Get your Health question answered in 3 easy steps

198 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 18 years

I will be looking into your question and guiding you through the process. Please write your question below.

Suggest treatment for tumor cells in parametrium of cervix

Answered by
Dr. Indranil Ghosh


Practicing since :2004

Answered : 1464 Questions

Posted on Mon, 1 Sep 2014 in Cancer
Question: My Mother was operated on 18th July for Cervical Cancer ( Wertheim's Hysterectomy). operation was successful and she is recovering fine. After the surgical Biopsy they declared it as Stage 2b, futher we sent her slides to SRL Ranbaxy for review and there they found the left paramatrium free & right paramatrium with few tumor cells all non reactive so Stage 1b. Now doctors here are saying there is one positive & one negative report so considering that she needs Radiation ( Both external Beam & Internal Beam ) + concurrent chemo apart from recent surgery to avoid the recurrence, I discussed this case with one more doctor & he do not think external beam radiation is indicated nor chemo at this time however brachytherapy to upper vagina could be given if surgeon was not able to remove all the tissue however closefollowup will be needed there is higher incidence of collateral damage with external beam radiation so try to avoid that include kidney damage. Please suggest. I am attaching her Reports.
Answered by Dr. Indranil Ghosh 3 hours later
Brief Answer:
I feel further treatment is needed

Detailed Answer:
Thanks for your query.
I have gone through both these reports. It appears that few tumor cells are seen in the parametrium by both the pathologists though their final interpretation is different. Apart from this another risk factor is the tumor size of 5 cm (relatively large). One thing is not mentioned, the extent of stromal invasion - superficial versus deep. Deep is another risk factor.

Hence, considering that she is only 59 and presumably quite fit, further treatment with external RT+ weekly chemo+ brachy seems appropriate. If the disease recurs then it becomes incurable mostly. So better not to take chance. Adverse effects are there, but manageable and kidneys can be spared by modern Radiotherapy techniques.

However, this is my personal opinion seeing the reports. The doctors treating her should be able to guide you select the appropriate option.

Hope I have answered your query. I will be available to answer further followup queries, if any.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Indranil Ghosh 39 hours later
Thanks.... but can you please throw light as to what do this statement means in Ranbaxy report & what impact does this statement makes in totality......... " RIGHT PARAMETRIUM SHOW FEW TUMOR CELLS, HOWEVER NO REACTION IS SEEN AGAINST THESE TUMOR CELLS, THEREBY INTERPRETED AS FLOATER"
Answered by Dr. Indranil Ghosh 1 hour later
Brief Answer:
floaters are artifacts

Detailed Answer:
It means that basically those tumor cells do not belong there and have been transferred from other parts of the specimen during processing (eg, through the cutting blade).

The SRL pathologist felt that as there no reaction (by the normal cells) around the tumor cells, they may be artifacts rather than actual presence of tumor cells. This is an entirely technical area and I can't comment if it is right or wrong.

That's why I suggested to give more treatment rather than less treatment.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,  
Medical Procedures

Recent questions on Brachytherapy

doctor1 MD

Hi I have been diagnosed with prostate cancer from a biopsy . They think it is confined to prostate. GS 3+4. 19/12 probes positive. 15% of tissue cancerous. 1) do you recommend radiation or surgery 2) for surgery do you recommend open, laproscopic...

doctor1 MD

What treatment would you recommend. I was diagnosed with prostate cancer . 30% of tumor is pattern 4, 70% is GS 3. 9 of 12 core sample had cancer 15% of all core tissue. Cribriform Pattern not identified, periprosatic fat invasion not identified,...

doctor1 MD

I was told my XXXXXXX Score was 7 2 wks ago. I am debating seed therapy. But I have several female relatives including small girls. How close can I be near them? My wife and I sit for our great granddaughters.

doctor1 MD

I ve just read the article about higher incidence of bladder and rectal cancer for patients who have previously undergone radiation treatment for prostate cancer. I was diagnosed with bladder cancer in April 2013 (T1G3) and had the tumor removed via TURBT in May 2013. Cancer had advanced into my left ureter so I underwent more invasive abdominal surgery (partial ureterectomy) in June 2012. Had 6 BCG treatments in July and August and received all clear cystoscopies in October and January. PSA test in January showed irregularities (especially having only 7% free PSA) so underwent prostate biopsy in early February. Results showed cancer in 7 of 12 samples with a Gleason score of 7. One sample showed cancer was very near external wall of prostate. Had 28 external beam radiation treatments and 2 high dose radiation temporary brachytherapy treatments in March and April. I m having my first cystoscopy since early January on Monday, June 30. What s the likelihood of bladder cancer recurrence with the abdominal radiation I ve been through. Thanks!

doctor1 MD

My husband has prostate cancer (diagnosed in 2006). He opted for brachytherapy and radiation treatments whichi were completed in 2007. For the past year, he has had blood and clots in his urine which in catheterization for several days during one of the more extreme episodes (~ 4 months ago). His urologist scoped his bladder concluding that no tumors were present -- his diagnosis was radiation damage to the bladder/vessels. The bleeding/clotting subsided considerably; however, last weekend, it became more severe. He was able to pass the clots and did not have to be catheterized. We have been exploring hyperbaric oxygenation treatment -- do you have any other suggestions?

doctor1 MD

I have type 2 neurofibromatosis, I have had surgery to remove most of the tumors, now I have 3 large fibromas left in my jaw/cheek. I thought cyberknife would be an effective treatment but my Dr said the tumors were too close to the surface, and they cant be removed surgically because the risk of facial paralysis is very high. my question is, would brachytherapy be a good option for my case?