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Lymph vascular space invasion (LVSI) on pathology report

Lyn70
Posts: 16
Joined: Jan 2021

Anyone have experience including this added metastatic risk factor, please?

tinacap77
Posts: 29
Joined: Oct 2020

I had that on my path report. The cancer had penetrated the uterine wall 89% and I have involvement in the lymphatic space with metastatic cancer foundation in one left pelvic lymph node of 12 removed. My diagnosis is Endometriod Endonetrial adenicarcinoma stage 3C1 Grade 1

 

Lyn70
Posts: 16
Joined: Jan 2021

I am so relieved to find this site and others with the same diagnosis of LSVI on their path report. It gives me hope. My pelvic lymph nodes were not removed due to frozen section looking like IA and my surgeon not wanting to cause lymphedema. My Ct showed one 9mm node in external ileac which was commented as possible metastases or possible normal. I had one treatment 1/13 contracted covid and go for monoclonal antibodies tomorrow. I am trying to remain in faith and calm. 

ConnieSW
Posts: 1546
Joined: Jun 2012

The antibodies are doing their thing and you get Covid behind you ASAP so you can concentrate on treatment.  This sure was a double whammy. Do let us know how you are doing. 

Lyn70
Posts: 16
Joined: Jan 2021

I am glad to report covid is behind me and the monoclonal antibodies did work. Covid delayed my second treatment but I just had treatment #3 and #4 coming up on 3/24. Fatigue is my major issue but I try to walk atleast 1 mile daily, 2 if I am feeling strong. Neulasta follows each treatments so bone pain comes at night but I take Claritin to help. I learned about the Alpha supplement for neropathy on this site. TY. I am feeling a little better about getting out but my vaccine delayed until 4/26 due to antibody therapy so wearing 2 masks and minimizing exposure. Sometimes I feel blessed and encouraged and other times I throw myself a huge pity party. 

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cmb
Posts: 644
Joined: Jan 2018

Happy to hear that your Covid episode has ended and that you have restarted treatment. Fatigue and the bone pain are quite common amongst the members here. Others have also found Claritan to help with the bone pain.

But conflicting emotions are normal while you're going through trreatment. And getting some exercise is very good, but accept that your energy level won't be the same while getting chemo. Your body is fighting hard now to process the chemo and you've only just gotten over a very serious illness. Be kind to yourself.

Lyn70
Posts: 16
Joined: Jan 2021

TY for your encouraging words. Here it is April already and chemo #5 is coming. I am not sure it will be 4/14 due to my platelet count is at 56 right now. Hopefully they will rebound. I continue to walk everyday atleast 1 mile. The great weather has helped my mood imensely. I have my first covid vaccine appt on 4/26, my 91st day from monocolonal antibody treatment. I am very excited to receive it!

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2878
Joined: Mar 2013

Lyn, while I have not had that diagnoses, I would welcome you to come to ask any questions.  Lots of wonderful women and their loved ones here to help.  It is all so overwhelming but you are not alone.  

EZLiving66's picture
EZLiving66
Posts: 1469
Joined: Oct 2015

Welcome to the board, Lyn. As "No Time" said, there are women here who can share their experience with you. 

Love,

Eldri

Tamlen's picture
Tamlen
Posts: 294
Joined: Jan 2018

Lyn, I had LVSI "suspected" on the path report following my hysterectomy. They had removed all my lymph nodes and since they were all clear, my original oncologist thought it was unlikely and poo-pooed it. It's a long story, but the short version is that I kept pushing for a scan that my onc kept denying, until it finally happened and I had mets in my lungs (but nowhere else). So, in my case, LVSI proved to be something they should have paid attention to sooner. I had a new onc soon thereafter ;)

It bears watching. Since it sounds like you have a diagnosis of LVSI, what is your onc's recommendation?

Tamlen

MoeKay
Posts: 317
Joined: Feb 2004

Hi Lyn, I had my surgery in May 1999 and my pathology report indicated that my LVSI was extensive.  I've seen references online to a three-tiered system for reporting of LVSI which includes: (1) no LVSI; (2) mild or focal LVSI; and (3) severe LVSI.  Since my LVSI was determined to be extensive, it would fall into the severe category.  Does your pathology report give any more information on the extent of your LVSI? 

Lyn70
Posts: 16
Joined: Jan 2021

My oncologist said my LVSI was extensive as it was in both ovaries. Two pathologists reports said I was very high risk for metastasis.The tumor invaded within 1mm of serosa.  I had my first of 6 Taxol/Carboplatin chemo 1/13. I will have 4 weeks of radiation. I am very fearful. 

