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Radiation OR Radiation w/ Chemo? Radiation OR Radiation w/ Chemo?

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  #1  
Unread 09-01-2005, 07:16 PM
Radiation OR Radiation w/ Chemo?

Hi Everyone,

I am so confused and wondered if anyone could shed some light.

I recently had a Radical Hyst. on Aug 18--(2 weeks prior I had a "fibroid" 2-3 cm removed that turned out to be Adenocarcinoma. After the Radical Hysterectomy, they found another 2.5 tumor (so they are guessing a total of 4.5 cm or more for the actual tumor).

Pathology Report Indicated:

Clear Margins
No vascular invasions
40 clear lymph nodes
and removal of uterus, 1/3 vagina, cervix

Anyway, 2 hospitals have two totally different opinions as to what to do. I am only 31 yrs. old.

One hospital (a leader in the midwest) states that they recommend 5 wks. of external radiation with 1 day per week of low dose chemo.

The other (leading hospital in my state) recommends only 5 weeks of radiation at 45gray. They say doing the chemo will only intensify any long term side effects I could get. And that after 25 yrs. of doing this type of treatment--the drs. are seeing what the long term side effects are for patients that have rec'vd both radiation with chemo---and I guess there is no research that supports for sure that adding chemo will benefit my situation. That over-treating someone in my situation would give me more than necessary and hurt me in the long run. It has me so confused.

While the first hospital claims the research supports the chemo being added.

Any input would be so appreciated. Thanks, Shawna
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  #2  
Unread 09-01-2005, 10:53 PM
Radiation OR Radiation w/ Chemo?

When clinical trials were done,in 1999,it was found that adding chemo to radiation made a big difference in long term survival for cervical cancer patients. I'm not sure if yoru cancer was found to be cervical or endometrial. But here are a couple of links about chemo and radiation:
http://content.nejm.org/cgi/content/...ct/340/15/1137
http://patient.cancerconsultants.com...nt.aspx?id=677

In 1999 clinical trials were stopped because it was so obvious that chemo greatly improved the survival odds. At that time, they recommended that all doctors add chemo to radiation for cervical cancer.

I don't know why the hospital would say that they've been doing chemo with radiation for 25 years when it has only been done for 5 or 6 years! Prior to the clinical trials in 1999, women got radiation only. And yes, 25 years ago, they gave much less focused radiation that caused long term problems.

I don't know what your primary cancer is, and every case is different, but I would suggest you get as much information as you can before you make the decision. 'Google' it, you find lots of information. If you can't decide, get a third opinion.

Hugs,
Janie
  #3  
Unread 09-02-2005, 07:48 AM
Radiation OR Radiation w/ Chemo?

I have Cervical Cancer--I meant to put that earlier.

I appreciate your post Janie.
I read these articles and don't understand if the patients in the study did or did not have a radical hysterectomy FIRST, then the Radiation or Radiation/Chemo.

My hospital that DOES NOT want to add chemo acts like the surgery was to rid me of the cancer and the RT is to get rid of any tiny stragglers along the pelvic wall or lymph nodes. But in actuallity I am prob. cancer free. The RT is supposed to be the icing on the cake to make sure. ???? I am trying to get a 3rd opinion.

Thanks for any advice.
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  #4  
Unread 09-02-2005, 07:57 AM
Radiation OR Radiation w/ Chemo?

Shawna4444,


I had almost the same treatments as Denton 56,except that
they were after a reoccurence. The surgery was originally to be
the only treatment.

I had 5 cisplatin and 25 external treatments with an internal kicker.

My treatments were for endo. cancer.

I wish you the best.

Tricia
  #5  
Unread 09-02-2005, 12:56 PM
Radiation OR Radiation w/ Chemo?

Shawna,

JMO, I would get the chemo..just to make sure. I know it stinks and I wish you didn't have to go through with it...but I will be here for you every step of the way...You'll get through it..NO...WE'LL get though it!!! I promise...this will all be over by Halloween...then you can slam the door shut...nail it..and never look back there again...Akkk, Erika is crying...I will talk to you later.

xoxo
Kara
  #6  
Unread 09-02-2005, 01:43 PM
Radiation OR Radiation w/ Chemo?

My two cents based on my discussions with my radiation and surgical oncologist (I turned out not to need the radiation/chemo, but had a couple of preliminary meetings about it).

Standard protocol up here (at the leading cancer hospital in Canada) is to combine the radiation with the chemo. The chemo apprently helps the radiation to do its job more effectively.

I can not report from personal experience, but I was assured that the combined side effects of both (fatigue and "the runs") were usually pretty tolerable, manageable with Imodium and extra sleep, and that many patients can even continue to go to work during the 5-week treatment cycle (depending on what type of work, of course).

Hopefully more women who have had the radiation/chemo treatment will be along to give their opinion.

