Stage 1c, grade 2 - Doctor suggesting clinical trial??

TawnyB

Hello everyone,

My mother in law was diagnosed with stage 1c grade 2 endometrial cancer after her hysterectomy 3 weeks ago. The doctor is suggesting additional treatment and has mentioned a clinical trial called "Pelvic Radiotherapy Versus Vaginal Cuff Brachytherapy, Paclitaxel, and Carboplatin in Patients With High-Risk Stage I or II Endometrial Carcinoma".

She is absolutely torn on what to do and I was wondering if any of you have heard about this trial or could raise questions or points we have not thought of. There are 2 arms of the clinical trial and she would be randomly assigned to ONE of the following: 1) Pelvic radiotherapy once daily, 5 days a week, for 5-6 weeks or 2) Vaginal cuff brachytherapy & patients receive paclitaxel and carboplatin. Chemotherapy repeats every 21 days for up to 3 courses in the absence of disease progression or unacceptable toxicity.

As an alternative to the clinical trial, the doctor would recommend Vaginal Cuff Brachytherapy alone. We’ve read many great articles about this treatment and it seems to have worked very well for a lot of endometrial cancer patients.

There is no evidence the cancer has spread and her lymph nodes are clean so we're questioning whether the clinical trial is "overkill". The question in our minds is if she gets the second arm of trial, would the chemo & pelvic radiation harm healthy tissue and is it worth that additional risk?? Or is it better to go through the pelvic radiation/chemo for precautionary measures? We have a lot going through our minds, but these things are top of mind.

Any insight would be appreciated!

Thanks for your time,
Stephanie

rmaureen · Moderator Joined: 06 Oct 2005 Posts: 335

Hi Stephanie,

Welcome aboard. I wish I could answer your questions, but I cannot. I had both radiation to the pelvis, abdomen, and brachytherapy--and some damage. Vaginal shrinkage is common place for those who undergo brachytherapy, and my oncologist last September speculated pain in my pelvis area is related to radiation damage. Additionally, the wall of my bladder thickened up after radiation.

Being we are speculating about a clinical trial, there is nothing to compare experiences with except to others who have gone through the same treatments. Is chemo suggested with both trial experiments? I can understand your reservation about overkill, and radiation can certainly cause damage. Myself, being stage III and grade 2--felt radiation made sense, as it reduces the risk of reoccurence. And in the long term, it may make damage worth it, if it is not significant damage, that is. So far, I don't think radiation cause damage which I can characterize as compromising my health. I got a lot of health problems, but none I can attribute as to deriving from my radiation.

Maybe others out there have heard about this trial will post. I never underwent chemotherapy, however, my current oncologist would had preferred it to my radiation--but a lot depends, once again, on the stage of the cancer (type and grade).

Thankfully, your mom found out about the cancer early. I wish I could been of more help. I personally would elect some kind of treatment to dissuade reocurrence, but it is such an individual's choice. The only thing I noticed with brachytherapy is vaginal shrinkage, and painful urination for a short period. (Oh yeah, the implant can hurt while in you). I think those things also depend on how the session(s) are set up (frequency and duration). All of the options you mention should effectively minimize the potential for reoccurrence, however. Your mom will be in my prayers. And if others out there can add to this, and post their experiences with chemo and these drugs, we hope you join in.

God bless,

Rhonda
_________________
Diagnosed Sept. 2005
Stage III-C Endometrial Adenocarcinoma
Grade 2
My Story:
http://fierytrial.wordpress.com/2009/12/09/my-diagnosis

Pixie · Experienced user Joined: 15 Sep 2009 Posts: 72

Hi Stephanie,

Welcome to the forum, I hope you find some answers here.

I also can't answer your questions about chemo as is wasn't considered in my case. I know that Vaginal cuff brachytherapy is meant to be one of the best treatments for utereine cancer and is much more effective than external pelvic radiation.

My worries would be what happens if she is put in the pelvic radiation group, is she getting the best possible treatment for her cancer.

As Rhonda says, radiation (both sorts) causes some problems, brachytherapy is a lot more uncomfortable (to be honest downright painful Laughing

) than external pelvic radiation but has less side effects and is usually better tolerated. Rhonda had both sorts and can probably be more helpful, I had just Brachytherapy (4 sessions) and was back at work full time 10 days after my treatment ended.

I hope that someone else with experience of chemo will answer, we seem to be a very small group here Laughing

If you have any other questions or fears post away.

Take care...
_________________
Endometrial Adenocarcinoma FIGO stage 1b, Grade 2. Diagnosed September 2009. Hysterectomy followed by 4 sessions of Brachytherapy.

rmaureen · Moderator Joined: 06 Oct 2005 Posts: 335

I just realized Stephanie, I misspoke. My osteopenia around my spine has been attributed to my radiation treatments. I got bigger problems then osteopenia at the moment, I get forgetful or preoccupied. Other than that, nothing long term has been pinpointed to radiation.

Rhonda

(Stephanine, I edited this, it sounded funny the way I worded it the first time)
_________________
Diagnosed Sept. 2005
Stage III-C Endometrial Adenocarcinoma
Grade 2
My Story:
http://fierytrial.wordpress.com/2009/12/09/my-diagnosis

Pixie · Experienced user Joined: 15 Sep 2009 Posts: 72

Rhonda, is everything ok?, has something else happened? I don't want to be nosy but I'm concerned Crying or Very sad

. PM me if you want.

Sorry Stephanie for hijacking your post
_________________
Endometrial Adenocarcinoma FIGO stage 1b, Grade 2. Diagnosed September 2009. Hysterectomy followed by 4 sessions of Brachytherapy.

rmaureen · Moderator Joined: 06 Oct 2005 Posts: 335

Hi Pixie,

I sent a pm to you. Wink

Rhonda
_________________
Diagnosed Sept. 2005
Stage III-C Endometrial Adenocarcinoma
Grade 2
My Story:
http://fierytrial.wordpress.com/2009/12/09/my-diagnosis

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