Hi ,
I am from Essex originally but currently living and being treated for high grade 3 endemetriol cancer in Singapore.
After having a total hysterectomy (which I’m recovering from brilliantly) my stage on the histology said 2b - no cancer found anywhere else, 1.8 cm tumour and less than 50% into the lining.
However when I went to the radio therapist he said I was more like a 1a and explained that FIGO cancer staging changed 18mnths ago to take the high grade more into account hence me being put on a pathway for chemo and brachytherapy. He didn’t seem to feel the chemo was warranted but also didn’t say that outright!
So I’m a bit confused abd can’t decide if I want to go ahead with the chemo. I’m waiting for pole test results and trying to get a second opinion from a UK oncologist.
I know there are so many variables but I’m interested to hear what follow up treatment did anyone else have in a similar situation?
Hi Sloop
Welcome to the Womb group.
I am sorry to hear of your diagnosis.
The grades and stages can be confusing and I know that the staging (FIGO) was adjusted.
I was stage 1 but high grade and had chemotherapy and external beam radiotherapy.
It is not just the stage and grade they use but also some of the genetic results. Also LVSI can make a difference.
There are also different types of grade 3 endometrial cancer. Mine was carcinoma sarcoma- there are others such as serous, clear cell etc. So its the whole picture that is normally used.
Normally a stage 2 endometrial cancer would involve some cells being found in the cervix and this would indicate brachytherapy would be useful. I did not have brachytherapy because no cells were found in my cervix. Stage 2 would be considered as confined to the uterus.
I did not have a POLE test and was told that it was not indicated due to my post op results. Apparently something would have shown up which would indicate the need to look further. From memory I had no MMR, was ER/PR positive and P53 wild type.
My chemo was due to it being a grade 3 cancer and it was explained that although I was stage 1 they could not guarantee that there were no tiny cancer cells that had been left behind. At the smallest size they would not be seen on scans but in time, in some people, especially with a grade 3 cancer, could develop and set up elsewhere. it was explained that it was easier to mop up any stray cells that may remain rather than wait for them to potentially set up elsewhere. Then they would be much harder to treat. They also explained that a grade 3 cancer or one with LVSI could mean that tiny cells could travel via the lymphatic./blood systems.
At my hospital any grade 3 was treated with chemo and radiotherapy. If cells were found in the cervix brachytherapy would be used. I had 25 sessions of external beam radiotherapy. There can of course be variation between hospitals.
There is no harm in getting a second opinion and have someone fresh look at the entire post op results. Only you can make the decision regarding which further treatment you would like to have, but just make sure you have all the information you need.
Jane