It certainly sounded to me like the possible advantages of having the chemo would outweigh any disadvantages.

Good luck!
  #7  
Unread 09-02-2005, 01:43 PM
Radiation OR Radiation w/ Chemo?

Shawna4444,

If your concern is fear of the chemo, my experience was that the chemo was much more doable than the radiation. Mine was also a low dose, same amount 5 weekly treatments. They
lasted about 3 hours. My onc. prescribed meds. to combat the
symptons of nausea, anxiety, etc.

The radiation had more side effects for me.

I have to say though they killed the beast and that is all that counts in the end.

Tricia
  #8  
Unread 09-02-2005, 07:56 PM
Radiation OR Radiation w/ Chemo?

Dear Shawna4444:

I'm so sorry you are going through all of this right now.

Were you given a stage? I had adenocarcinoma of the cervix and I had two different spots found on my cervix. My Oncologist told me I did not need to have radiation. He said once you have it you can't have it later down the road in the same area and also told me it could cause me more problems. I guess that's why I'm wordering what your stage was as mine was 1a with no lymph or vascular involement.

Hope to hear from you soon.

Love and Prayers,
Donna
  #9  
Unread 09-03-2005, 10:08 AM
Radiation OR Radiation w/ Chemo?

Thanks everyone for the responses.

I have Adenocarcinoma 1B2 (perfect pathology report)
No vascular invasion
No lymph node spread (40 nodes taken)
Clear Margins

I had two separate surgeries--but they have to assume the tumors were 2 pieces of the same tumor.

Hospital 1 is 5 hrs. away and they want to do chemo plus radiation. All the literature I read that they are faxing me says only for "High Risk" patients--which I am not--the above pathology report would make me high risk if I had any of the bad reports. Hospital 1 also said that Hospital 2 should be warey of a lawsuit for malpractice in this day and age.

Hospital 2 is one hour away here in Iowa.
I called and asked them if they would opt to give me chemo if I ASKED for it. They said no--the head oncologist refuses to give it to me. The negative side effects long term outweigh the benefits. They also felt that Hospital 1 was showing ignorance in stating the "malpractice" comment. Hosp. 2 said they had the oncology bible in front of them that said it should be "considered for High Risk patients".

I am very depressed the past couple of days and just don't know what to do. Any input is very helpful.
At least I have a long weekend to think it over.

  #10  
Unread 09-03-2005, 09:27 PM
Radiation OR Radiation w/ Chemo?

Why constitutes 'high risk'? A cervical cancer that is stage 1B2 is a rather large tumor, over 4 cm. Do you know how big your tumor was? According to my gyn/onc the chance of survival, after 5 years, is 80%, with chemo and radiation. My tumor was 5 to 6 cm. My doctor doesn't operate on anyone with a tumor 5 cm or larger. If he operates and finds that the tumor was larger than expected, (5cm or over) radiation with chemo follows the surgery. My radiation oncologist told me the same thing. I don't know if a 20% mortality rate is 'low risk', in physician's terms, but it isn't low risk in my personal view. A one in five chance of dying, doesn't seem low risk to me, but perhaps that's because it's me, and not a random statistic. Also, I might feel very different if I had lung cancer or pancreatic cancer, with a much higher mortality rate. I might think that 80% is low risk. What do the doctors at hospital 2 consider 'low risk'?

The standard treatment here is chemo with radiation. I have not heard of any cervical cancer patient with a tumor that large not getting chemo along with the radiation. Actually, I haven't heard of any cervical cancer patient getting radiation without accompanying chemo. With chemo and radiation being the standard care, and the one that UK and US government recommends for cervical cancer, I can understand why hospital 1 said that hospital 2 could be open to a lawsuit. I would think that if you were to have only radiation, and you recur (Heaven forbid!) I suppose that you might have grounds for a lawsuit since the hospital didn't follow the standard protocal for cervical cancer. (If you have endo cancer, ignore everything I've said. I don't know much of anything about endometrial cancers and radiation alone seems to be a more standard treatment for endometrial cancers.)

We only get one chance to knock out cancer. I can't imagine not hitting it with all the ammo available. Nor can I imagine a gyn/oncologist recommending anything less.

When you refer to hospital 1 and hospital 2, does that mean that you don't have a gyn/onc? Did a gyn/onc do your surgery? What does he recommend for treatment?

If your concern is the distance for chemo, remember you only have to do that once a week, 5 or 6 times total. I think you could probably arrange to have it at a hospital closer to you, or an oncologist's office. I had my chemo at the gyn/oncologist's office.

M.D. Anderson, in Houston, is probably the best cancer treatment facility for pelvic cancers. If I were you, and undecided about treatment, I would contact them for a phone consult. They will want you to fax your pathology reports, and I think that they charge for the consult, but it would be well worth it for your peace of mind.

I can't imagine having to make this choice. My thoughts are with you,
Janie
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