Update: To add radiation or not after chemo

I have the same stage and type of cancer as you. Mine is a grade 3 which makes me high risk for recurrance.

What was also important was that I had one positve pelvic lymph node on each side, 80% myometrial penetration, and my cancer originated just above the uterine neck. Pelvic and/or vaginal radiation is done because that is where recurrence is most likely to occur. Having radiation there ups your odds for preventing recurrence in the vaginal cuff area, but it does not guarantee it. After that, recurrence is most likely to occur in the lungs so expect chest x-rays when you have check-ups after treatment. If you don't have pelvic radiation now and end up having a pelvic recurrence, they'd be able to treat it with radiation, but that's not an option for recurrences in areas previously treated with radiation therapy. 

The stage, lymph involvement, myometrial penetration >50%, and origin in the lower part of the uterine body are all indicators for the need for radiation or not in addition to chemotherapy. Since I had all of the indicators I had both pelvic radiation with a vaginal boost which is basically brachy delivered externally instead of internally. 

Everyone is different and different doctors have different views on how to treat, so that may be why yours is recommending just brachy treatments. If you do have those other indicators that would recommend the inclusion of pelvic radiation, I would get a second opinion about it. Frontline treatment is your best chance for achieving a cure instead of facing chronic treatment to keep this cancer at bay, so you want to cover all of your bases rather than trying to go the easiest route. On the other hand, you don't want to over-radiate if there isn't a need for it. 

They usually give you a few weeks to recover from your last chemo before you go for radiation. I didn't have internal radiation so I can't speak to what that is like. The most commom side effects are fatigue, diarrhea or constipation, and bladder irritation. You'll need to continue being vigilant about drinking lots and lots of water. If you aren't taking a probiotic, start because that has helped a lot of us. 

You've got some time to ask questions about your care plan as you have a ways to go yet with chemo. Most of us freak out about radiation when we hear all of the possible side effects, but remember it's just like the TV commercials for drugs. They have to tell you about them all, but that doesn't necessarily mean that all of them will happen to you. There's a lot of discussion on the board about radiation, so keep on reading for things that helped others cope with issues that came up from them, but remember we all come with different strengths and weaknesses when we enter treatment, so what happens to some of us doesn't happen to all of us. Stay strong and do what is in the best interest of your particular circumstances.

my diagnosis (dx) was UPSC Stage 1A Grade 3.  treatment was the "sandwich".  3 chemo/25 external radiation & 3 brachy/3 chemo.  The radiation to your pelvic area - there is a LOT of bone marrow there -- takes a toll on your blood counts.  I had a hard time wrapping my head around the radiation, and probably like Soup because the doc was a jerk.  

I would double recommend MAbound's suggestion of probiotics.  The dietician I met with showed my a study that was done with 40 women with cervical cancer.  1/2 got probiotics and 1/2 did not.  In the study, the women who did not take probiotics who were hospitalized with dehydration from diarrhea was so high it seemed to be an incredible cruel study.  I took probiotics before but I shared the information with people I worked with and some of the women started taking probiotics. 

Everyone has to do what is best for them and everyone's reaction to a treatment is different.  I would suggest asking lots of questions.  I wish there was a simple answer.

I was diagnosed November 2016, had full hysterectomy November 2016 and then started chemo dec 23, 2016. Had 6 taxol/carboplatin infusions 6 weeks apart and finished in April.

My radiology oncologist discovered cancer in two lymph glands in my neck in addition to 2 in my pelvis. The ones in my neck had shrunk after chemo so we put them on "watch" and he did 25 rounds of external radiation and 3 rounds brachy. 6 weeks after finishing that my scan showed the lymph glands in my neck growing again so I had 30 ronds of radiation to those lymph glands. I am now awaiting my scan on Monday and I see my (wonder marvelous amazing loving kind best doctor ever) radiology oncologist.

Chemo was rough on me...I gained weight with the steroid and a lot of fatigue.

With radiation I had mild fatigue, some diarrrhea, a bit of nausea but mostly felt pretty good. I exercised (yoga or spin class) almost daily (5-7 days a week) throughout both series of radiation. My doctor called me "crazy" when I did 2 hours of yoga after my first brachy but I felt fine...he came to realize that for me the exercise was important to my well being.

