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Had Total Laparoscopic Hysterectomy, Bilateral Salpingo Oophorectomy. Suggest Further Treatment?
Question: Dear sir,
my mother has gone through total laparoscopic hysterectomy+bilateral salpingo-oophorectomy and lyumph node biopsy. this was done on 01.10.13. the
biopsy report :
Total laparoscopic hysterectomy+bilateral salpingo-oophorectomy+pelvic lymphnodes
-shows well-differentiation endometriod carcinoma(FIGO grade-1).
-Focally infiltrates in outer half of myometrium.
-Closest inked serosal surface is 0.5 cm away from tumour.
-Lymphovascular emboli are not seen.
-Sections from ovaries and tubes are unremarkable.
-Bilateral parametrium are negative for malignancy.
Right pelvic nodes:
-4 nodes dissected, negative for malignancy.
Left pelvic nodes
-5 nodes dissected, negative for malignancy.
Pathological stage: pT1b,pN0.
could you pls let me know nexttreatement?
my mother has gone through total laparoscopic hysterectomy+bilateral salpingo-oophorectomy and lyumph node biopsy. this was done on 01.10.13. the
biopsy report :
Total laparoscopic hysterectomy+bilateral salpingo-oophorectomy+pelvic lymphnodes
-shows well-differentiation endometriod carcinoma(FIGO grade-1).
-Focally infiltrates in outer half of myometrium.
-Closest inked serosal surface is 0.5 cm away from tumour.
-Lymphovascular emboli are not seen.
-Sections from ovaries and tubes are unremarkable.
-Bilateral parametrium are negative for malignancy.
Right pelvic nodes:
-4 nodes dissected, negative for malignancy.
Left pelvic nodes
-5 nodes dissected, negative for malignancy.
Pathological stage: pT1b,pN0.
could you pls let me know nexttreatement?
Brief Answer:
OBSERVATION AND FOLLOW UP
Detailed Answer:
Hello XXXX
Thanks for writing to us with your health concern.
As you know by now, your mother has been diagnosed with uterine cancer.
Luckily, FIGO stage 1 has a good prognosis.
THe 5 year survival rate ( number of people who survive for 5 years ) is more than 85 %.
This figure is used to tell you that the survival rate is good, of course, many patients live for more than 5 years also.
The primary treatment of course is extensive surgery - total hysterectomy + BSO + staging of pelvic lymph nodes.
THis part has already been done successfully, so congratulations on surviving the main part.
The next management step is - OBservation and follow up care.
A thorough physical examination, XXXXXXX vaginal and rectal examination with ultrasound is a must every 3 - 6 months for the first 3 years, and then yearly for the next 2 years.
A Pap smear should be done every year.
Some studies recommend providing local vaginal radiotherapy even for Stage 1B cancers, however most studies have shown that the morbidity outweighs the benefits.
This area is controversial.
Current consensus however agrees that rigorous observation and follow up is sufficient for patients with Stage 1 disease.
Please discuss the treatment options thoroughly with a reputed Gynaec Oncologist also.
All the best to you for the future.
Please feel free to ask for further clarifications.
OBSERVATION AND FOLLOW UP
Detailed Answer:
Hello XXXX
Thanks for writing to us with your health concern.
As you know by now, your mother has been diagnosed with uterine cancer.
Luckily, FIGO stage 1 has a good prognosis.
THe 5 year survival rate ( number of people who survive for 5 years ) is more than 85 %.
This figure is used to tell you that the survival rate is good, of course, many patients live for more than 5 years also.
The primary treatment of course is extensive surgery - total hysterectomy + BSO + staging of pelvic lymph nodes.
THis part has already been done successfully, so congratulations on surviving the main part.
The next management step is - OBservation and follow up care.
A thorough physical examination, XXXXXXX vaginal and rectal examination with ultrasound is a must every 3 - 6 months for the first 3 years, and then yearly for the next 2 years.
A Pap smear should be done every year.
Some studies recommend providing local vaginal radiotherapy even for Stage 1B cancers, however most studies have shown that the morbidity outweighs the benefits.
This area is controversial.
Current consensus however agrees that rigorous observation and follow up is sufficient for patients with Stage 1 disease.
Please discuss the treatment options thoroughly with a reputed Gynaec Oncologist also.
All the best to you for the future.
Please feel free to ask for further clarifications.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor,
Thanks your reply. The doctor who did the surgery, suggested for RT as the disease has been detected in 1B stage. we discussed to other reputed doctor in other hospital . She also suggested the same. So, we went to Radiation Oncologists in different hospitals. Oncologist also suggested for RT. Now i have a confusion a about the cost of the treatment and what would be the side affect for this treatment. In Semi govt hospital, the change is 50-70 thousands rupees, where in private hospital the change is huge different. In one private hospital, the cost is 120 thousands, another it is 2.2 Lacks to 3.5 Lacks and another hospital different packages : 95 thousands (conventional treatment), 1.6 Lacks 2.2 lacks and 2.8 lacks. I would like to know what is the difference between these packages. If we take basic treatment what would be the side effects? does RT has any effect on kidney and other organs if we take basic RT? Could you please guide us ?
Regards,
XXXX
Thanks your reply. The doctor who did the surgery, suggested for RT as the disease has been detected in 1B stage. we discussed to other reputed doctor in other hospital . She also suggested the same. So, we went to Radiation Oncologists in different hospitals. Oncologist also suggested for RT. Now i have a confusion a about the cost of the treatment and what would be the side affect for this treatment. In Semi govt hospital, the change is 50-70 thousands rupees, where in private hospital the change is huge different. In one private hospital, the cost is 120 thousands, another it is 2.2 Lacks to 3.5 Lacks and another hospital different packages : 95 thousands (conventional treatment), 1.6 Lacks 2.2 lacks and 2.8 lacks. I would like to know what is the difference between these packages. If we take basic treatment what would be the side effects? does RT has any effect on kidney and other organs if we take basic RT? Could you please guide us ?
Regards,
XXXX
Brief Answer:
DETAILED BELOW
Detailed Answer:
See basically it could be external radiotherapy applied to the pelvis ( cheaper - what you probably are calling basic radiotherapy ) , or XXXXXXX localized radiotherapy through the vagina to the specific site ( costlier, localized ). XXXXXXX radiotherapy has very less side effects compared to external - common side effects of external RT include - fatigue, tiredness, diarrhoea , nausea and vomiting, skin changes, hair loss, lower count of protective white blood cells and fall in hemoglobin etc.
Government hospitals are cheaper, but you would have to go through cumbersome waiting processes and paperwork, while private hospitals are more expensive.
Regarding the differences in the packages, only the hospitals providing those packages can explain the differences.
All the best.
DETAILED BELOW
Detailed Answer:
See basically it could be external radiotherapy applied to the pelvis ( cheaper - what you probably are calling basic radiotherapy ) , or XXXXXXX localized radiotherapy through the vagina to the specific site ( costlier, localized ). XXXXXXX radiotherapy has very less side effects compared to external - common side effects of external RT include - fatigue, tiredness, diarrhoea , nausea and vomiting, skin changes, hair loss, lower count of protective white blood cells and fall in hemoglobin etc.
Government hospitals are cheaper, but you would have to go through cumbersome waiting processes and paperwork, while private hospitals are more expensive.
Regarding the differences in the packages, only the hospitals providing those packages can explain the differences.
All the best.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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