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Should I have radiation or not? Should I have radiation or not?

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  #1  
Unread 08-24-2006, 01:31 AM
Should I have radiation or not?

I had my hysterectomy on July 27 and it turned out that I had endometrial cancer. It was in the very early stages. Because they didn't think it looked like cancer at first (and because there was extra danger for me) they never checked the nodes. Although the tumor was rather large, it did not go very far into the muscle. It seems that I am in a gray area as to what to do. So, now they want me to decide if I want to have radiation treatments. It would only be 4 treatments. My chances for a reoccurance without the radiation is 5-10%, but only 1% if I have the radiation.

I know that this is my decision to make, but I'd like other peoples' opinions on this.
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  #2  
Unread 08-24-2006, 01:39 AM
Should I have radiation or not?

I had cervical cancer and my margins were very small so I had the choice to have more treatment or not. I chose to have the treatment, because I wanted to reduce my chances of it coming back as much as possible. From 5-10% to 1% is a pretty big drop.

And the treatment is doable. Not a vacation, but it is doable.
  #3  
Unread 08-24-2006, 05:42 AM
Should I have radiation or not?

I too had cervical cancer with unclear margins...my doc opted for radiation with a chemo booster. *I* tried to get out of the additional treatment. After talking to my doc about it a bit more, I went ahead with them. Happy I did. Now I know I've done everything I can to prevent a recurrance.
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  #4  
Unread 08-24-2006, 07:12 AM
Should I have radiation or not?

Hi Cyreena:

If it is 4 treatments, then it sounds like they are suggesting the HDR brachytherapy. I had thatalong with external radiation for endometrial cancer. The HDR, while uncomfortable, usually has fewer side effects than the external.

I was also told similar statistics regarding local recurrence for my case. It's obvious which way I went. The drop from 5-10% to 1% seemed pretty significant and the doctors strongly recommended it.

I was diagnosed at stage 1b grade 3. Can I ask you what grade and stage they gave the cancer, if they were able to do that without sampling the lymph nodes?

Also, it depends on your personality. Depending on the diagnosis, many women have no further treatment and enter a period of watchful waiting. Some studies seem to show that radiation can be equally effective following a local recurrance as if it were administered right off the bat.

It's a tough decision to make... a friend told me the important thing is to decide on a course of action and follow it with good intentions and resolve, since we cannot of course know the outcome of all our decisions. Whatever you decide, I wish you the best. Regards, Blue.
  #5  
Unread 08-24-2006, 08:19 AM
Should I have radiation or not?

I also had cervical cancer, had clear margins and lymph nodes after surgery, but it was suggested that I also have radiation - external and 3 HDR as well as a chemo boost, just to do everything possible to make sure it didn't come back.

It sounds as if you will be doing the HDR if you choose to continue with your treatment. While I dreaded each of my appointments for that, it wasn't so bad because I was put into a twilight sleep each time. That seemed to make the process easier for me as I didn't remember a thing. If possible, ask for the same, it saves some dignity, even if it's only in your mind. Of course, you may choose to be completely awake, it's up to the individual and your how you feel.

If the drop goes to 1%, that's wonderful. It's always easier to treat the original cancer than a reoccurance.

Good luck to you in whatever path you choose.
  #6  
Unread 08-24-2006, 10:05 AM
Should I have radiation or not?

Hi Cyreena,

I had Endo Cancer and did not have radiation. There seems to be many grey areas of treatment when it comes to endometrial cancer. I was a grade1 stage1b (31%) infiltration...with no other contributing factors.

My chances for non-recurrence were about 95%. I decided that the possible risks of radiation were not worth the benefits, in my case. ( And, I researched this extensively) There are even studies that have shown no survival benefit at this low stage and grade.

Sometimes the prescribed treatment is based on the bias of your Doctor and the region you are from.

I think another Sister asked already....but what is your stage and grade. That would be helpful in understanding your diagnosis...so that feedback could be given from a more informed perspective. ie If you are a low stage but your grade is 2, then internal radiation is often the treatment.

Below are the NCCN practice guidelines. I think page 9 has the schematic you would be interested in. Sorry, I don't think you can click on it....you will need to cut and paste it into your browser. I actually printed everything out myself because I found the guidelines very informative and wanted to study them. The information/quidelines are based on data from 8 or 9 of the major cancer centers.


http://www.nccn.org/professionals/ph...DF/uterine.pdf

If you can't get it this way...you could google in NCCN practic quidelines and try to access it from there.

