Q. My mom had hysterectomy for adenocarcinoma. Is radiation therapy compulsory?

Answered by
Dr. Varadarajan Kumar
and medically reviewed by iCliniq medical review team.
Published on Nov 19, 2017 and last reviewed on: Oct 09, 2018

Hello doctor,

My mother had complex endometrial hyperplasia for which surgery was fixed and last week, 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, 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?

Dr. Varadarajan Kumar

Medical Oncology Radiation Oncology
#

Hello,

Welcome to icliniq.com.

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

For further queries consult a medical oncologist online --> https://icliniq.com./ask-a-doctor-online/medical-oncologist

Thank you doctor,

I have attached the reports here.

Dr. Varadarajan Kumar

Medical Oncology Radiation Oncology
#

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 showing clear lymph nodes.
  • This is the current ESMO (European society for medical oncology) treatment guideline for a tumor with these features.

For more information consult a medical oncologist online --> https://icliniq.com./ask-a-doctor-online/medical-oncologist

Thank you sir,

I would like to know if surgery alone is not enough since it was grade-1 and it was within the uterus. Or, is radiation therapy compulsory?

Dr. Varadarajan Kumar

Medical Oncology Radiation Oncology
#

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 as 'micro-metastasis' and it could happen in the vaginal stump (cut end of the operation at the back of the uterus).
  • Equally, the operation may have removed everything and there may be no cancer cell left behind in which case it may be an overtreatment. But, we do not have a crystal ball to predict that.
  • But, because of the age, I would mitigate the risk with vault brachytherapy.

For more information consult a medical oncologist online --> https://icliniq.com./ask-a-doctor-online/medical-oncologist

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