First a bit of background, consultant has given me an initial staging of 1b2. He said the tumour looks about 1.5cm and is clearly differentiated adenosquamous. I had an EUA on 4/12 and will have an MRI on 15/12. I am provisionally scheduled for a radical hysterectomy on 6/1 (was offered 23/12 but asked for after Christmas due to lots of reasons).
I am now wondering whether the MRI will show lymph node involvement or whether this can only be done by removing nodes during radical hysterectomy? I’m also wondering whether lymph node involvement can be indicated by size of tumour?
I know cc is usually relatively slow growing but I’m wondering whether me asking to wait until after Christmas for the op may give the cancer time to move to lymph nodes. The fact the consultant agreed to let me wait makes me think he doesn’t think much will change, but now I’m worrying it might!
I think I'm correct here, but if not will somebody please put me straight - thanks!
If lymph nodes are enlarged then that will show up during an MRI, though it won't tell them for definite if any enlargement is down to cancer. I think that a PET scan would show the difference. What the MRI will do is it will show up the entire tumour so that it can be accurately staged. It is very rare that a stage will be amended as the medical teams are pretty experienced and know what they are looking at.
Lymph node involvement can be hinted at by size of tumour which is why anyone at stage 2b and above normally goes straight onto chemo-radiation and skips out the surgery.
So, if your consultant has given you an initial stage of 1b2 then he's not concerned about the likelihood of the cancer having already reached the lymph nodes and neither is he concerned that there is any likelihood that it will reach them in the next few weeks. In the very unlikely situation that your MRI shows that you are in fact a stage 2b or above then he will cancel the hysterectomy and schedule you for chemo-radiation instead.
That does help and has offered some reassurance too. It just feels like there are so many hurdles to jump even before the treatment is finalised and agreed and the waiting associated with that is definitely the worst Though I totally understand the need for correct staging to ensure chosen treatment is the right one!
The information on this site is great, but hearing the stories and experiences of the ladies on this forum is even better!
I've done a lot of reading while waiting for my surgery and here's what I found out (not from google mind you but medical research papers etc:)) Basically the larger the tumour the higher the likelyhood of lymph node involvement. Depth of invasion is a factor too. However it's not always that a large tumour means lymph nodes are affected, so there's no sure way of knowing from the size alone. My tumour was 17mm by 8mm by 2.7mm and I was given a 3-5% chance that they might find lymph node involvement. It goes up to about 50% at stage 2b etc.
Another indicator of lymph node involvement is the presence of LVSI (lympho-vascular space invasion)-they usually report on it if you've been diagnosed through LLETZ or a biopsy.
As Tivoli says the MRI shows node enlargement and PET is more accurate in showing if it's due to cancer or not.. If they don't see any enlargement on the MRI or PET they still have to remove the nodes and check them in the lab as microscopic involvement won't show up on any scans.. That's why we have to have them removed unfortunately..
The waiting part should be fine, if the consultant is happy to wait, then you shouldn't worry. I had to wait for 4 months from the date of my Lletz until surgery and was assured that nothing would change during that time, however to be honest I wasn't comfortable with that, but the consultant I was booked with had no availability for surgery at an earlier date. My results came as all clear so they were right:))
Hello Anna, thanks for you response, like Tivoli's it has offered me some reassurance and good information.
If I understand correctly, it is inevitable that they will remove some nodes during hysterectomy, I suppose they will decide how many. Do you know whether the number removed is related to the chance of developing lymphodema, eg if they take out lots is it more likely to have lasting implications of developing it?
I will have to write all these questions down for my next appointment in the clinic!
Glad to help and offer a bit of reassurance:) Yes, it is unfortunately inevitable.. They told me they would remove as many lymph nodes as they can find, but at the end it was 19. As I understand it's still not clear why some people develop lymphoedema while others don't and I heard about people suffering after removal of just 1 lymph node and many many ladies here have no problems after having many removed. So I guess the amount does make a difference but again you can't predict what chance of developing lymphoedema you'll have, I was told it was a small chance and majority of lymphoedema problems are mild..
I don't know if this is of any help at all but reading through my biopsy report I had 13 tissue samples taken varying in size between 0.8 to 3.2cm. In these were found a total of 17 lymph nodes varying in size between 0.2 to 2.3cm. None of these were cancerous and I didn't develop lymphodema. I think that most people don't and it's only a very unlucky few who do.
Hi, sorry to wade in! I have advanced CC and I had a pet scan, ct and mri before I was diagnosed the pet scan is the most detailed one it shows everything and the mri the injection they give you clings to your veins and stuff yhat shouldn't be there like the cancer I beleive.i was told my cancer had effected one lymph node, if I remember correctly, as I was suppose to go into a new trial that was being done but as it had spread to this and my kidney tube slightly I couldn't go into it.
I know from reading other posts that some ladies have had radiotherapy after having a hysterectomy, obviously this is something to discuss with your doctor.
Your doctor will tell you if it has gone anywhere else and it won't make any difference with the fact that your waiting until after christmas x
Thank you both for your replies, I guess I'm just going to wait and see what my consultant says/suggests following my MRI. i'm just keeping everything crossed that the radical hysterectomy will be enough and that my lymph nodes are clear.
I had a RH and Lymphadectomy (Not sure how many, never told, never asked) Lymph nodes were clear but there was LVSI. My tumour was 37mm stage 2A.
I was really worried about lymphodema and think I may have a small amount that has come recently at top of my right thigh but certainly not the elephant legs that I tiold myself I would have before surgery.
The point of the MRI is to show up any lymph involvement and also a more accurate positioning of tumour.
LVSI is an indicator of higher risk of recurrence but only slightly. I'm 2 years on and although I've had other issues my vaginal 'stuff' is a separate issue and not a recurrence as such.
