Do I have/ need radiotherapy after surgery for grade 1 stage 1A endometrial cancer

Hi Liverpoollou

I am sorry to hear of your cancer and I hope that you are recovering ok from the surgery.

What normally happens is that you are given a provisional stage and grade before surgery and then afterwards everything that is removed is sent to pathology to be looked at in more detail. These are the results that they look at to see if you need to be offered any further treatment. My results took 3 1/2 weeks to come back but there can be a variation in this.

Stage and grade are important in determining whether any follow up is needed but there are also a few other markers that can be taken into account. For me my results went to the MDT and discussed and then I was contacted with a suggested treatment plan. 

I had both chemo and external beam radiotherapy. I was stage 1b carcinoma sarcoma. 

I did not have any brachytherapy although there are several ladies on here who have had this. 

Radiotherapy is to help reduce the risk of recurrence/mop up any stray cells in the area where recurrence is most likely. Chemo is to mop up any cells whole body wise. Sometimes there can be other reasons for it to be given.

If you are recommended to have radiotherapy nowadays it is very targeted to go to the area where it is needed. 

As far as I am aware it is normally only chemo and/or radiotherapy that is offered as an adjuvant treatment. There are hormone treatments used in certain circumstances. 

From what I understand, if you do have radiotherapy it needs to be done within a certain timescale. 

I went with both treatments after a lot of consideration. I am glad I did. My oncologist said that it was better for them to deal with any tiny cells that remained while they were to small to be seen on a scan rather than wait for them to potentially set up elsewhere. So it was basically it is better to mop up the cells now than deal with a recurrence that could be harder to treat. 

You are right in thinking that radiotherapy is not normally given in the same area twice. 

I would recommend waiting and seeing what your post op results come back as, it may well be that if you remain low grade and low stage and there are no unexpected factors- that you may not need further treatment. Making treatment decisions can be hard so perhaps give the Support Line a call and talk things through.

I hope you do not have to wait too long. I wish you well for your recovery.

Jane

Jane. Thank you very much for your reply. This has all happened so fast. Diagnosed on 13 November to hysterectomy on the 2 December so a lot to take in and process. It’s the waiting for results that are the worse as so many thoughts go through your mind. It is so helpful having an outlet through this forum to ask questions etc. At the moment I just want to not go through any other treatment if that is a viable option. Of course that may change when I get the results. 

It does all happen very quickly for some of us. I remember waiting for my results and it was really tough, it almost felt better once I knew- even though they weren't as expected. 

I wasn't expecting to have to have the further treatment I did, so the shock was tough. I suppose if you find out a bit about the potential treatments it can help to have some background info so you can make an informed choice when the time comes. 

And do ask away on here- it does help to share any worries. 

Thanks again xx

Hi Liverpoollou

I hade the same op and grade of cancer as you.  It really does depend on the results of the histology on whether you are offered adjuvant treatment. The consultant at the hospital where I had my operation told me I didn’t need further treatment (before receiving the outcome from the MDT). I then received an appointment with the oncologist at the regional cancer centre which was a bit of a shock. The histology had shown the presence of LVSI (I think about a third of cases have this but I could be wrong). The oncologist was excellent and took me through all the options and I had time (a couple of weeks) to make up my mind and she said she would support whatever decision I made so I didn’t feel any pressure. In the end I opted for four sessions of brachytherapy. Like you I was really reluctant to have further treatment but the discussions I had with the oncologist helped allay my fears and weigh up the pros and cons.

Hopefully you won’t need any additional treatment but if you do I hope you are supported in whatever decision you make like I was.

Thank you. What is LVSI? 

LVSI is the presence of cancer cells in the blood vessels outside the tumour.  So although everything was captured by my operation I opted for the adjuvant treatment as a belt and braces approach. 

Thank you.

Hi Liverpoollou, could I ask where you’re doing all this reading? Is it info the hospital has given you or have you been Googling?

I’ve probably been googling too much