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LaKrystal Warren
LaKrystal Warren,
Category: Oncology
Satisfied Customers: 45
Experience:  Physician at Contemporary Women's Care
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My mom has endometrial cancer 3 years ago. She had Hysterectomy,

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My mom has endometrial cancer 3 years ago. She had Hysterectomy, followed by radiation. She had vaginal recurrence 3 months ago. She had partial vaginactomty. Lab analysus showed recurrence was of same orginial tumor but all margins of sample were FREE of cancer. days after surgery, she had abdomen pain and chill sympotrms. She had an MRI done that showed something like a 4cm by 4cm (tumor or abscess) at vagina cuff. Note that colored CT scan had not shown anything here before vaginactomty. She then had another operation to drain the abscess as she was feeling very sick. After drainage she is feeling much better. She performed a rectal sonography and color MRI that still shows a smaller absces or tumor at same location. She has gone to radiation oncologist that recommends high dose Brachytherapy to prevent reucrrenace (even though it has now been 13 weeks since vaginactomy) and also potentially treat this remaining abscess, even though we do not know what it is. My concern is the brachytherpy might worst the abscess (if it is abscess) per this paper
and as she is feeling better, would it not make sense to wait 2 more month and perform another MRI to see if it has become smaller. Also, it has been 13 weeks, so would brachytherapy be effective here, or should we proceed with brachytherapy as scheduled.
Submitted: 5 months ago.
Category: Oncology
Expert:  LaKrystal Warren replied 5 months ago.
Hello, I am an OB/GYN and can help you with this. I am sorry to hear about your mother's fight with endometrial cancer. It sounds as if she has had great care and appropriate treatment, however had a recurrence in the vagina. Vaginectomy was performed with clear margins (great news!), but postoperatively there is some sort of mass at the top of the vagina (Vaginal cuff). Drainage improved symptoms, however, the mass is still there. This is highly concerning for tumor. Brachytherapy is very reasonable for treatment to prevent recurrence and/or possible abscess, especially given that she has already had one recurrence. We don't want to take any chances that the area is tumor and it can grow and spread in 2 months if we wait and perform another MRI to see if treatment is necessary. With cancer, any delays in treatment should be avoided. With regards ***** ***** article and your concern about vagina cuff dehiscence (vaginal cuff coming open) after brachytherapy--this is a rare complication and not typical. It is certainly possible that brachytherapy could cause additional problems, however, chances of that are not as great or as severe as if your mom has recurrent cancer, it is not treated, and it is able to spread. We want to avoid recurrence/spread of cancer and early recognition and treatment is the way to go. If the radiation oncologist recommends getting started with brachytherapy, it sounds like the right thing to do.