forum | Macmillan Online Community
I wish your wife well with her recovery from the surgery and hope that her further treatment goes well.
Jane
Hi RoRho
I can understand your concern.
I think it is the stage that is making them recommend follow up treatment.
If the cancer cells were found growing into the outer surface of the womb (serosa) then this would be a possible stage 3a. Because a stage 3 cancer has a higher chance of coming back they would tend to offer adjuvant treatment to mop up any stray cells.
Staging with womb cancer is
1a- grown less than 50% into muscle wall
1b-grown more than 50% into muscle wall
2- cells are found in the cervix
3a- cells are growing into the outer lining (serosa)
Have they mentioned LVSI? This is where tiny cells are found in the blood/lymph vessels. Was a type of cancer mentioned? (some types can have different recommendations for treatments) When they are looking at the pathology there is quite a lot of different factors involved. ( Mine included No MMR, P53 wild type, ER/PR positive for example)
I myself was stage 1b and had chemo and radiotherapy.
The idea was that chemo would tackle any cancer cells whole body wise.
Radiotherapy would tackle local recurrence or in the pelvic lymph nodes.
Have you got a supportive CNS that you can talk things through with? They would have all the medical details and would be able to explain exactly why the treatment is needed. Alternatively you could call the Support Line and talk things through with one of the nurses.
Jane
