When we look at treatment survival
When we look at treatment survival with regard to the majority of cancers, I will just briefly spend time on this because this will be covered in the GYN oncology section. When we treat patient’s with cervical cancer, five year survival, it runs about 80 to 90% for stage I, for stage III, 16 to 40%. If you look at therapy with radiation therapy. The results are exactly the same for stage I as treating the patient’s with surgery, with radical hysterectomy. The five year survival for stage I runs about 90% regardless if you use radiation therapy or a radical hysterectomy and pelvic lymphadenectomy. The important thing is, who do you select for which treatment modalities. Buy cipro online.
Usually an elderly patient or an obese patient will receive radiation therapy, a younger patient with an early stage disease will receive a radical hysterectomy. We also treat the periaortic area with radiation therapy for cervical cancer, the dose we give 4000 to 5500 however, the five year survival varies and it varies with regard to the size of the lymph node and the amount of disease present. Five year survival with radiation therapy to the periaortic area runs about 10 to 50%, depends on whose series you read with regard to it’s efficacy, however, for the majority of time, it’s rare to cure a patient who has gross disease in the periaortic area. The complication rate can be rather high because you often incorporate the small bowel, so it can range anywhere from 3% to as high as 60%, the majority of complications you see in this patient are small bowel complications. Again, the likelihood of curing a patient with periaortic node involvement depends upon the size of the lymph nodes. If it’s less than 2 cm, there is a good chance you will be able to cure or get control of the disease, if it’s greater than 2 cm it’s unlikely. We also often recommend radiation therapy in that case, for example where the Pap smear shows dysplasia, a hysterectomy is done and incidentally cervical cancer is found. These patient’s usually receive 50 gray or 5000 centigrade of radiation therapy and occasionally an implant or intracavitary therapy will be recommended.
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Endometrial cancer, it varies. It varies from institution to institution. The determination of whether a patient receives radiation for endometrial cancer depends if there is, one, deep myometrial invasion; two high grade of tumor, grade three or three lymph node involvement or stage III. Those are the determining factors whether patient will receive adjuvant therapy with endometrial cancer. For ovarian cancer, again, occasionally there will be a patient who has an advanced ovarian cancer who has microscopic disease, or no evidence of residual disease but is extremely high risk for recurring. The majority of institutions in the United States, however, will treat these patient’s with chemotherapy, however, if you are practicing in Canada, the majority of these patient’s will get whole abdomen radiation. With regard to P32, as adjuvant setting in ovarian cancer, early stage, stage I, stage IIA who are at high risk for recurring. Those are the stage IB, 2A or stage IC and those with grade III, stage IA ovarian carcinoma. Occasionally someone will recommend P32 to these patient’s but they are randomized trials that show the use of chemotherapy or radiocolloid therapy or P32 have exactly the same results. Canadian cialis