@terradean. Oh goodness, you've really "been though the wars" ( experienced difficult emotions and conditions) if you know that expression. I've driven through Oregon a few times but that was many years ago so I don't recall the distance from Grants Pass to Eugene. It does seem as though the radiation oncologist in Williamette has little interest in coordinating your care but that's a good question to ask the oncologist directly yourself when you are seen there again. It's good that your son is going with you because as you wrote he can ask questions too. It's a good idea to have a loved one present with you during your appointments. What you are going through brings up such stressful and anxious emotions. This means that when you're talking with the oncologist you might miss important pieces of information because you are in that high emotions state. Your son can help with that and take notes for you. Ask your son to sit down with you and write your questions and his down on paper. That will help both of you to focus and will make the appointment go better.

If you need to you can take a day or two or more to make your decisions on what treatment plan you want. I did that with my radiation therapy plan and my radiation oncologist was fine with that.

Will you please come back to Mayo Clinic Connect and let me know what your oncologist says? And what treatment plan you choose?

I'm dismayed by all the delays you experienced in Grants Pass before you were seen and diagnosed.

@terradean. That sounds very stressful to be getting confusing information from different directions like that. Have you tried looking at the pathology reports for your hysteroscopy and hysterectomy specimens in the hospital's patient portal? Those reports should state directly what the oncologists are looking at to make their treatment decisions. Some things to look for are
1) the type of cancer and Grade. On my pathology reports, this is near the top under "Final Diagnosis". Mine says "Endometrial adenocarcinoma endometrioid type FIGO Grade 3." Grade is an indication of how much the cells in the tumor look like normal endometrial cells under the microscope. Grade 1 means they look pretty similar to normal cells, which usually means the cancer is less aggressive. Grade 3 means they don't look much at all like normal cells, which usually means the cancer is more aggressive. There can also be different types of cells such as "serous" or "clear cell", which is a different from "endometrioid". These other types are all Grade 3.

2) the Stage. On my report this is closer to the bottom under "Synoptic Report". Mine is "FIGO Stage (2018 FIGO Cancer Report): IB: Invasion equal to or more than half
of the myometrium." The stage is an indication of how much the cancer has spread. From your description, it sounds like yours is IIIA, which the American Cancer Society website defines as "The cancer has spread to the outer surface of the uterus (called the serosa) and/or to the fallopian tubes or ovaries (the adnexa) (T3a)."

You can also look at "Lymphovascular Invasion" which is also under the "Synoptic Report" on my report and the "immunohistochemical stains" for "p53", which will be reported as positive or negative. Lymphovascular invasion means that the cancer has entered the system that carries lymph fluid. Mine was positive. p53 is a gene that when mutated (reported as "positive" on the pathology report) is associated with more aggressive cancers. Mine was positive for this too.

The oncologists use these things to determine the level of risk that the cancer has spread, even though they can't detect any tumors elsewhere in your body or in your lymph nodes. Cancer cells may be lurking somewhere and will grow into tumors later if they aren't killed with chemo and radiation now. You should ask your doctors, but your Stage IIIA is probably the main reason for the aggressive treatment plan.

I'm having chemo and vaginal brachytherapy, even though my lymph nodes were negative and I don't have any known tumors after the hysterectomy, because I have a trifecta of high grade (Grade 3), greater than 50% myometrial invasion, positive for lymphovascular invasion, and positive for p53.

I've had two rounds of chemo so far and have found it tolerable. On the day of the infusion and for two days afterwards I have felt pretty good, and would have been able to work my desk job if I hadn't already quit. (This is probably because of all the other drugs they infuse like steroids and anti-nausea meds). I'm not sure about a job on your feet. The next 2-3 days I felt very tired, was uninterested in eating, and would not have been much good at work. But after that I felt fine again. Something about the chemo gives me brutal constipation, and I'm still trying to figure out how to use Miralax properly. My hair started falling out after 2 weeks, and now at almost 5 weeks, it is very thin with lots of scalp showing through. I'm looking forward to this being over.

Good luck to you.