Stage 1B

Hi Robe H,

Sorry you find yourself here.

My understanding is if its Stage 1b, she would need an operation and then some form of radiotherapy. It could be that he is just warning you in case it is not stage 1B after the operation.

I was told I was 1A, and had all the lymph nodes removed round about. They were clear, but they didn't know that until after the operation. I was also told I might need radiotherapy. After the operation, once they have examined everything, I was told I needed no more treatment, so I think they err on the side of caution!

At the end of the day they are not going to give you stuff you don't need and I really believe they know what they are doing. Try not to worry too much. xxx

Hi Robeh,

everyones treatment plan is tailored to the individual and will depend on different factors. After the operation they will test everything they remove and that will let them provide a final diagnosis and treatment plan. So treatment can depend on, for example, whether there is any evidence of the cancer in the lymph nodes when they sample them, they are basically looking for anything that the eye can't see. They usually fill the pelvic area with fluid and then remove the fluid and test for cancer cells too.

Try and focus on the operation first, it'll be a few weeks after the operation before they have the pathology back. When they have the results back they will explain all of your mums treatment options and the benefits of each, if your mum wants a second opinion she can ask for one and if she wants to discuss her treatment plan there is a great gynaecologist nurse specialist service at the eve appeal. 

lots of love

xxx

HI ,

It sounds as though you are very lucky with your consultant who is taking a careful approach with your Mum.  I was diagnosed with stage 1a grade 2 endometrial cancer.  I had no lymph nodes removed  but the pathology following surgery showed LVSI ie some cancer cells in the lymphatic channels. I was advised to have external and internal RT to the pelvic area  as a preventative measure to reduce the chance of recurrence. .  Even so for some time I did wonder about whether there were other nodes that might have been affected. 

There is some variation in the opinion about the value of routinely removing lymph nodes as there can be complications like lymphoedema later on.  Many centres only remove them if there is indication on the scans that it is needed  but there is always the possibility of a rogue node.   

Your consultant seems to be taking extra precautions in trying to establish more positively whether there is a need to clear the nodes during surgery rather than just doing it as a routine matter.   

It is always the case that until the final histology is available after surgery, no  suggestions can be made about any further treatment.  The age of the patient and the grade as well as the stage is taken into account as well as any spread into the lymph nodes.  Every patient is different. .   The extra step your surgeon is taking will give more information and will have lessened the chance of unnecessary harm to the lymphatic system.  

Thank you for these informative responses, everyone, very helpful and much appreciated.

Hi, I was told prior to surgery that I had a grade 1 type of cancer which was very slow to spread and then after surgery when all the bits were sent away to histology I was told that I was staged at 1b, that is confined to the womb, but with growth through more than 50% of the wall. In my case I was originally staged at 1a (less than 50%) but was regraded because the wall of the womb was distorted by fibroids which made it hard to measure accurately  the distance of the cancer from the outer edge of the womb and they went for a worst case staging. I was therefore offered a couple of sessions of brachytherapy which the consultant described as belt and braces. They also checked for LVSI as part of the post op histology, which indicates if there is any spread to the blood or lymphatic system. Fortunately in my case, nothing was found so no need for any further lymph nodes removal or treatment. I think basically what happens is that whilst they can give a probable staging pre-op, in my experience, they like to wait until everything has been fully tested post-op before they give an absolute definitive staging and they like to wait for that before committing to a final post-op treatment plan. What they've told you so far all sounds very positive and an operation may be all they recommend, but I would say, even if they suggest more treatment, it is usually very doable and most people are successfully treated. Take heart, there is lots of reason for optimism.

Mind was 1B and I had brachytherapy after surgery recovery. I was told by my hospital it didn't look aggressive under the microscope and the brachytherapy was a preventative to reduce the chance of cancer occurring in the vaginal vault.