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Suggest Treatment For Endometrial Cancer
Question: Good Afternoon, My name is xxxxxx I am also a R.N. and I have a big problem. I was diagnosed with grade 1a endometrial cancer. My myometrial invasion was <50% measures 2mm/14mm maximal tumor invasion
Melf pattern was noted. I had no lymphvascular invasion. my right sentinel lymph node is benign. my left sentinel lymph node had a single isolated tumor cell I had the davinci hysterectomy. I have to decide by tomorrow if I want full pelvic or brachytherapy radiation I am a wreck I need to know what is your opinion on the radiation full pelvic or brachytherapy? Thank you I will wait patiently.
Melf pattern was noted. I had no lymphvascular invasion. my right sentinel lymph node is benign. my left sentinel lymph node had a single isolated tumor cell I had the davinci hysterectomy. I have to decide by tomorrow if I want full pelvic or brachytherapy radiation I am a wreck I need to know what is your opinion on the radiation full pelvic or brachytherapy? Thank you I will wait patiently.
Brief Answer:
I would prefer pelvic radiotherapy
Detailed Answer:
Hi
Thanks for your query.
Overall I must say that your cancer is a good prognosis one even without treatment. If we leave aside the isolated tumor cell in sentinel node, then probably there is no need of even brachytherapy.
In grade 1 stage IA, lymph node dissection is not mandatory and if it was not done even then we would have been okay with observation only. The significance of single isolated tumor cell in endometrial cancer is unknown at this point of time. But, if we consider it as metastatic lymph node then definitely full pelvic RT is recommended. As we do not know the exact significance of single cell in lymph node, we would be inclined to give radiotherapy as a protective measure. But this is certainly not very evidence-based.
Hope this helps.
Regards
I would prefer pelvic radiotherapy
Detailed Answer:
Hi
Thanks for your query.
Overall I must say that your cancer is a good prognosis one even without treatment. If we leave aside the isolated tumor cell in sentinel node, then probably there is no need of even brachytherapy.
In grade 1 stage IA, lymph node dissection is not mandatory and if it was not done even then we would have been okay with observation only. The significance of single isolated tumor cell in endometrial cancer is unknown at this point of time. But, if we consider it as metastatic lymph node then definitely full pelvic RT is recommended. As we do not know the exact significance of single cell in lymph node, we would be inclined to give radiotherapy as a protective measure. But this is certainly not very evidence-based.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Dear Dr. XXXXXXX
Thank you for helping me. With the melf invasion which I understand is a predictor for lymph node metastasis I think it is safer to do the full pelvic. No one knows what is in the other lymph nodes right? They tell me radiation does not improve survivablity but in my case I think it will help I am afraid of melf invasion. Am I right? I know you said if it is considered a metastatic lymph node then definitely full RT I just think brachytherapy may not be enough and if I have a recurrence if not local I can die Which is better living with side effects of pelvic RT or being dead. It really comes down to that. Thank You
Thank you for helping me. With the melf invasion which I understand is a predictor for lymph node metastasis I think it is safer to do the full pelvic. No one knows what is in the other lymph nodes right? They tell me radiation does not improve survivablity but in my case I think it will help I am afraid of melf invasion. Am I right? I know you said if it is considered a metastatic lymph node then definitely full RT I just think brachytherapy may not be enough and if I have a recurrence if not local I can die Which is better living with side effects of pelvic RT or being dead. It really comes down to that. Thank You
Brief Answer:
yes it comes down to that
Detailed Answer:
Melf alone is not considered a high risk factor. In you I think it is the single cell in lymph node which is changing the decision. Just to stay on the safe side.
yes it comes down to that
Detailed Answer:
Melf alone is not considered a high risk factor. In you I think it is the single cell in lymph node which is changing the decision. Just to stay on the safe side.
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Above answer was peer-reviewed by :
Dr. Sonia Raina
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