Doctor doesn’t know: Brachytherapy or 25 radiation treatments?

@ddpatrick13 Do you know the kind of endometrial cancer? There are different kinds and some are more aggressive than others. The kind of endometrial cancer in addition to the Stage and FIGO Grade is reported in your pathology report after your hysterectomy. It is this information that your oncologist is using to recommend what, if any, kind of radiation or other treatment would be helpful for you.

American Cancer Society: What is Endometrial Cancer?

— https://www.cancer.org/cancer/types/endometrial-cancer/about/what-is-endometrial-cancer.html

From what you wrote, I figured that your oncologist is presenting your “case” to the tumor board. This is a very good thing because this allows other physicians such as other oncologists, pathologists, radiation oncologists and other medical doctors to discuss your case and then make recommendations to your oncologist.

I understand how confused and frightening this is. Do you know when the tumor board meets? In my community they meet weekly but you could ask your oncologist that question. And ask the oncologist when you are likely to hear back about the recommendations. I am hoping that your results will be discussed at the next tumor board meeting.

While you wait for your oncologist to get back to you I’d like to suggest that you do whatever feels the best to take care of you. Since your surgery was recently you may have some restrictions on activities. Can you go for walks? Prepare healthy food for yourself? Spend time with close friends and family? Here is something I did after my diagnosis of endometroid adenocarcinoma. I like to walk outside my house in the evening and look up at the sky. It’s dark enough in my neighborhood that I can see the night sky, and the stars. I listen for night time calls from bird or animals. Or I listen to the silence.

What do you like to do? What would you like to do?

I had Endometrial, endometriod adenocarcinoma, FIGO grade 1 and had a total hysterectomy in 12/2024. I was staged at 2 because of greater than 80% invasion into myometrium and minor invasion into the cervical stroma. I had no other invasions anywhere, including lymph nodes. I also had wild type expression, and I did a complete genetic testing routine, and had no genetic markers or anything to watch for (surprised, because both parents, one sister, and multiple cousins had cancers).

The initial recommendation from the gyne oncologist who did the surgery was 25 sessions of external radiation as well as some number of chemo. I and my husband nearly fainted when we heard this. We sought two second opinions, and went to the radiologist that the surgeon referred me to locally. All three said absolutely no chemo. They were all mixed on Brachy or External Beam or a combo of both.

Ultimately, because I had no lymph node invasion, I went into a clinical trial with just two sessions of extremely high dose Brachy. My primary desire was for quality of life not quantity of life years. Not everyone is in the same mind-set, but I made mine very clear to the doctors. I have had no side effects from it at all, but I am suffering from sciatica due to the hysterectomy and have been doing PT. Had my 3 month exams and imaging, and all clear. Of course, I don't feel "cured" by any means; not until I at least get past the year mark.

So, bottom line, I think the thing that may make the biggest difference is the lymph nodes and detection of other cancer cells after the hysterectomy. Best to wait to hear back from your doctor after the board review. It sounds very much like he has your best interest in mind.

Tumor board is good, to get a consensus. FYI I had 25 radiation treatments, and then 5 brachytherapies.