How to treat my mother's stage II endometrial cancer?

Question

Hello doctor,

My mother had complex endometrial hyperplasia for which surgery was fixed, and last week, a hysterectomy, along with salpingo-oophorectomy and pelvic lymphonodectomy, was done. After surgery, the parts were sent for histopathology. It was diagnosed as stage-2 endometrial adenocarcinoma.

The lymph nodes were normal, the uterus border was also normal and well-differentiated. Now, what is the treatment for this? Is radiation therapy required even after the removal of the entire uterus and its neighboring parts?

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

It depends on theextent of disease within the myometrium and endocervical extent.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I have gone through your mother's reports (attachment removed to protect patient identity). Brachytherapy (vaginal vault) alone will be the adjuvant treatment based on the following factors:

1. Grade-1 tumor.
2. Less than 50 percent myometrial invasion.
3. The absence of lymphovascular invasion and complete surgical staging showedclear lymph nodes.

This is the current ESMO (European Society for Medical Oncology) treatment guideline for a tumor with these features.

I hope this helps you.

Thank you.

Answer 3

Hello,

Welcome back to icliniq.com.

Your question is very valid. Yes, it was within the uterus, and it had been removed. We are looking at reducing the risk of what people call 'micro-metastasis', and it could happen in the vaginal stump (the cut end of the operation at the back of the uterus). Equally, the operation may have removed everything, and there may be no cancer cells left behind, in which case it may be an over-treatment. But we do not have a crystal ball to predict that. But, because of the age, I would mitigate the risk with vault brachytherapy.

I hope this helps you.

Thank you.