HELP - DECISION TO MAKE

Oh bless you Maddy. What a tough call. I’m not the stage or grade that you are, so I can’t offer any opinions. My radiotherapy was offered to me as optional but recommended. I really feel for you as I honestly don’t know what I’d do in your position. What do your family think?

Family are divided 

I was ready for chemotherapy as from what I've read it's the 'right' thing to do with this type of aggressive cancer. The surgeon when discharging me after the op was adamant I should have Chemo. The MDT team changed this to my decision.

What would the planned process and timing be if you said yes to both? 

If you are offered Carboplatin I would take it.  It's my 'belt and braces' approach due to a ruptured tumour (ovarian cancer - stage 1c2 (grade 2)) but my endometrial cancer was treated with my hysterectomy. 

Do you know which chemo drug your surgeon was thinking you should have?  

I don't know if they have told you the names of the potential chemo drugs but if you were to be offered Taxol that might be a bit of over treatment (and you would lose your hair with Taxol but not with Carboplatin).  

My Carboplatin takes two hours once every three weeks with a blood test a day before.  Very easy to manage but my blood count is a bit off at times.    

You say you are asking for opinions - mine is definitely have Carboplatin but I will leave it to somebody more knowledgeable than me to say whether you also require Taxol.    

Hello lovely I wasn’t given the options I was told that I would need chemo and brachytherapy. I found out January this year that I was officially clear of cancer after my hysterectomy December 2020. They advised me to have 4 rounds of chemo 21 days apart and 4 brachytherapy to ensure that like you said if any stray cells had escaped. So personally I’m glad I had the chemo and brachytherapy xxx

6 cycles (18 weeks)of Carboplatin and  Paclitaxel first then 3 sessions of Brachytherapy one each week - if I decide on the chemo. Due to start six weeks following op. Roughly week beginning 7th March. X

That's really helpful. How did you cope with the chemo? X

I was fine with the chemo I just experienced bad bone pain on the 3rd day for about 3 days and that was it. I wasn’t sick at all I did have nausea but they give you anti sickness drugs and they help a lot. My chemo nurse said because I’ve had 5 children was I sick with each pregnancy I said no and she said you won’t be sick and she was so right. My hair fell out on the 2nd treatment but I wasn’t left completely bald I had whispy hair, it has grown back lovely and curly which I never had xxx

Dear Madesp.  I was diagnosed with Grade 3 stage 1A Serous and Clear Cell 6.5 years ago. Like you I was given a choice about chemo.  It seems there is still not a definitive answer about whether the risks of chemo outweigh the benefits in cases like ours. I did lots of research and spoke to two oncologists and my surgeon. I will tell you my interpretation of the situation.  Because these type 2 cancers are rare, there are not enough randomised trials to inform decisions.  The two oncologists I spoke to thought there was about a 30% chance my cancer would recur. Chemo would probably reduce this to about 25%. But Chemo has risks. One oncologist didn’t think the possible benefit outweighed the risks. The other was slightly more in favour of me having chemo.

Another way of looking at it is that if 20 ladies have Stage 1A serous. Estimates are that 6 of them will have a recurrence if none of them have chemo. 5 of them will have a recurrence if all of them have chemo.

I decided not to have chemo and just had brachytherapy. I am well and healthy, without a recurrence, 6.5 years later. I am very grateful. I have seen ladies on this forum who have said they feel they should do everything possible to prevent a recurrence so have chosen all available treatment. I know how stressful it is having to decide, but when the evidence is so finely balanced you could say it is right that our medical teams have given us the option to decide.

If you decide to consider my interpretation please discuss it with your team. I have no medical training. Your case may be different to mine and more could have been learnt in the last 6.5 years.

I hope you get good support and help while making this important decision. Sending you very best wishes.

Em (Class of 2015)

Thank you that's really useful they way you have put this and I will put this to the doctor before I decide x