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Had laparoscopic hysterectomy for endometrial cancer. Also have multiple sclerosis. Suggest the best treatment?

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I just had a laparscopic hysterectomy for endometrial cancer. i was told that it was Stage1 . The pathology report after surgery
said it was Stage1 / Stage 2 my gynec/oncologist said . He is giving me options and sending me to a Radialogist.
He said he could go back in and take out the lymph nodes and depending on the results i could have radiation and chemo. That was one option. Another option just external radiation. Third option XXXXXXX radiation.

I see the radiologist Oct.15th. My questions are: why didn't he take out the lymph nodes then instead of me having another surgery? Also I have multiple sclerosis- how will I tolerate the radiation with a compromised immune system? What quality of life will i have after? I already have bladder incontinence most of the time.
Posted Thu, 24 Oct 2013 in Cancer
 
 
Answered by Dr. Indranil Ghosh 1 hour later
Brief Answer:
Need at least some additional treatment

Detailed Answer:
Hi
Thanks for your query.

To answer your queries one by one..
1. why didn't he take out the lymph nodes then instead of me having another surgery?

A. Depends upon whether the diagnosis was confirmed before surgery by biopsy. If it was, then taking out the lymph nodes at the same surgery was a good option. Otherwise, he had to take the uterus out, establish the diagnosis and then go in for lymph node resection.
But, many institutes have their protocol on how to go about it and they just follow that.

2. Also I have multiple sclerosis- how will I tolerate the radiation with a compromised immune system?

A. Again, depends upon how much immune suppressive drugs are you on. If not too much, then radiation will not have excess adverse effects.

3. What quality of life will i have after?

A. Side effects from radiation to the pelvic area may include diarrhea, rectal bleeding, incontinence, bladder irritation, and sexual problems. Some of these get better over time while others tend to persist.
As you already have bladder problems, things may turn worse after radiation.

My suggestions on your further treatment are that, I would rather go for the lymph node resection first. If they are free then probably you may be observed. If you can upload a copy of the histopathology report, then I may be able to guide you better.

Regards
Above answer was peer-reviewed by
 
Follow-up: Had laparoscopic hysterectomy for endometrial cancer. Also have multiple sclerosis. Suggest the best treatment? 18 hours later
Dear Dr. XXXXXXX

Thank you so much for your reply. I will see if I can get the pathology report.

I have questions on the lymph node resection- How long is that surgery? What does it involve as far as affecting the bowel and/or bladder or other organs?

What actually is a lymph node resection?

Will I have other side effects? Will it cause anything to the MS?

I have not been on any MS medicine for a few years now. Had been on an injectible one- Copaxone- for the first 5 years, then Zenapax- Intervenous med
once a month for a year. Tried others, but had side effects. So haven't been on any. My MS Neurologist has wanted me to try one of the new pills out, but once again I am concerned about the side effects. Also the new meds are really for relapsing/remitting MS. I believe I have one of the progressive forms of MS now.
What do doctors think about the new MS drug- Tecifedera- (BG 12)?
 
 
Answered by Dr. Indranil Ghosh 13 hours later
Brief Answer:
see below

Detailed Answer:
My answers -

1. How long is that surgery? What does it involve as far as affecting the bowel and/or bladder or other organs?

A. Duration of surgery depends upon surgical expertise, patient factors and disease factors. It can be between 3-8 hrs. It does not directly involve the bladder or bowel. However, they may get inadvertently injured.

2. What actually is a lymph node resection?

A. it is the systematic exploration and taking out of all the lymph glands in the lower part of the abdomen (where the tumor may go).

3. Will I have other side effects? Will it cause anything to the MS?

A. The surgery will not affect your MS but it itself has known side effects, like swelling of lower limbs, prolonged recovery, etc.

4. Tecfidera has no known effects on cancer.


Hope I have answered your queries. If you are satisfied with the answer then please close the query and give your feedback.
Regards.
Above answer was peer-reviewed by
 
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