Need opinions: Radiation Therapy or not

Last month I was diagnosed with stage 1B2 cervical cancer (seven years after having been diagnosed with cervical cancer in situ, which was removed with a cone biopsy).

Last Tuesday I had a TLH and lymphectomy. Today I had my post-op appt. and my path report looks good insofar as there isn't any lymphovascular or lymph node involvement, BUT there is marginal involvement, meaning that the tumor is (was) < 1mm from remaining healthy tissue. So my gyn. onc. is recommending radation therapy, essentially as a "better safe than sorry" course of action.

The primary long-term side effects could be an additional shortening of my vagina (which was already been shortened in the hysterectomy--she took the top of it) and potential bladder issues. Short-term effects would be fatigue and skin issues.

So now I'm left to decide: Radiation therapy as a sort of "insurance" that may or may not be necessary at all, or leave it up to chance.

What would YOU do? TIA for any and all thoughts and opinions on the matter.

My situation is more or less the same: I have cerv ca 1b2; I had a radical hysterectomy with lymphnode removal. My lymph nodes were clean, but I also had a marginal involvement, less than 1,5 mm.

I was told too that it was better to be safe than sorry.

I did say Yes. I have discussed it with my GP (who is besides being a regular GP also a homeopathic doc. and always looking at alternatives). We both agreed that this would be a wise thing to do. To be honest I have not really been thinking about not doing radiation. I do trust my gyn/onc and after reading a lot about it (on this forum and on a Dutch site with protocols for treating cancer) it seemed indeed like the right thing to do. After all, I did want to survive!

I didn't like the radiationperiod. I had 23 sessions, in a limited area (not the whole pelvic area, just the top of my vagina (the cuff), lying with a full bladder on a belly board to reduce the damage on my intestines. Though the radiation sessions weren't that bad, I did have some diarrhea. I hardly had any bladderissues though. I didn't have skin issues either (although I have the skin of a redhead). And yes, fatigue was an effect, too. Still is. Sex is painful sometimes, but it hard to say whether that is b/c of the shortening of my vagina, or b/c the sudden menopause, or the effects of radiation.

However, I am recovering bit by bit and am absolutely positive about the future!

I wish you wisdom in making your decision!

I was dx with cervical cancer 1b1 3.5 years ago. After my hyster I wasn't given the option of further treatment, I was told I would have further treatment. (my doc was awsome, so I don't resent her for that lol) Basically I was told my risk of recurrance was 30-35% without it. With treatments it would be lowered to 10-15%. I was also told that its easier to prevent recurance than to try to treat it afterwards.

Yes, I had/have the side effects you mentioned, along with others. As much as I complain about the lasting effects of the radiation, I am greatful my doc didn't let me back out of them either. It gives me peace of mind that I did everything possible to kill the beast.

If you chose radiation with a chemo booster (please ask about the booster if you're going through the radiation- do it right!) the side effects can be handled as they arise. Treatments aren't a cake walk, but they are survivable.

only you can decide what is right for you, but here's my story in case it's helpful.

I also faced this question, although for slightly different reasons. I had endometrial cancer with cervical involvement.

my gyn onc surgeon recommended brachytherapy (internal radiation), but no external rad or chemo. I sought my reg gyn's and my gp's opinion. they both thought the brachytherapy "insurance" was worth it - even with the side effect of vaginal atrophy. (of course, it's not THEIR vagina...)

anyway, as you can see from my signature, I went for it and have 3 of 5 treatments done. it's not fun, but it's really not bad either. (the anti anxiety meds help.)

either way, do NOT skip your follow up appointments as that is the only way to catch it early if the beast returns.

I was diagnosed 1b2-2a, somewhere in the middle because my tumor was large, fast moving, and was found in the surrounding lymph nodes. I was told initially I'd get radiation (external and internal) and chemo and no hysterectomy. (I'm really suprised your doctor did a TLH.) I had 5 weeks plus a few days of daily radiation. My radiation covered a wide area because my Gyno Onc was concerned about lymph node travel.

I ended up only having external radiation - they couldn't do brachytherapy because my tumor was in the way. By the end of external treatment I had experienced a UTI, 2 yeast infections, open sores, diahrea, permanent hair loss (down there), fatigue and just a feeling of mental drainage - just not "there", if that makes sense.

All of that has healed/cleared up (except for the hair loss but I don't mind it being gone). Even though it wasn't the greatest experience, it was worth it if this cancer never comes back.

As far as the vaginal stenosis - they have dialators that prevent that (or you can buy much cheaper vibrators that do the same thing). All pelvic radiation poses a threat to your bladder/bowels - just make sure to have a full bladder during treatment. I haven't had any issues but I know folks who have. I didn't experience the stenosis since I ended up not having brachytherapy but my TAH-BSO did shorten my vagina slightly. The doctor says it shouldn't be noticeable should I ever decide to have intercourse again.

And I can totally relate to your story. In 2004 I had a LEEP to remove cancer in situ, had clear margins and clear pap smears all up to May of this year. I was diagnosed with cervical cancer in June. Makes me disappointed in all the money I spent on regular pap smears and angry at being told they were the greatest thing. Anyway..i'm ranting...lol...

Your not in Vegas...dont take that gamble.I had the same situation as u. I did not have chemo, just radiation. I finished in July and it has been pretty good so far. The only side effect that i seem to have right now is that I have BM's like a bunny, pellets,lol. All managable. Wish you the best

I would take the insurance. I had both external and internal radiation and the side effects were only temporary for me. My biggest issue were my painful bowel movements, but I gave myself steroid suppositories the dr. gave a script for. Getting the suppository is not as bad as it sounds, not painful. But I can tell you they were far better than the pain I had with bm's. So I didn't mind at all.

It's a decision only you can make. But as the other ladies have said, they've also had side effects, but they are doable and this is your life and you don't want to take this gamble.

I was cc 1B2 - high grade - lymphatic space invasion - cancer cells in pelvic wash. I had the radiation and wish I had been offered the chemo booster, too. I'm past the 5-year hysterversary and nearing the 5-year radsversary. I would do it again even though I have some continuing issues. What you should do is your decision to make. Best to you always!