Treatment options

Morning TootyFlutey

i had a PET scan just before my op, and they was a phrase in there that no one could explain to me, but didn’t really change any outcome. I would imagine the report uses quite technical words/language. Hopefully you don’t have long to your appt with oncologist?

I was stage 3A as they found a few cells in one of my ovaries, nothing in cervix,and a mix of grade 1/2.

i had adjuvant treatment, which is basically treatment after they have removed the cancer, and is really an insurance policy to prevent the cancer from coming back, as there could be minuscule little blighters that wouldn’t show up on any scans.

The radiotherapy targets the specific area where cancer was found, chemo targets the whole body.

i actually had two lots of Cisplatin ( chemo drug) with my radiotherapy on days 1 and 22, with my 25 radio starting on day 1. This chemo was to help boost the effectiveness of the radio, I’ve only seen this used for others that were at least stage 3.

i then had 4 lots of Carboplatin/paclitaxel every 3 weeks after this.

the main bit of advise I can say to you is, try to focus on one thing at a time. At my initial appt, I could cope with discussing the first bit of radio/cisplatin, but couldn’t get my head around the further chemo, so I asked them at that meeting to kick that out into the long grass, and not discuss it. My oncologist was brilliant and respected that immediately, and him and his team kept to their word. We only discussed it again once I had completed the radio. There can be a lot to take in/worry about, so try to break it into chunks you can deal with. There will always be time later for further discussions.

good luck for your appt

Hi Tooty Flutey

Adjuvant therapy is where they believe that all the cancer has been removed by the surgery but to be on the safe side they want to do some extra treatment. I was told it was like a mopping up sort of treatment and was doing everything possible to reduce the risk of a recurrence. 

In certain circumstances there can be a higher risk of recurrence. For me - I had a stage 1 cancer but it was a higher grade. I also had some lymphatic/vascular invasion. This is when tiny cells are found in the tiny vessels leading away from the main cancer. They are so small that they are not visible on scans. So it is not just the grade and stage that is important but there are also other factors. It is the whole picture that is looked at to decide whether any further treatment is wise. 

For example mine was stage 1b, grade 3 carcinoma sarcoma, LVSI, ER/PR positive, No MMR, p53 wildtype. All these factors were taken into account. 

Without knowing your results, it would suggest that if your cancer is a grade 2- that could be the reason further adjuvant treatment is recommended. Chemo is used with the intention of mopping up any stray cells whole body wise and radiotherapy is to mop up any stray cells in the pelvis. So together they are a comprehensive whole body treatment. 

My cancer was in 2022. I had the surgery first. Then chemo and then radiotherapy. I remain well from the original diagnosis and have not had any recurrence. Treatment was tough at times but it was doable and we are here to support you. 

I know it is scary to be told that you need some further treatment that was not expected. My chemo was not expected either. 

if there is anything you want to ask about please do so. 

Jane

Hi Waidh, thank you for taking the time to respond to my post. It definitely helped to hear your experience of this, and my brain has calmed. I have been trying to keep my head down and focus on what I am currently dealing with (which is getting over the operation at present). Every now and then though I am forced to look ahead and it is scary, especially the thought of chemo. 

Jane, thank you for your informative post, which was very helpful. It really is far more complicated than I had thought - I did not realise there were so many factors they take into account when planning treatment. 
it is quite exhausting wondering and imagining when you don’t have all the facts. I don’t have an appointment yet, but hope it will be this week so I can just get on with it. 
im glad to hear you continue to be cancer free ️

My advice is to continue to focus on getting well after the surgery. Once you have had your meeting hopefully things will be clarified. Hopefully you should hear something this week, if not give them a ring. 

It is difficult to know without having all the facts but I would imagine they are suggesting the further treatment due to it being a higher grade- especially as they said your stage has not changed. (suggesting it has not spread any further than originally thought.)Where the grade is higher (2 or 3) then adjuvant treatment is normally recommended to mop up any stray cells that may have been missed. Its a sort of belt and braces treatment to give the best chance of avoiding any trouble in the future. 

With a higher grade cancer they tend to offer adjuvant treatment at an earlier stage. I am sure they will go through it all at your appointment and you'll have a chance to ask any questions. I remember taking in a list to mine. 

Hi Jane, thank you for your further comments on this. I will chase if I don’t hear anything. Although so far my experience has been very positive with things happening at speed. I have just returned from a CT scan that follows histology result which were only ready Wednesday morning! I am lucky. 
You are right that I should focus on my post op recovery, and that is going well, which is making me feel positive.