As to brachy---he  inserted a device (called a Capri unit) in my vagina. It had several "leads" on it that were attached to a machine later. The device was immobilized inside me with what we laughingly referred to as the "sumo wrestler diaper" and they took a scan of me. The doctor and the physicist conferred about how much radiation was tto be delivered (this usually took them a while to calculate so I was just hanging out in the bed watching tv and not allowed to move about) and the leads were connected to the machine that delivered the radiation. the radiation part lasted only about 10 minutes or less...it didn't hurt but it tickled a bit. 

Throughout treatment and after I was instructed to use the dialator (they gave me one) as I am single and without a hubby/boyfriend/partner...it doesn't hurt but is annoying...

hope this info helps...

good luck!

xoxo

Anice

Laura,

If you haven't read this thread: 'Let's Talk About Radiation' please find the time to do so. Several of us discussed the pros and cons and our experiences in the decision making process and the actual physical experience once we decided to do it. I think it will help you.

Best of luck in your decision. For me, brachy was the easiest part of my frontline treatment.

Love and Hugs,

Cindi

I admit being confused about this as well. My current surgeon does not appear to be doing this. My second-opinion surgeon, however, does do this. I am scheduled to meet with the second-opinion doctor to see what that's about. I'll try to keep you folks posted!

Lyn70 said:

We share the same diagnosis,

We share the same diagnosis, stage IIIA grade 2 endometrial adenocarcinoma. I had extensive LSVI. I finished my 6 rounds of chemo. Oncologist initially indicated radiation with a 3 week break in between but now I have had a ct, which was good and he now recommends a PET. He says we will talk after Pet. I want to start radiation but don't quite know where we are going from here. I noticed you post was awhile ago and wondered how you were doing. 

You can always see if someone is still checking in with this site by looking at their profile (click on their user name) and reading the "Last Online" date.

However, barnyardgal just posted on the "Good News" topic yesterday that she just reached her 3-year NED post-treatment milestone. - always a reason to celebrate.

MAbound said:

Same Stage & type

I have the same stage and type of cancer as you. Mine is a grade 3 which makes me high risk for recurrance.

What was also important was that I had one positve pelvic lymph node on each side, 80% myometrial penetration, and my cancer originated just above the uterine neck. Pelvic and/or vaginal radiation is done because that is where recurrence is most likely to occur. Having radiation there ups your odds for preventing recurrence in the vaginal cuff area, but it does not guarantee it. After that, recurrence is most likely to occur in the lungs so expect chest x-rays when you have check-ups after treatment. If you don't have pelvic radiation now and end up having a pelvic recurrence, they'd be able to treat it with radiation, but that's not an option for recurrences in areas previously treated with radiation therapy. 

The stage, lymph involvement, myometrial penetration >50%, and origin in the lower part of the uterine body are all indicators for the need for radiation or not in addition to chemotherapy. Since I had all of the indicators I had both pelvic radiation with a vaginal boost which is basically brachy delivered externally instead of internally. 

Everyone is different and different doctors have different views on how to treat, so that may be why yours is recommending just brachy treatments. If you do have those other indicators that would recommend the inclusion of pelvic radiation, I would get a second opinion about it. Frontline treatment is your best chance for achieving a cure instead of facing chronic treatment to keep this cancer at bay, so you want to cover all of your bases rather than trying to go the easiest route. On the other hand, you don't want to over-radiate if there isn't a need for it. 

They usually give you a few weeks to recover from your last chemo before you go for radiation. I didn't have internal radiation so I can't speak to what that is like. The most commom side effects are fatigue, diarrhea or constipation, and bladder irritation. You'll need to continue being vigilant about drinking lots and lots of water. If you aren't taking a probiotic, start because that has helped a lot of us. 

You've got some time to ask questions about your care plan as you have a ways to go yet with chemo. Most of us freak out about radiation when we hear all of the possible side effects, but remember it's just like the TV commercials for drugs. They have to tell you about them all, but that doesn't necessarily mean that all of them will happen to you. There's a lot of discussion on the board about radiation, so keep on reading for things that helped others cope with issues that came up from them, but remember we all come with different strengths and weaknesses when we enter treatment, so what happens to some of us doesn't happen to all of us. Stay strong and do what is in the best interest of your particular circumstances.

Such a wonderful post,such a help.

How are you now ?