To Brachy or not

Hello

I had Grade 3 Stage 1a cancer and was given the choice of nothing, Brachytherapy or 25 seeions of external beam.

i chose 3 sessions of Brachytherapy as it significantly reduced of chance of

local reoccurrence at the cuff.

The initial session to do the initial setup was longer but the following sessions were literally 8 minutes of actual treatment and was in and out of hospital within 30 minutes.

iI had some loose bowel movements until about 4 weeks after final treatment but that was it.

iI think it is  a personal decision but I felt this was worth it for my particular cancer.

Happy to answer any specific questions.

Hi AnnaFor

I am sorry to hear of your cancer and hope that you are recovering ok from the surgery.

I was treated in 2022 for a similar grade 3 cancer. I was stage 1. 

Before surgery we are normally given a provisional stage and grade of cancer. It is the post op results that will normally give a final confirmed stage and grade. So the biopsy has shown that your cancer is serous- a grade 3 type and that would not normally change. (as those cells have been identified in the biopsy) 

It sounds promising that your provisional stage is 1a and this means that the cancer appears to be confined to the polyp and endometrial lining. It is promising that the CT scan has not shown any visible spread. The thing to be aware of is that there can sometimes be some LVSI. This is where some tiny cells are found in the blood/lymph vessels leading away from the main cancer. These cells are so minute that they are not able to be picked up on a CT and would only be identified with the post op pathology. 

My post op treatment in the end was external beam radiotherapy and chemotherapy. 

My feeling would be that you need to have those post op results but for serous I would recommend any further treatment offered. Any grade 3 cancer can behave more aggressively and I remember being told that they normally offer adjuvant treatment at an earlier stage as it is better to try to prevent a recurrence than to try to treat one that has happened. 

Both my treatments have left me with long term effects. However I do not regret them. I am nearly 4 years post surgery and around 3 1/2 years post treatment. I have had no recurrence. 

The thing with brachytherapy is that it is targeting the area at the vaginal cuff as this is an area where recurrences can happen. It is by nature a localised treatment and if there are any effects, then ladies on here appear to say that they are mild and short term. 

I do understand that any treatment can be scary and it is a personal decision. If it would help to talk things through then please do give the Support Line a call. 

I will pop a link to the radiotherapy support thread and there may be some discussion on there about brachytherapy that may help you decide. 

(+) Radiotherapy support - Macmillan Online Community

Jane

Hi I had four sessions of brachytherapy in May 2024. I didn’t have any bowel issues but seem to be a bit more susceptible to UTIs not that they’ve been frequent, but that may be just an ageing thing!

My cancer was grade 1 stage 1a with some LVSI present. I was given the choice of no treatment, brachytherapy or external beam therapy beam whilst the consultant would have supported my choice of no treatment had I gone down that path she appeared to be more in favour of treatment and was happy with my decision to go for brachytherapy. My CT scan was also clear after my operation and before the treatment started and I have had regular scans since 2024 which have also been clear. 

Hi Jane, thanks for sharing all this information - I finally have my appointment tomorrow to get histology results and plan for treatment. I had similar provisional diagnosis to yourself, Stage 1 Grade 3, which I can see from your reply the final stage and grade will be confirmed by the pathology results. I am worried about the appointment, but I can see from the discussions here that we get good advice about the options. 

Good luck for tomorrow

Hi Anna

i wasn’t in same position as you as I had a higher stage. I was recommended radio with two lots of Cisplatin, followed by 4 lots of Carboplatin/paclitaxel.  I was determined for so long not to have the Carboplatin/paclitaxel, even as I was finishing the radio. Told all my friends I wasn’t going to do it, and then I made the decision to do it, because if it came back could I look at myself in the mirror? Im grateful now that I did it.

Hi AnnaFor, I had 25 x radio and 2 x brachy in 2022. For me the brachy was a breeze. A separate brachy unit with kind staff and music playing during the treatment, which lasted 6 mins (2 songs’ worth!) and felt little different from a tampon being inserted. Only extremely minor side effect for me was a slight warmth when peeing after the first treatment. I had it because I knew it was easier to try to prevent recurrence than to treat it, and wanted to give myself the best chance possible of preventing.

Hi Waidh  thanks for your input, that's kind of what I'm thinking belt and braces.  Hope you're doing well.

MarmiteFan59 Hi, thanks for your info and reply.  I will go for it and fingers crossed.

NickyCros Hope your histology and plan goes good for you. It's a scary path we travel but good to have insightful feedback on here.