Fallopian Tube Cancer confusion re: treatment

[rauni]

After surgery to remove the uterus, ovaries and fallopian tubes it was discovered I had Stage 1 GRADE 3 cancer in the fallopian tube.  No other types of surgery (sampling of lymph nodes, omentum etc) have been done.  I had to give up chemo after 2 sessions because of neuropathy.  

Imagine my shock when the radiologist told me I had a suspect lymph node from the lst catscan before chem and is now insisting I have 30 treatments of radiation.

QUESTION: i HAVE A LOT OF OTHER CONDITIONS GOING ON, MAINLY ARTHRITIC - VERY IRRITATED BY THE CHEMO AND AM AFRAID OF WORSENING THEM WITH RADIATION and/or getting new conditions.  WHAT IS YOUR ADVICE?  IS THE GRADE OF TUMOUR VERY IMPORTANT?

Rauni

[Annekathryn Goodman, M.D.]

Dear Rauni,

You have an unstaged fallopian tube cancer. that is - without extensive biopsies of your lymph nodes, omentum, and lining of your abdomen (surgical staging), we do not really know what you are starting with.

I cannot really address the issue of radiation completely. radiation can be useful for focused therapy to a small region. Where are these lymph nodes?

As far as chemotherapy, some people cannot tolerate the standard chemotherapy of carboplatin and taxol. in that case, it is worth considering a modification such as just using one drug - carbo or taxol. the other variations include giving one or two drug in smaller doses every week instead of every 3 to 4 weeks. This can substantially reduce side effects.

radiation will not affect your arthritis. the side effects of radiation depend on how much of the body is receiving radiation  and where in the body it is being given
Grade of tumor is a short hand for how fast it is growing grade 3 or poorly differentiated grows faster than grade1 . Please see my comments on an earlier post of MMMTs.
best wishes to you

[Mark4124]

My mother had a fallopian tube cancer 3 years ago that was said to be confined to the tube. She had complete historectomy and was cancer free for 2yrs. It came back in 1 lymph node in June. It grew to almost 6cm by Nov when they surgically removed it and determined it was MMMT (a gynocological cancer with sarcoma and carcinoma qualities). She had radiation after surgery but a month later it was discovered she had mets in the lungs, liver, and elsewhere. She had gemzar with no effect. They are now looking at a clinical trial drug called sutent at Dana Farber for her. It is her last hope. I would take your cancer very seriously.

[Mark4124]

My mother had severe neuropathy with taxol 3yrs ago btw. She tolerated radiation fairly well by comparison. Mostly naseau and tiredness.

[Mark4124]

3yrs ago she was stage 1, grade 3 as well.

[rauni]

Thank you for your reply.

Comments on your email are:  They want to radiate my abdomen and pelvis and I am most worried about side effects with my gastric reflux disease as my stomach is often painful and I get chest pains from the GERD.

I think the suspect lymph node is in the pelvis.

They do not want to do further surgery or chemotherapy.  They want to start the radiation ASAP.  Your further comments would be appreciated.

Rauni