Radiation or not after surgery for endometrial cancer?

@therese73 Welcome to Mayo Clinic Connect and our Gynecological Cancers Support Group. I know what a huge shock the diagnosis is that includes the word "cancer". Like you I am 73 years old. I was diagnosed with endometrioid adenocarcinoma Grade 1 Stage 1a in 2019. I had a recurrence (at the vaginal cuff) in 2021 and had 25 sessions of external beam radiation and 2 sessions of brachytherapy. Since then I have kept up with all my cancer surveillance appointments and have been NED (no evidence of disease).

What a huge disappointment that your gyn oncologist could not complete surgery (for a hysterectomy?). Do you know if the plan had been to remove the uterus, fallopian tubes, and ovaries? It is a relief that the PET scan showed no lymph node involvement and the only area that "lit up" was presumably where the endometrial cancer is located.

It sounds like you found an excellent radiation oncologist who has a lot of experience. When do you start the radiation therapy?

I have Stage IB Grade 2 Endometrial cancer. Because of 3 prior huge abdominal surgeries the Gyn oncologist and her assistant surgeon decided to close me because of dense adhesions. Referred for 25 sessions of External Beam Radiation and 3-5 sessions of Bracytherapy, telling me this is a curative treatment. The Pet Scan showed no lymph node involvement and only a focal hypermetabolic area in the posterior fungus of the uterus. I am 73 years old and because of the sepsis I suffered necessitating all the surgeries am really afraid that this is not going to work. None of the doctors I have seen have given me any statistical information, with the exception of the rad oncologist I am scheduled to do the external beam radiation with. He told me he has cured 4 women with this treatment plan, 2 while he was at Mayo and 2 in his present job. I cry constantly. He told me the gold standard is surgery.

i decided on my own not to have chemo or radiation. i am going for a biopsy d&c camera inserted polops removed on april 7

Glad to hear that you have made a decision and feel good about it. Thanks for letting us know what they said.

@naturegirl5
Thank you so much for sharing. I will hop over to read those posts as well. I am so happy to hear that radiation went well for you. I think I have made up my mind that I will have the treatment. Then hopefully put this all behind me and move on!

@dlgbb Thanks for coming back and letting me know about your follow-up exam. There is a Discussion that I started in our Gynecological Support Group on radiation therapy that you might like to read through. You'll get various perspectives including side effects, if any. Personally, when I had radiation therapy (external and internal) after a recurrence in the vaginal cuff I had very few side effects. I experienced a little fatigue, occasional diarrhea, and that's really all. I continued weightlifting and balance training and went for daily walks. I went for 5 days/week for 5 weeks for external and then 2 treatments of brachytherapy (internal). I met with the radiation oncology nurse and the radiation oncologist weekly to monitor my progress and to discuss any problems I was having.

Discussion: What kind of radiation therapy did you get for your gynecological cancer?

-- https://connect.mayoclinic.org/discussion/types-of-radiation-treatments-for-gynecological-cancers/

@naturegirl5 @val64

I had my follow-up today in Calgary, and now I have to make a decision. No chemo is required. Standard of care is to do radiation, but a clinical trial is being offered where there is no radiation because of the POLE mutation - they just observe every three months, and then treat if there is a recurrence. I guess the choice is between being proactive and preventative, or reactive and treating cancer again if it comes back. I am leaning towards doing the radiation. I would rather stop it in its tracks than have to try and get rid of it again. It will be 5 weeks of 5 days a week, 25 treatments - external only.

Diaz,
I have yet to see my Dr post hysterectomy but am interested in radiation and its side effects.
A quick questions for you: What is the dilator you use to prevent scarring after radiation? Is it placed up the rectum and do you still have control of your anus opening? How much longer will you have to use the dilator?
Thanks for any insight you can share:)

I sure will. I am 58, and until this past fall, a picture of health and fitness! This is all so bizarre.

@dlgbb I hope your 6 week follow-up goes well. Do you have some questions written that you can ask your oncologist? You have good questions here that you can start with and in your place these are questions I would be asking. I'd also ask about the mitral valve prolapse and if that is something to be considered in your cancer care treatment. I'm 73-years-old and it seems like every time I'm ahead something new shows up to address. And I need to see yet another specialist. Sound familiar?

Will you please come back here and let me know what you learn at your appointment tomorrow?