Chemo plus radiation vs Chemo without radiation for Stage IIIC uterine cancer?

runwithloki said:

Tolerating treatment
Thanks for the input. My mom just turned 67 and is otherwise in excellent health- very fit, eats well, exercises regularly, etc. so far, she has been tolerating her treatments very well. I'm of the same mindset- I think she should be more aggressive now to reduce her chances of recurrence. How severe were the side effects from external radiation?

mollymuch said:

1) Get a second opinion if
1) Get a second opinion if at all possible. I had stage 3(c) low grade and got many (5 I think, when you include radiation specialists) - each was slightly different, well informed and based in current research, and I had to do a lot of thinking to find my path. One doctor said that they no longer think radiation is necessary, another said the older research was still valid, etc.

2) I went for it all - had chemo and both forms of radiation, external and brachy. Vaginal stenosis - shrinking from scar tissue - is an ongoing problem for me, almost two years out. I hate dilating and didn't expect to as much as I do. Am not currently sexually active, but I'm 44 so I need to keep my options open - plus, even a speculum can hurt. My drs underplayed this issue as far as I'm concerned - I think their assumption was that having sex would sort it out. Overall, I disliked radiation more than chemo because of the nausea and tiredness and it lasted longer. I worked my way through both, taking a few days off to recover from chemo but not with radiation because it just goes on and on, so that may have something to do with it.

Side effects for external pelvic radiation mostly went away in the first year - diarrhea.

I'd still make the same decision again because I really want to live. But radiation for me was not a small thing.

daisy366 said:

my experience
I also have a high grade uterine cancer - originally stage 3a uterine papillary serous carcinoma (UPSC).

For me, the ca125 has been a reliable marker (UPSC acts like ovarian cancer) though for many it is not. My doctor did NOT recommend the pelvic radiation for me and I do not regret following his advice - he said there was "no science" to justify it - even though it seems most doctors do recommend the aggressive approach.

I admire my doctor's thinking - give enough treatment but not too much. Last time we discussed options he said he does not believe in using a cannon when a bullet will work. Chemo and radiation are severe assaults on our bodies. The body tries to heal itself and we are trying to avoid doing irreparable damage to my body in the process of killing off cancer when a less toxic approach may give the same result.

I've been on this site for over three years and even people with aggressive treatment have recurred (even stage 1) so I really don't think aggressive treatment is any guarantee. I often wonder if it makes the DOCTOR feel better - that THEY've done everything possible.

I also have recurred - twice - and the ca125 helped alert this in addition to routine scans. First recurrence was successfully treated with chemo and radiation in neck (supraclavicular lymph nodes) and second is now being treated with aromatase inhibitor medication (hormone treatment) for lymph node recurrence in paraortic & pelvic nodes. I've got my fingers crossed. I have excellent quality of life.

Bottom line. Your mother needs to gather all the facts and consult trusted people and then make a decision that she is comfortable with.

I hope all goes well. Mary Ann

RoseyR said:

Some Tips on Pelvic Radiation

Stacey,

I too was diagnosed with grade 3 uterine cancer although stage IB.

Initially it was recommended that I have (along with six rounds of taxol/carboplatin) both internal and external pelvic radiation.
When I finished my 25 treatments of external radiation, however, my radiological oncologist said she didn't think I'd need brachytherapy (vaginal vault radiation) for two reasons:

My tumor had not been not that close to my cervix.

Reurrences of my kind of cancer (carcinosarcoma) would be less likely in the vaginal vault than other parts of my pelvis or distant organs.

So whether to use brachytherapy depends on two elements: how close the tumor was to the cervix and the KIND of tumor you had and its typical spreading patterns.

By the way: I had so side effects at all from my 25 pelvic radiation sessions, not even fatigue. However, this may be for the following reasons:

I had IMRT (intensity-modulated radiation therapy), which has fewer side effects than the old form of radiation.

I was seeing an integrative doctor at the time, who prescribed the following to avoid damage to my intestines:

glutamine (one teaspoon in a glass of water two to three times a day)

curcumin (50 milligrams, three times a day)

fish oil (two teaspoons a day)

90 mgs of zinc JUST DURING RADIATION (this is too high a dose to continue for long periods but studies show that chelated zinc can prevent damage to mucosal linings in the mouth and throat for patients undergoing brain radiation. From these studies my doctor extrapolated a similalry protetive role for zinc during pelvic radiation. Nature's Way is a good brand for chelated zinc. (But take it with 1-2 multivitamins a day; PURE makes a brand without copper or iron, two minerals that cancer patients should avoid in all supplements.)

A final tip: one way to avoid damage to intestines is to drink as much water as possible 15-20 minutes before each radiation session. And try to drink approximately the same amount each time--esp when you have your "test run" (photos that are taken to set up the radiation, called a "simulation." Remember how much you drank before the simulation and try to drink about the same amount before each real session. And don't worry about "leaking" or an "accident": my bladder isn't the greatest anymore but so what if you have an "accident" even on the table? What is more important--your pride or your quality of life after radiation? Many of the best centers TELL their patients to drink at least one small bottle of water beforehand; others refrain from doing so because (in my opinion) they can't always predict within minutes when your session will be each day (they sometimes run a little late) so don't want to cause "anxiety," as my center told me. I'd drink the water no matter what (you can test how much you can hold; each radiation session is about 20 minutes--and perhaps you'll wait for it ten to twenty minutes. Bottom line: remember how much you drank before the simulation and keep drinking that amount before each REAL session. That will help them target your pelvic region most accurately.

Finally: a macrobiotic chef I know--and serious student of macrobiotics who had helped a relative through radiation--advised me to eat miso soup every day during radiation: one to two small bowls a day. The seaweed in it (wakame) ALSO protects against radiation damage. He also advised me to eat cooked greens (spinach, kale, etc) nearly every day during radation.

Having done all these things, I experienced no bowel distress or even fatigue during radiation. My doctors were pretty amazed. And my integrative doctor was careful not to prescribe any supplement that would interfere with radiation's efectivenss; indeed, curcium and vitamin E succinate (600-800 mgs a day) have been found in many studies to enhance it.

Best,
Rosey

tinapal said:

Fanniemat

I am like you. I had radiation and 5 of the chemo done.  Suppose to have my last chemo done next week. But I am so sick. Don’t want to do it!!!  My doctor can’t tell me yes or no.  Has to be my decision. Just hard!!  So glad you are doing good!!! Just confused here.  I just got to believe 5 Is enough 

Tinapal,

Fanniemay was last online in January and remainder of the other posters in this old thread haven't been on in several years. But I think that most of the current members would say that the decision whether to continue with the final chemotherapy treatment depends upon (1) the type and stage of your cancer and (2) other health issues.

I do know that at least a couple ladies had to stop chemotherapy because the side effects were too intense. Because I am Stage IIIB with an aggressive form of cancer, I persisted with the second phase of my chemotherapy, even though the side effects were far worse than I had had with Paclitaxel/Carboplatin during the first phase. I did have external radiation as a preventative measure after chemotherapy. For me, radiation was much easier than chemo,

But if I had had earlier stage of cancer or a less aggressive form, my decision to continue with chemo or have radiation might have been different.