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What Does This CT Scan Of A Cervical Cancer Patient Indicate?
Question: My mother diagnosed with Cervical Cancer stage 3B.
We have taken 2 opinions, they both differ so need your inputs,
Opinion 1 - Oncologist/ Radiologist suggested 5 weeks, Monday to Friday EBRT/IMRT radiation. Chemo therapy (drug name - Abraxin) one a week and 2 brachytherapy after 5 weeks of radiation is complete.
Opinion 2 - Doctor suggested this cannot be controlled because cancer has spread to axilla.
I am not sure how cancer can spread to axilla when it is locally advanced.
Questions:
- Can you please check reports and let me know if this is controllable/ curable?
- If it is controllable then can you suggest detailed treatment plan? next steps?
- How do I help my mother to control symptoms if there is no suggestive treatment plan in this situation?
- Do you suggest any alternative therapy?
I don't have much time, appreciate if you can respond at your earliest.
We have taken 2 opinions, they both differ so need your inputs,
Opinion 1 - Oncologist/ Radiologist suggested 5 weeks, Monday to Friday EBRT/IMRT radiation. Chemo therapy (drug name - Abraxin) one a week and 2 brachytherapy after 5 weeks of radiation is complete.
Opinion 2 - Doctor suggested this cannot be controlled because cancer has spread to axilla.
I am not sure how cancer can spread to axilla when it is locally advanced.
Questions:
- Can you please check reports and let me know if this is controllable/ curable?
- If it is controllable then can you suggest detailed treatment plan? next steps?
- How do I help my mother to control symptoms if there is no suggestive treatment plan in this situation?
- Do you suggest any alternative therapy?
I don't have much time, appreciate if you can respond at your earliest.
Brief Answer:
oncologist is right
Detailed Answer:
Hello dear thanks for trusting health care magic.
After studying the CT scan report, it is quite evident that the cervical cancer has spread beyond uterus and cervix and is not a localised cancer anymore.
Ever since it has involved the peri renal fat then chances of spread to axillary lymph nodes are very high because of rich lymphatic supply of peri renal fat.
The treatment of choice for her will chemo radiation followed by extrafascial hysterectomy and lifelong follow up. XXXXXXX opinion without keeping any information away from you is that chances of success are low in terms of total eradication of cancer but quality of her life can be improved.
The oncologist you are consultating seems learned and has given you right line of management according to international guidelines.
Chemo radiotherapy will decrease the bulk of diseased tissue and brachytherapy thereafter will shrink the origin of spread of cancer and once under control and all the adjacent tissues seem to be from cancer on repeat MRI then we can plan extrafascial hysterectomy which will prolong her life but it can not be eradicated from her body now because it is an advanced stage of disease now.
I hope I have answered all your questions but in case you have other questions i will be happy to help.
All the best.
oncologist is right
Detailed Answer:
Hello dear thanks for trusting health care magic.
After studying the CT scan report, it is quite evident that the cervical cancer has spread beyond uterus and cervix and is not a localised cancer anymore.
Ever since it has involved the peri renal fat then chances of spread to axillary lymph nodes are very high because of rich lymphatic supply of peri renal fat.
The treatment of choice for her will chemo radiation followed by extrafascial hysterectomy and lifelong follow up. XXXXXXX opinion without keeping any information away from you is that chances of success are low in terms of total eradication of cancer but quality of her life can be improved.
The oncologist you are consultating seems learned and has given you right line of management according to international guidelines.
Chemo radiotherapy will decrease the bulk of diseased tissue and brachytherapy thereafter will shrink the origin of spread of cancer and once under control and all the adjacent tissues seem to be from cancer on repeat MRI then we can plan extrafascial hysterectomy which will prolong her life but it can not be eradicated from her body now because it is an advanced stage of disease now.
I hope I have answered all your questions but in case you have other questions i will be happy to help.
All the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your answer.
I was in middle of uploading reports while you answered my question. There are few more PET Scan images and reports that you may want to check.
- When you say the treatment will increase the quality of life, does this mean her life span will increase?
- If cancer has spread to axillary lymph nodes, then how radiation will help control/ eliminate this?
- Second doctor suggested to not go for any treatment because it may disturb her health. she hardly has any symptoms. She has DJ stents in both ureters and her health is completely normal except occasional mild pain in pelvis area. If treatment can improve quality of her life then shouldn't we opt for treatment?
- Do you suggest any alternative therapy?
- Both doctors suggested extrafascial hysterectomy is not option before or after in this case. Can you please explain your opinion of extrafascial hysterectomy in little more detail?
I was in middle of uploading reports while you answered my question. There are few more PET Scan images and reports that you may want to check.
- When you say the treatment will increase the quality of life, does this mean her life span will increase?
- If cancer has spread to axillary lymph nodes, then how radiation will help control/ eliminate this?
- Second doctor suggested to not go for any treatment because it may disturb her health. she hardly has any symptoms. She has DJ stents in both ureters and her health is completely normal except occasional mild pain in pelvis area. If treatment can improve quality of her life then shouldn't we opt for treatment?
- Do you suggest any alternative therapy?