Hugs,

Diane
  #7  
Unread 08-24-2006, 10:26 AM
Should I have radiation or not?

Two things in your post worry me a little and, if it were myself, would make me lean toward having the radiation. You had no lymph node dissection and it sounds as if a regular gyn performed the surgery since you said cancer was not suspected.

It's a very tough decision to make and my suggestion, if you haven't already, is to consult with a gyn/onc for a second opinion on a course of treatment. Remember, whatever you decide to do, you have to be comfortable with that decision. Best of luck and keep us updated.
  #8  
Unread 08-24-2006, 11:22 AM
Should I have radiation or not?

Dear Cy,

GrnEyedLdy makes a good point. I just noticed that you mentioned your tumor was large. That right there could tip the scales towards radiation. I think many factors come in to play when choosing or not choosing radiation. In many ways, you have to make the decision you feel most comfortable with based on the information you have gathered.

I also second GrnEyedLdy in suggesting... if you do not already have a gyn/onc it would be important to get a second opinion. And, often a second read of your pathology report by ( cancer) radiologists is helpful as well.

I also had my surgery done by my regular gyn. And, I did not have my lymphnodes checked. I was very close to having a second surgery. Instead, I was sent to have a CTscan to check for lymphnode enlargement. Not having proper lymphnode staging has always been the 'unknown' factor in my case. That is why some us are so adament about wanting any Sister who is suspected of having cancer to have an 'expert' gyn/onc do their surgery.

Good luck... I am sure you will make the right decision for you. Certainly, get all the information you can so that your decision is an informed one. Many of us have copies of our pathology reports..it helps with asking questions and better understanding our diagnosis.

Hugs, Diane
  #9  
Unread 08-24-2006, 12:58 PM
Should I have radiation or not?

Hello Cyreena,

Big s to you in this difficult decision. My story is very similar to yours. After they discovered my endometrial cancer involved my cervix, the tumor board suggested radiation, even without knowing the status of my nodes. (I subsequently had a lymph node dissection, which turned out negative.) They gave me the same percentages for recurrence. For me, I felt better going ahead with the HDR brachytherapy (internal) radiation. It was 3 treatments one week apart. It was mildly uncomfortable, but I have had no lingering side effects.

I'm still glad I did it. Like the others here, I would encourage you to get an opinion from a gyn/onc too.

Also, try searching Hyster Sisters for the keywords brachytherapy, HDR, internal radiation. This will give you more threads on recent discussions. Feel free to PM me if you have questions.

Take care, keep in touch, we'll be thinking of you.
  #10  
Unread 08-24-2006, 03:22 PM
To rad or not to rad...

As others have said, the stage and grade of your cancer may make a difference in your decision.

I think it is important that you find out the grade of your cancer. Grade 3 is more aggressive and if you have that then you might really want to consider radiation.

Here is a link to a thread from a while back on Hystersisters. It may give you more insight. It contains links to other sites with information, too.
https://www.hystersisters.com/vb2/sho...d.php?t=242235

Here are some links with information you may find helpful:
http://www.medpagetoday.com/Hematolo...ancers/tb/2541

The next link
http://www.medicinenet.com/script/ma...ticlekey=57562

says, in part,
"Radiation Increases Survival for Early Stage Endometrial Cancer

By Serena Gordon
HealthDay Reporter
TUESDAY, Jan. 24 (HealthDay News) -- Along with surgery to remove the uterus, women with stage 1 endometrial cancer should also consider adding radiation therapy to their treatment regimen.

That's the conclusion of new research that found that women with early endometrial cancer who add radiation to their treatment can improve their odds of surviving longer..."

One other thing to consider in your decision, is that once you've had radiation, it probably can't be given again to the same area. You need to check this out with a radiation oncologist, because there is a new machine out there that might make radiation possible a second time but the machines that most places use for external radiation are such the radiation can't be used if you recur in the same area after having it. Not sure, but I think the same is true for HDR.

That's my two-cents. I'm not a medical person so be sure you check with your doctor and don't rely solely on this thread.

What ever you and your doctor decide, I wish you the best. You might want to consult with a couple different doctors to get a second and third opinion to help firm up your decision, to rad or not to rad...
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