MoeKay
Posts: 317
Joined: Feb 2004

Lyn, I too was very anxious after surgery when I learned about my risk factors for recurrence.  When I was diagnosed in 1999, chemotherapy was not standard of care for my stage and grade of cancer.  I would have felt much more comfortable if I had chemo since I was worried about distant spread, which the radiation I had did not address.  I found that the fear and anxiety slowly got better with the passage of time, but I initially needed medication to get through the rough spots.  Good luck as you complete your treatment!

ConnieSW
Posts: 1546
Joined: Jun 2012

That was nearly nine years ago.  I have been NED since treatment.

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cmb
Posts: 644
Joined: Jan 2018

My pathology report stated "The tumor shows vascular space invasion into parametrial and lower uterine segment soft tissue." I guess this would make me a Tier 2 according to MoeKay's references (thanks for sharing this MoeKay).

The tumor measured 5.1 cm, invading 0.5 cm out of a total myometrial thickness of 1.3 cm. Staged as 3B, Grade 3, uterine carsinosarcoma (MMMT). 

This was one of the factors considered when I was deciding on external radiation after chemo. I'm still NED 3 years after treatment.

zsazsa1
Posts: 553
Joined: Oct 2018

I had LVSI (and isolated tumor cells in one of the two sentinel nodes they took) with UPSC/clear cell.  Surgery 10/2/18.  Carbo/Taxol/herceptin chemo.  Whole pelvic IMRT.  No recurrence so far.

Yes, LVSI is most definitely a risk factor for recurrence.  But it doesn't mean for sure that it will happen.  

jan9wils's picture
jan9wils
Posts: 152
Joined: Mar 2017

My pathology report showed LVSI when I had my hysterectomy in 2014. My oncologist recommended radiation as a result. 

Jan

Dak82's picture
Dak82
Posts: 34
Joined: Dec 2020

My CT scan indicated enlarged lymph nodes in left iliac region. Surgeon took some para-aortic lymph nodes during surgery and it's good she did. 3/6 were cancerous. I went from IIIC1, G2 to IIIC2, G3. I am now halfway through chemo, completed 3 sessions of internal radiation, and will have 5 weeks of external radiation after chemo. Don't be afraid. I feel pretty crappy today--had to start Neulasta due to low WBC numbers--I chose that to keep from delaying chemo. Mostly run down feeling but still did 4 mile walk and worked a half day. My first 3 weeks with this felt like I was getting a gut punch every time a new test result came in. But now my CA125 reads 22 down from 62 when I was diagnosed and 77 3 weeks ago. The news will start to turn. Your body might feel beat up but now you are battling this thing actively.

 

Deb

Armywife's picture
Armywife
Posts: 452
Joined: Feb 2018

I had both LVSI and a positive pelvic wash.  Was diagnosed endometrioid endometrial adenocarcinoma Stage IVB Grade 2.  Thankful to report I am 3 years and 4 months NED from end of chemo.  No radiation. 

Lyn70
Posts: 16
Joined: Jan 2021

Hello to All.

Armywife & tina, I find great encouragement from your experiences and diagnosis, particularly LSVI. I am IIIA grade 2. While covid prevented me from having family are friends with me at chemo, I had card and phone call support and prayers. I finished chemo on 5/5 rang the bell. The last chemo was my worst as I had severe shortness of breath which temporarily stopped chemo. It was continued and completed. I had a brief afib episode last week which I pushed through alone. I hope that doesn't return. I have a CT on 5/20 and then discussion on radiation. I was praying for 4 weeks but sounds like I might have to plan on 5. 

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cmb
Posts: 644
Joined: Jan 2018

Lyn,

Glad to hear you finished chemo, despite the issue with the last infusion. That's always a relief. The number of external radiation sessions does vary, but I had 25 sessions, which seems pretty common here. Because of the Labor Day holiday, I went into the sixth week. It is tedious to go there every day, but once the initial pre-radiation setup is done, the sessions themselves don't take very long. I chose to go early each day so I could get it out of the way for the day.

Lyn70
Posts: 16
Joined: Jan 2021

Thank you for your reply, cmb.

5 weeks is likely for me considrring we both had LSVI on our path reports. 

I am not as fearful now talking with those that have had radiation. I am going to get prebiotics and follow a low fiber diet to control diarrhea. My CT indicates 'checking for bony masses on my pelvis. I dont understand the meaning of this. 

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