Tuesday, May 12, 2009

Radiation Update

Met with the radiation oncologist this afternoon-most definitely my fav doctor so far!! He is incredibly smart and does not even think about leaving the room til he has asked at least 3 times if we have any more questions-MAJOR points in my book!!

There is alot more we know and alot we still don't know (told Ben I'm gonna become a professional wait-er and make millions!!).

What we DO know (best listed first):
  • I'm still stage 1B1-awesome news!!
  • Pathology on lymph nodes all came back BEAUTIFUL and clear!
  • Pathology on all the organs removed came back BEAUTIFUL and clear!! (except the obvious cancer in the cervix)
  • Size of lesion was 3.3cm
  • Lesion went 11mm into the cervical tissue
  • Clear margins-AWESOME!!
  • No parametrial involvement
  • There was lymphovascular invasion (UGH I am NOT liking this "invasion" word... gonna have to come up with a prettier term!). This means that the cancer was found to have started moving into the vascular system. In layman's terms, there are all kinds of tubes coming off the cervix. Each tube also has little knobs (aka lymph nodes). Basically its like plumbing-the tube has started to get clogged with some cancer but they don't know if any of it broke off and has gone further into the blood system or if its just a small clog. I do NOT like this one iota cuz I just sit there and think, "Ok so if it is in the vascular system in that area, and blood runs all thru my body via the vascular system, what is stopping it from going all over the place?" Answer-we don't know. PET scan and CT scan didn't show anything.

What we do NOT know:

  • Stromal invasion: we know how deep into the cervix tissue the cancer went (11mm) BUT we do not know what percentage of the total cervical tissue it comprised. In other words, if my cervical tissue was 22mm thick and the cancer went 11mm deep into it, then it took up 50%. Dr. Smith was going to call the pathologist and get them to do more research and determine how much total cervical tissue there was, so we can find out the percentage.

What all this means as far as radiation gameplan:

  • There are 3 criteria that they use to determine if women with stage 1B1 cervical cancer who have had a radical hysterectomy need to have radiation therapy. If a woman meets 2 of the 3, then radiation is recommended:
  1. Lymphovascular invasion-I have
  2. Size-the criteria they use is 4cm=large. Mine was 3.3cm so it was not "large" but closer to large than small or even medium. So kind of a half point for that one.
  3. Stromal invasion-if the cancer's depth into the cervical tissue is more than 1/3 the total depth.... this is the part we don't know yet.

Sooooo Dr. Smith is hoping to get the further path results back in the next few days, will review my case with his entire team of colleagues on their regular Thursday meeting, and then I call him on Monday to determine where we go from here. If we are going with radiation, it will start immediately per his recommendation, will luckily only be external and will be 5 days a week for 5 weeks. Each treatment takes less than 20 minutes and luckily I can do it in the Bentonville office. Most likely I will go up there around 4:00 and take the kids, Ben can meet us there when he gets off, take the kids home and I can get my treatment and head home in time for dinner:) Side effects are fatigue (my constant companion), increased frequency urinating (another companion I already have-gotten kinda use to that having been pregnant, recovering from CSection, pregnant again, another CSection, and then hysterectomy.... you come to appreciate catheters LOL), and loose stools (TMI, but at this point that would be a welcomed relief!!!). He said my blood counts will drop around 6wks after treatment so we'll have to keep a close eye on that since I'm anemic already-knowing me I'll just faint alot and have to eat extra salty foods-no biggie. BEST side effect-cuts chances of recurrence in half!!!!

eeeek "Super Bella" (naked, post-bath Bella running thru house with her hooded towel aka cape on) screaming for mama... more later


  1. This all sounds pretty great to me, considering. I like the fact that we don't have 3/3 criteria right off the bat! However, I'm with you... I could be the world's best waiter with all of Logen's stuff (God only knows we've waited all of his life for answers)... I know you want answers now and you don't want to wait until next week. It'll be here sooner than we think. I'll be waiting {yet again lol} for your post.
    I'm praying for you and the family of course.
    We will have to put our visiting plans on hold til next week since I'm stuck in the hospital until at least tomorrow. See you soon though :)

  2. I came over from Holley's blog. Just the word cancer sucks the wind out of my lungs. I love my brother to cancer 7 years ago (diagnosed on 3/1 and he died on 3/28) and now my husband's little nephew (13) is going through treatment for osteosarcoma at St. Jude's. He's having "limb saving surgery" on Friday.

    I have all sorts of respect and admiration for people going through chemo and radiation. Cancer doesn't care who its victim is. Luckily, we have doctors and care providers who do care. I'm glad you have one you like and who takes time to answer your questions!

    God bless you and your family as you travel through the "C".