- Both doctors suggested extrafascial hysterectomy is not option before or after in this case. Can you please explain your opinion of extrafascial hysterectomy in little more detail?
Brief Answer:
Needs treatment
Detailed Answer:
You are most welcome and I will be very happy in case I'm able to make a contribution to the management of your mother's disease.
By not doing anything for removal of cancer tissue just because she has no symptoms despite of diagnosis is not a wise act.
It will get worsened suddenly and thenot we might not be able to help her at all.
Quality of life means no symptoms despite of such an advanced stage which will definitely appear soon.
Prolongation of her life is also possible in case she shows good response to chemo radiation.
The spread to axillary lymph nodes will be taken care to some extent by chemotherapy and your oncologist might like to give it a shot if radiation too.
In my opinion she needs therapy whether she has symptoms or not and the treatment line of first doctor i. e. Oncologist is best with added extrafascial hysterectomy in case second look CT scan shows uterus and adenexa clear from disease.
I have seen multiple such cases and have seen favourable results many a timesmall.
Keeping my fingers crossed I wish you all the best.
Needs treatment
Detailed Answer:
You are most welcome and I will be very happy in case I'm able to make a contribution to the management of your mother's disease.
By not doing anything for removal of cancer tissue just because she has no symptoms despite of diagnosis is not a wise act.
It will get worsened suddenly and thenot we might not be able to help her at all.
Quality of life means no symptoms despite of such an advanced stage which will definitely appear soon.
Prolongation of her life is also possible in case she shows good response to chemo radiation.
The spread to axillary lymph nodes will be taken care to some extent by chemotherapy and your oncologist might like to give it a shot if radiation too.
In my opinion she needs therapy whether she has symptoms or not and the treatment line of first doctor i. e. Oncologist is best with added extrafascial hysterectomy in case second look CT scan shows uterus and adenexa clear from disease.
I have seen multiple such cases and have seen favourable results many a timesmall.
Keeping my fingers crossed I wish you all the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for you quick reply.
I never meant I dont want to go for treatment because she is showing no symptoms. My point was, Chemo-radiation should not deteriorate her current state of health. It should not happen that it does not help because of advance stage of cancer and on top of that it deteriorate her current state of health.
Per your answer, it appears that the treatment will do the good than not doing treatment at all.
I have visited third doctor because opinions of first 2 doctors differed. The third doctor suggested to do FNAC test to confirm if there is cancer in axilla lymph nodes. He is suggesting us to do this because he thinks it is very rare for cancer to spread in axilla lymph nodes, specially when it is cervical cancer. I am not getting anxious as from your reply it appears that I should rush the treatment rather than waiting any longer.
do you suggest any alternative therapy that can go along with chemo-radiation. Like Ayurvedic treatment? If we go for ayurvedic treatment to boost immunity as well as to kill cancer cells, would it interfere with chemo-radiation?
I never meant I dont want to go for treatment because she is showing no symptoms. My point was, Chemo-radiation should not deteriorate her current state of health. It should not happen that it does not help because of advance stage of cancer and on top of that it deteriorate her current state of health.
Per your answer, it appears that the treatment will do the good than not doing treatment at all.
I have visited third doctor because opinions of first 2 doctors differed. The third doctor suggested to do FNAC test to confirm if there is cancer in axilla lymph nodes. He is suggesting us to do this because he thinks it is very rare for cancer to spread in axilla lymph nodes, specially when it is cervical cancer. I am not getting anxious as from your reply it appears that I should rush the treatment rather than waiting any longer.
do you suggest any alternative therapy that can go along with chemo-radiation. Like Ayurvedic treatment? If we go for ayurvedic treatment to boost immunity as well as to kill cancer cells, would it interfere with chemo-radiation?
Brief Answer:
FNAC can be tried too
Detailed Answer:
I appreciate your warm response and its pleasing to know that you intend to follow my advice.
I personally don't believe in Ayurveda and don't know much about it but in case you have an access to some good Ayurveda doctor then no harm in showing him once but chemoradiation is the treatment to be started with priority.
FNAC is a good option but that won't change the treatment plan except that they may give local radiation therapy to the affected node.
Even if they don't feel like giving local radiation to node it might be taken care of by the chemotherapy.
Your mother will definitely start having some minor ailments like hair fall, diarrhea and nausea but counsel her beforehand for it so that she doesn't say no to the therapy thinking that it is harming her rather than helping.
Wish her to recover soon.
Take care.
FNAC can be tried too
Detailed Answer:
I appreciate your warm response and its pleasing to know that you intend to follow my advice.
I personally don't believe in Ayurveda and don't know much about it but in case you have an access to some good Ayurveda doctor then no harm in showing him once but chemoradiation is the treatment to be started with priority.
FNAC is a good option but that won't change the treatment plan except that they may give local radiation therapy to the affected node.
Even if they don't feel like giving local radiation to node it might be taken care of by the chemotherapy.
Your mother will definitely start having some minor ailments like hair fall, diarrhea and nausea but counsel her beforehand for it so that she doesn't say no to the therapy thinking that it is harming her rather than helping.
Wish her to recover soon.
Take care.
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
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