Radiation or not after surgery for endometrial cancer?

@ramidimitri You are very welcome. Yes, I am in agreement with you on how different hospitals and oncologists will recommend varied protocols for their patients. I also understand how fearful your wife may feel as I felt this way after my first diagnosis and then after my recurrence was found. Once I decided on the treatment I felt better because a decision had been made. I hope that will be the case with your wife.

I have lived in Montréal and while I did not have cancer at that time I found the care that I received to be very good.

Would you and your wife like to ask for a second opinion? If so, since you are living in a large urban area she will have other choices of who she might like to see. I don't have any recommendations for Montréal based on my own experiences however the two largest cancer centers are at Jewish General and McGill University. Perhaps your wife is already being seen at one of these?

Jewish General Hospital-Segal Cancer Centre:

-- https://www.jgh.ca/care-services/segal-cancer-centre/

Cedars Cancer Centre at McGill University/Montréal General Hospital:

-- https://www.cedars.ca/en/impact/cedars-cancer-centre

One last thought. Do you know if your wife's case was discussed at a Tumour Board Meeting? In these meetings the physicians involved in cancer care come together to discuss the more challenging cases and make a recommendation for treatment.

Jewish General Hospital: Tumor Boards:

-- https://www.jgh.ca/care-services/segal-cancer-centre/health-services-team/tumor-boards/

@ramidimitri This may be of interest to you https://www.cancer.gov/news-events/cancer-currents-blog/2019/endometrial-cancer-chemotherapy-without-radiation
I have advanced endometrial cancer (stage 3C), which, according to the article, explains why I didn't receive radiation, just chemo. Also, I have already had my life-time's limit of pelvic radiation to get rid of anal cancer.
The radiation has had lasting effects on my vagina--stenosis--which makes it virtually impossible for doctors to give me an internal exam without knocking me out.
If your wife has a non-aggressive form of endometrial cancer, then you might want to consider radiation, again, according to the article.

@naturegirl5
Thank you so much for sharing your experience , we live in Montreal Canada , and I understood that may be every hospital and country has slightly different protocol , I heard the european approach is different than the north american one..My wife is in a state of fear , and often when you are afraid you don't take the right decision , she has tendency to believe more is better , but I am trying to open her eyes at the long term side effects

My wife was diagonised with uterus cancer stage 1A confined, agressive cells 'serous carcenoma '' , they removed the uterus and gave her 6 sessions of chemotherapy , now it comes the radiotherapy,the doctor is giving us two options to decide , and don't want to tell us wich one is better , she said'' it's a personal choice '',,, the two options are :- the internal tratment ( vagianal treatment ) or exterenal one (Pelvic treatment ) , van any body shed some light on the issue , many thanks

@ramidimitri Welcome to Mayo Clinic Connect. This is a good place to get support for you and your wife as we have lots of experience to share here. We aren't medical professionals but we can share our own experiences and make suggestions on what to ask the doctors.

I was diagnosed with a less aggressive kind of uterine cancer than your wife. Mine was endometrioid adenocarcinoma, FIGO Grade 1, Stage 1a. I had a radical hysterectomy and no further treatment at the time. Two years later I had a recurrence and the recommendation was for radiation therapy. I had 25 external pelvic radiation treatments and 2 internal (brachytherapy vaginal) treatments. I did not have chemotherapy.

Many of us here have external and internal radiation and were not asked to choose between the two options. I'm wondering why your wife is asked to choose? My recurrence was found at the top of vaginal (the vaginal cuff) which is why the internal treatment was recommended along with the external treatment. My understanding is that internal vs. external is not a question of which is better but instead which is more effective for treatment.

Here is something to read about radiation therapy from Mayo Clinic:

Mayo Clinic: Radiation Therapy

-- https://www.mayoclinic.org/tests-procedures/radiation-therapy/about/pac-20385162

American Cancer Society: Radiation Therapy for Endometrial Cancer:

-- https://www.cancer.org/cancer/types/endometrial-cancer/treating/radiation.html

Let's wait and see what other members share about their experiences with radiation. May I ask where you and your wife live? Are you in the U.S. or Canada?

@ramidimitri I had a higher stage than your wife, but lymph nodes were clear and all genetic testing and bio markers were unremarkable. I was recommended to have chemo and external radiation, but when I sought a second opinion, chemo was not necessary but available to me if I chose. When I went to the radiologist that the onco surgeon referred me to, she did give me options and told me the standard pros and cons of each. The possible side effects (fecal and urinary incontinence, tailbone damage, etc etc) were out of the question for me, and being a "minimalist," I opted for the most minimal internal radiation. I am very comfortable with my decision, but I realize that many other people feel more comfortable with a "scorched earth" approach and they feel comfortable that they have done the maximum that is available.

My wife was diagonised with uterus cancer stage 1A confined, agressive cells 'serous carcenoma '' , they removed the uterus and gave her 6 sessions of chemotherapy , now it comes the radiotherapy,the doctor is giving us two options to decide , and don't want to tell us wich one is better , she said'' it's a personal choice '',,, the two options are :- the internal tratment ( vagianal treatment ) or exterenal one (Pelvic treatment ) , van any body shed some light on the issue , many thanks

My wife was diagonised with uterus cancer stage 1A confined, agressive cells 'serous carcenoma '' , they removed the uterus and gave her 6 sessions of chemotherapy , now it comes the radiotherapy,the doctor is giving us two options to decide , and don't want to tell us wich one is better , she said'' it's a personal choice '',,, the two options are :- the internal tratment ( vagianal treatment ) or exterenal one (Pelvic treatment ) , van any body shed some light on the issue , many thanks