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Had Bleeding. CT Scan Showed Grade 2 Endometrial Carcinoma. Prescribed Uterus Hysterectomy. Taking Radiation. Suggest?

Posted on Thu, 22 Aug 2013

Question: Doctor i am 63 years of age and had bleeding a month back,for which i consulted a doctor. I was advised to get a sonography done and then an x-ray. I was also asked to get a CT scan done which showed grade 2 endometrial carcinoma for which i was then prescribed to get the uterus hysterectomy done which i had on 10th July. The samples post operation was sent for investigation.I have attached the report for your reference and suggestion . I have also been asked to undergo 25 radiation sittings of 5minutes each along with 3 sittings of chemotherapies .Kindly suggest what do i do and what is the current status and why have i been asked to go for chemotherapies

Answered by Dr. Dr. ARIF N K (54 minutes later)

Hi XXXXX,
Thank you for choosing XXXXXXX After analyzing your query and histopathology report, the surgery done for you is complete. But, because of the involvement of pelvic lymphnode (metastatic deposit) makes it a higher stage, hence you have been advised radiotherapy.
I strongly advise you to go ahead with radiotherapy, if you do not undergo RT(radiotherapy) there is very high chances of recurrence of tumor.
I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow-ups. If you like my answers kindly rate it, and write a review as well. Please do not forget to accept it.
Thank you,
Wish you good health.
Regards,
Dr Arif
You can consult me again directly through my profile
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. ARIF N K (53 minutes later)

Doctor i am thankful to you for your advice and would be grateful to you if it could be clarified whether only Radiations therapy have to be taken or the Chemoradiation therapy which is a combination of Radiations and Chemotherapy)are to be given.
Just to inform you more about this case we have also got a USG test done which shows a clear pictiure of the liver,kidneys,panchreas as well as a chest xray was also taken out which is also clear and free from metastatic deposits.

As per 2 different doctors one has advised only 25 radiations of 5 Minutes each and the other doctor has advised 4 Chemotherapy with 25 radiations.

Kindly suggest as i am confused doctor and would now only reply on your suggestion or advise.

Answered by Dr. Dr. ARIF N K (2 hours later)

Hi XXXXX,
Its a good sign that USG is normal. Kindly note down CA-125 value also, because it is important for follow up of case.
Coming to your doubt I strongly suggest you to go ahead with CHEMOTHERAPY + RADIOTHERAPY (better option for pelvic lymphnode positive & grade II tumor).
The reason for different opinions with doctors is due the controversial thing in the post-operative management of cancer endometrium. The latest NCCN (National comprehensive cancer Network) guidelines which is followed by most gynaec oncologists stats the same.
If I am not wrong your cancer stage will be STAGE III C1 (bacause of +ve pelvic lymphnode), then according to NCCN adjuvant treatment will be CHEMOTHERAPY AND/ OR TUMOR DIRECTED RADIOTHERAPY.
For more information you can visit the NCCN website. All the best for your future treatment.
If you do not have any further clarification you can close the discussion and kindly rate & review my answer. Wish you good health.
Regards,
Dr Arif
You can consult me again directly through my profile
WWW.WWWW.WW

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. ARIF N K (46 hours later)

Thank you doctor for your as we will be going ahead with the chemoradiation therapy as advised by you,and lastly I wanted to ask is it fine if we get the therapy in jabalpur or shoudl we visit tata memorial - mumbai post the 1st chemo we can continue the rest of the therapies in jabalpur,as we have come across instances where patients had started the therapy as advised for 4 chemos but when reaching the last session,the patient was then advised to visit tata memorial mumbai and continue the treatment. Please suggest as I seem confused and abit frightened beacuse of chemos.

Answered by Dr. Dr. ARIF N K (15 hours later)

hi XXXXX,
You can continue your treatment in jabalpur if the facilities are availabe for the same, you need to complete the full course of chemoradiation. I cant reason out why patients are send back to Tata memorial hospital. But you can always clarify before hand in Jbalpur hospital if they are having all the facilities and what are the chances of you being send back to tata hospital.
Lastly before starting the treatment, get yourself clarified and councelld well regarding the possible side effects of chemo & radiotherapy, and also the chances of relapse and followup.
If you do not have any further clarification you can close the discussion. Kindly rate & review my answer. Wish you good health.
Regards,
Dr Arif
You can consult me again directly through my profile
WWW.WWWW.WW

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar