no sprd to lymph but still radiation?

Hi ladies! I had a radical hysterectomy on 3/4/4, cancer of the uterus and cervix, but no spread to lymph nodes. Still my ob/gyn wants me to have radiation. I have appntmnt with cancer specialist tomarrow. Why is this neccessary if they know there was no spread? Also, I'm wondering if anyone can tell me what does 'radiation' entail? what is the procedure? Hooked up to machines for a while? I cant wait to find out. I suppose they want to start me next week....ughh....another can of worms....i feel like I've been through so much already. Please give me any advise possble. thanks - love, martha

Hi - I am glad that your ca had not spread. That is truly a blessing.

The purpose of the radiation is that it will "sterilize" the surrounding tissue in case there are any microscopic cancer cells. If the oncologist recommends it, I would do it b/c even if they "got it all" there can still be cells, perhaps 1-2 cells per site, with numerous little sites, that are too small to been seen or even surgically removed and the radiation will kill them.

As for radiation, I had 36 treatments. You do not feel a thing. You just lay there. My site ran on time, so I knew that I would be in there for 15 minutes or so and on my way. Ask then how prompt they are b/c you don't want to sit there one minute longer than you have to. I had some burning of the skin (like a sun burn) b/c I am fair skinned but treated it with the green stuff you use for a sunburn. It has lidocaine in it so it was very effective.

The hardest part for me was the constant reminder that I had cancer. Once the radiation was over, I had a party to celebrate and that is it. The staff was very helpful and I went to their ca counselor. Use ALL the resources they have and ASK questions.

Don't be afraid. Compared to your surgery, it will be a breeze.

Martha, same with me. I was diagnosed with ductal carcinoma in situ / stage 0 (very, very early breast cancer). Had lumpectomy with good margins. Did not need chemo, but did get full 33 radiation treatments to catch any cancer cells that might have been left behind.

Mary D.

Hello, Martha--

My gynecologic oncologist prescribed both external and internal radiation for my endometrial cancer even though it had not spread to any of the 30 lymph nodes he removed. I did have numerous other risk factors that placed me at an elevated risk for recurrence, however. These factors included a deeply-invasive tumor, extensive LVSI (meaning that the tumor had invaded the uterine lymphvascular space), and a tumor arising in the lower uterine segment.

My daily radiation treatments took no more than 5 minutes. Most of the time was spent getting dressed and undressed. I would lay face down on the treatment table while the radiation machine moved around me to four different points--above, below and along both sides of my body.

I would recommend that you ask the radiation oncologist you will be seeing why radiation is being recommended in your case. He/she should go over the pathology results from your surgery and discuss the findings, including the basis for the recommended radiation. I would also suggest that, if you have not already done so, you obtain a copy of your operative and pathology reports, which will provide a lot of useful information about the nature and extent of your cancer.


Best of luck to you!

MoeKay

Dear Martha,
Everyone has already covered most of it -- just a couple more (but very detailed) notes on what to expect with radiation.

(Mine had not spread to lymph nodes, either -- the surgeon got it all excepting those little possible stray cells.)

My external radiation was almost precisely like MoeKay's -- I didn't have to get undressed though. Just had to remove my below-the-waist clothing. After I got on the table, they held up a little sheet to shield my privacy while I tugged my undies and pants down around my knees.

My first visit was called a "simulation." They took lots of xrays and when they had me positioned correctly to target only the mathematically-calculated areas they were going to irradiate, they drew blue lines on my back and an x on each hip, then placed a pinprick tattoo in two places as a permanent marker. Literally one dot of ink -- I can't even see them! Then they squirted some gel into what looked like a plastic trash bag under my pelvis. A chemical reaction made it expand, creating a mold of the exact position I would lie in each time.

I also had to have internal radiation treatments. So I did four days of external and one day of internal for 6 weeks (weekends off).

They do internal a couple of different ways. It's also called "brachytherapy." Some people have a radioactive implant inserted into the vagina and stay in the hospital in an isolated room for several hours or a day. Mine was the other kind, which directs a series of "zaps" over about 10 minutes.

They still had to make an internal device and mark the area of treatment first, so this one had a 'simulation' first also.
First they inserted a Foley (urinary) catheter. Then, for their measurement markers, they put tiny gold slivers in my vagina. (This isn't supposed to hurt more than a pinch, but it did hurt me. I had just gotten over a yeast infection, so was perhaps more tender than normal.) They look at this on a screen, then they find the right size of internal device for you. This looks like a ceramic popsicle. It's hollow inside. They tape it up to you so it won't move, and insert a metal rod for x-ray positioning purposes. After the xrays, they take the metal rod out of the popsicle device and wheel you into the treatment room. The radiation machine looks like a big pencil sharpener (actually it's where they attach the cable from the machine to the person). They clip the cable into the 'vaginal popsicle' and leave the room and start the treatment. While my treatment only took about 10 minutes, all the preparations made each appointment last about an hour. Then they come back into the treatment room, swoop over you with a Geiger counter to make sure you're clear, take the Foley out, and take you to the bathroom to wash the area/pee/put clothes on. (Note: they only insert the gold splinters once -- they stay there inside you and eventually after a couple of months they will come out in your urine.)

I didn't like the internal treatments. I'm tough to insert the Foley into (small urethral opening) so that usually took 2 or more tries. Then, I found it very uncomfortable when they secured the 'popsicle' cylinder -- it's just pressure, not pain, though. I took a stuffed cat with me to all the internal treatments. However, I much preferred this method to the idea of staying alone in a hospital room for hours (although I've heard that's really not bad, either.)

I was lucky with side-effects. My skin didn't burn (amazing, as I'm quite fairskinned). Ironically I kept all my pubic hair until the last two days of treatment. (Some people don't lose their pubic hair at all -- thought I was one of 'em.) After about 3 weeks, I started to get unpredictable diahrrea -- the doctor gave me a personalized dosage schedule for OTC Imodium A-D (more than on-the-box directions recommend). Then I had some bouts with nausea -- a prescription for Compazine cleared that up. I was pretty fatigued after a couple of weeks. The doctor also had me douche daily with water and a tiny proportion of hydrogen peroxide. This was to flush out the little dead cells the vagina sloughs off. (The dead cells often come out as a whitish discharge, which I didn't experience.)

I'm glad I had the radiation! I feel confident that I have been fully and successfully treated for cancer. Wishing you the very best!
=e