Hysterectomy route after chemo. Opinions and advice needed

Cervical cancer treatment
1

Hello guys!

This is Kayla here. In September 2021 my mum just diagnosed with cervical cancer stage 3 (adenocarcinoma) with 2.8 tumour and multiple lymph nodes involvement. Initially the oncologist told us that the treatment will be 6 chemotherapy (carbo-taxol), 25 sessions of radiotherapy, and 3 sessions of brachytherapy.

However, just yesterday during the consultation prior to her fifth chemotherapy, the blood results show that my mum has low platelet counts. The oncologist told us to stop the chemo first and do the MRI, if the tumour is operable, then he will perform radical hysterectomy. However, if the tumour hasn’t shrunk enough, he will continue with radiation and brachytherapy.

I actually never heard any case where someone with stage 3 cervical cancer is undergoing chemotherapy first and then radical hysterectomy. What I would like to ask you guys is that…

  1. Do you think it’s okay to only receive four sessions of chemo? Should I ask for the extra two chemos after radiation (if the tumour hasn’t really shrunk) or the radical hysterectomy (if the tumour is operable)?

  2. Since her lymph nodes in pelvic area were also affected, isn’t it quite risky to go for radical hysterectomy instead of radiation and brachytherapy? What I often read and heard is that the combination of chemoradiation is very effective and that’s why I prefer it to be that way. Can someone enlighten me on this?

Thank you so much for your attention. Wherever you are in the world, whether you are a survivor, a family of someone diagnosed with cervical cancer, or currently undergoing treatments to beat or control the cancer, I’m sending you love, strength, and positivity. All love x

2

Hi Kayla,

The likelihood is that the tumour satellites would be the first to be destroyed by the treatment, and the tumour would not be finally eliminated until after brachytherapy. I have heard of other people not being able to have the full course of chemo, and going ahead with radiotherapy and brachytherapy. I myself was only scheduled for 5 chemos, and had them all.

Yes, I agree with you on 2) that I would think it pretty risky to go for a radical hysterectomy if there are still ‘live’ cancer cells. Radiotherapy will deplete red blood cells and platelets - I’m surprised they didn’t recommend giving your mum a platelet transfusion, unless they think there’s some other reason than the treatment for the platelet count being low. I had two lots of blood transfusions and a platelet transfusion during my treatment. It was counted as normal procedure for low cell counts.

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