UPSC Treatment

Thank you for providing the

Thank you for providing the link. It was copyrighted in 2014 and looks like it was published March 2015.  It does take several times to disect (ha-ha - get it) what medical speak is saying sometimes.  

I will say I did question the need for radiation myself (1A) for this reason, the radiologist even told me "it is up to you", but ended up going for the full monty.  The chemo was welcomed to kill off any little crazy cell that escaped the uterus.  

Again, thank you for sharing the link.  For me, I like to read all the information I can and need to read this a little more. Is this what I am reading?

103 patients included in the study.

Of this, 29 developed a recurrence.  (8 vaginal, 4 pelvic, 17 extra-pelvic) – 28.2%

It did go on to say:  The majority of recurrences were extra-pelvic. Vaginal brachytherapy has a significant role in reducing the risk of vaginal recurrence and surgical staging was the only predictor of outcome. Therefore, both (brachy and surgical staging - the parenthesis is my notes) should be considered in these patients.

ghorselady said:

study upsc

http://www.ncbi.nlm.nih.gov/pubmed/25575483 This is the study I mentioned.  I had to read it several times to understand what my doc was talking about.  Bottom line for me is that with no myometrial invasion and if lymphedectomy was done, radiation and chemo make no difference.  This is really hard because the title makes you think that radiation does make a difference.  As I understand it, 1A includes instances of myometrial invasion.  Therefore,  there are different classes of 1A.  My second opinion doc made a big deal about the noninvasion, and even redid my labs to make sure there was no invasion.  He said if there was invasion, I would need the full treatment. 

Different classes of 1A

Based on FIGO 1988 staging criteria, there used to be stages 1A (no myometrial invasion), stage 1B (up to 50% myometrial invasion) and stage 1C (more than 50% myometrial invasion), but that was changed in 2009, with the old 1A and 1B grouped together to become the new (FIGO 2009 revised) stage 1A.  That means if the study is pre 2009, stage 1 refers to supeficial only (no invasion of myometrium) patients.  Something to keep in mind is that one really can't go by studies that go back a quite a few years to **** risk of recurrences for early stage uterine cancer, because not all studies have been carried out on fully surgically staged stage 1 patients, this cancer is tricky, and has been known to be found in lymph nodes/omentum even if in patients with only superficial endometrial involvement. That means, if you have been fully surgically staged, as seems to be the standard now, and determined to be stage 1A/B, your prognosis would be better than results from similar stage (but not fully surgically staged) patients. When I was staged last year, my oncologyst did the full monty, took out even my appendix, 39 lymph nodes (para-arotic and pelvic), the omentum, as well as all the obligatory uterus/fallopian tubes/ovaries combo. I have seen studies where patients would have no lymphadenectomy, or no omentectomy, but still classified as stage 1A because of no myometrial invasion was found, that is misleading because this cancer is known to spread even in the presence of only a tiny polyp, or superficial micro zones. That is good news to most on this board with stage 1 since the standard for diagnosing moved to full surgical from clinical/partial surgical. Do not despair when you see recurrence rates as high as 25% (I have seen) in early studies, later studies are more comparable, better prognostic use.    

Question for cindy

was your cancer confined to a polyp?  did your oncologist only recommend radiation without chemo?  that is what my dr recommended Because mine was confined to polyp with only pre cancer cells in uterus. I hope you are doing well.  thanks for your input.

CindylovesMike said:

Hi Terry

I had uterine cancer it was grade 1 stage 1a. The recommendation was brachytherapy I had 4 treatments which started in March and ended in April. Then almost 2 years later I coughed up some blood it was a meatasis to my rt lung 31/2 c. They removed the tumor and the middle lobe of my lung. that was a year and half ago. I finished chemo may 4th 2015. I go for a scan this FRiday. I am afraid because I don't feel good. no energy. I still don't understand how a cancer cell got to my lung when it was not in my nodes.  Sending you hugs and prayers Terry.

 

Cindy

Question

hi Cindy. Were you staged at original diagnosis?  Was it uspc cancer?  My mom was staged 1a serous confined to polyp. No chemo needed. Here's the kicker: 5 small lung nodules that they are having trouble biopsying. Ugh!!!  he is also a 20 year breast cancer survivor so if these are metastases in lung they need to find out if breast or uterine?  Her gyn onc said he has never seen this stage in the lungs. All lymph nose negative. Everything else negative except the polyp. We sent her slides to mayo too for 2nd opinion. Thx for your help

Cindy, I think it is unusual for a woman diagnosed

with grade 1, stage 1a to have a distant metastasis. If there is one thing I've learned from my cancer journey, it is that how cancer spreads is not well understood and that each of us have cancer that is specific and unique to us. When cancer progresses, it doesn't change your stage. I was diagnosed with grade 3, stage 3a cancer. If I have a recurrence, my doctor would tell me that I have stage 3a cancer with metastasis.

Wishing you the best,

Cathy

CindylovesMike said:

Hi Ksdehn

yes I was grade 1 stage 1a at original diag.Now I am stage 4 because of the lung metastis. No it was reg uterine cancer not uspc. Hope this helps. Are the nodules all in the same lobe?

cindy

No, the nodules are not in the same lobe.  Her gyn onc thinks this is potentially breast cancer recurrence from 20 years ago because he said it would be so rare to be contained to the polyp and jump to the lungs....The good news is she feels really good.  Had a abd hyst with complete staging April 18th...She is 70.  So hopefully if this is cancer, she is in good health now which will help with the fight!  So your lung metastases were removed because it was in one lobe and contained to one tumor?  Her largest tumor is 1.5cm with 4 other smaller ones....so they are not overly large.  Thanks for your help!