Stage 1a to 2 after hysterectomy possibility’s

Hello Mollysue 

I'm not that experienced on this forum and I'll do my best for you. Stage 2 does mean cervix is involved (I think that's correct).

Adjunct treatment depends on many things:

The final staging.

The final GRADE and TYPE of cancer.

Any blood test results re Pole Mutation/Lynch Syndrome/ and and other tests such as these.

Any evidence of LVSI.

There are no set rules about treatment either as hospital policies may vary slightly. 

That is what makes everything impossible to predict exactly  - everyone is an individual and treatment is tailored to your individual results and circumstances. 

Waiting for the final results is hard but they will soon be here and you will have clarification. But please be reassured that if you need adjunct treatment, they will do what is best for you. Hopefully you won't but no-one can predict anything until all results are in.

I hope you are recovering well Mollysue and enjoying the sunshine. Spring is on the way and that is a wonderful time of year to continue to recover and heal.

Hi mollysue, here’s what the Macmillan site (the website that contains this forum) says about it - it’s worth checking it for any info you need as it’s a safe reliable resource:

Just going by what my own consultant said to me: he said statistically MOST stage 1A stay 1A post histology, some change to 1B and a few change to stage 2 or further (rare). Mine was one of the few that changed - with a few cells being found on top of the cervix. That changed mine to a stage 2 and I was offered radiotherapy as a precaution/insurance policy/belt and braces. He did say it was a technical stage 2 and that if he’d sampled any lymph nodes during my op and they’d been clear, I wouldn’t be being offered radio, but this was a just in case thing. 

Hi Mollysue

Stage 1A means the cancer is on the inside of the womb and it has grown less than 50% into the muscle wall.

Stage 1B means that the cancer is on the inside of the womb and it has grown into 50% or more of the muscle wall.

Stage 2 means that there were cancer cells found in the cervix. The cervix may appear normal in scans but if any stray cells are found during the post op pathology then it would become stage 2.

To become stage 3 there would need to be cancer cells found anywhere on the outside of the womb surface, fallopian tubes, or in any lymph nodes. 

To become stage 4 there would need to be some cancer cells out of the pelvic area for eg attached to bowel etc. If they had seen anything like this during your surgery they would already have mentioned it. 

Treatments can vary between hospitals, depend on your medical history, stage, grades, LVSI, genetic markers etc. 

Surgery is the normal first line treatment.

Brachytherapy (internal radiotherapy) tends to be given to try to prevent recurrence at the top of the vagina - as this is where local recurrences may happen. It can be given at any stage and grade. I did not have it as I had no cancer cells in my cervix. Cancer can grow in different directions and mine was going side ways into the muscle of the womb, rather than downwards towards the cervix. So in my case if mine had been left and continued to grow into the muscle of the womb it could potentially have missed stage 2 and gone to stage 3.

External beam radiotherapy can be given for any stage and grade. I had it at Stage 1b and it is was to prevent recurrence in the pelvic area. LVSI was a factor. 

Chemo can be given at any stage or grade. I had it for stage 1b. It was to prevent whole body recurrence. Certain factors mean chemo is considered- eg higher grade, higher stage, genetic factors, Lymphatic or vascular invasion, type of womb cancer.( adenocarcinoma, serous, sarcoma, clear cell etc)  It seems to be used more often in type 2 endometrial cancers. For type 1 cancers other factors may have to come into play. 

There are so many factors Mollysue and so many different types, stages and grades and the best thing to do is to wait for those results and then talk to your doctor about what they advise. 

I remember my own CNS saying to just be aware that there are sometimes further treatments but no one can be 100% sure until the pathology- that is what it is for - to have a thorough look and to make sure nothing is missed. 

Have you phoned your hospital at all and asked for an update. I did that myself. If you know when the MDT meet then that day is a good one to call. 

Jane

think they meet in a Friday not sure so hope to get a apt next week 

they said waiting longer doesn't  t mean it's bad news just taking time and have up to 4 weeks 

My gyno never said she was taking a sample of my lymph glands surely she would have said before my op if she was going to ? 

My surgery was listed as total hysterectomy with BSO and sentinel node biopsy and my consultant explained that I would be having the lymph node biopsy also and this was the reason I could not have the surgery at my local hospital. 

Molly sue, I would really try to distract yourself with something that nourishes you as you will keep going round in circles second guessing, unfortunately you cannot know the answers from the histology until they are given to you. I totally understand your anxiety, I have been waiting for over 10 weeks for the results of my Lynch Syndrome test and am just trying to keep busy.