Do I need chemo or radiation after hysterectomy for stage 1 endometrial cancer?

It may depend on exactly what type of uterine cancer you have. Some are more aggressive than others. I had an undifferentiated uterine sarcoma, stage 1B. No evidence of spread pre/post surgery. That was what my tumor came back as after full hysterectomy in Feb 2025 and the pathology results. My lymph nodes were clean but there was some lvi invasion. 6 weeks after my surgery, I started a course of vaginal cuff brachy radiation, reasoning being that if the disease was going to spread it usually starts in the area it was in initially. And so that is the best chance to protect the vaginal area. It went well and that what sounds pretty scary and invasive, it's really not so bad. I did not get any side effects from it. My first follow-up scans in May came back clean. My second set of follow-up scans in July showed a 10 mm nodule and a 2 mm nodule on my lung. I had thoracic surgery on August 1st 2025 to remove them. Surgery also went well but because of the spread, I have to start a course of chemo. My first chemo treatment was last Friday. So far I'm feeling okay except for I've had a headache since that day. If I've learned anything through this, it is unfortunately you must be proactive and as much as possible and catch things early. Going through the treatments, though not pleasant can extend your life and potentially remove your disease. If you haven't yet, go for more opinions. I started out with my home team. Then I went to the Mayo Clinic for a second opinion. And then a third opinion at City of Hope. I found Comfort hope caring huge amount of information and opinions on all options at City of Hope. I highly highly highly recommend if you haven't been there, that you go online and set up a free consultation. My initial consultation was over two days with 14 different appointments with different Specialists from the radiologist to the oncologist to holistic health to dietary to mental health,sexual health, financial counseling, just a huge array of people to support you through your journey. Best of luck and please don't hesitate to reach out if I can be of any help.

I'm sure your oncologist and surgeon will explain. I'm postmenopausal of 15yrs. Had a complete hysterectomy as all 4 glands were clear and the flap was clear also. I'm Stage 1b, aggressive cancer called, Serous papil carcinoma endometrium. But all markers are clear. Still, it's those micro cells that might return. I had one chemo treatment, felt good, the next day had 2 hours of hydration, and WBC injection (white blood cell). Please ask questions and side effects, ask to know all important blood tedt results, wbc, rbc, platelets (help to stop stop bleeding as in a cut, or brusing) Diet is important to maintain protein, magnesium and potassium levels up. Hydrate with electrolytes, green tea, protein supplementlike ensure, premier, , no caffeine, take multivitamin and minerals. I had rough first round of chemo, only because I wasn't aware of side effects to WBC injection. So much to take in about Chemotherapy and or radiation. Age is a factor also. I'm great full I'm on chemo, peace of mind over side effects any day.

I was diagnosed with Stage 1, 1b, serous uterine cancer in 2022. In 2023, had complete hysterectomy which removed the tumor, then 6 chemo treatments and no radiation. I was 68 at the time. Two years have gone by and my right leg swelled to almost double its size. Very scary, but after 5 docs looking at it and having a Doppler done to rule out DVT, my oncologist told me that based on my CA 125 blood test, I should probably prepare myself for the cancer to have come back. And it has, but this time it's close to my lymph node near the ureter. Since I only have one working kidney, they put a tube into my kidney that rerouted the urine into a bag. Now my leg is losing the swelling. I lost 12 pounds already.. lol!

Prayers

Yes. My cancer came back even tho I did radiation.. Dr ignored my complaints for 4 years had to beg for an MRI. Stage 4 now from stage 1. 5 years ago.

That is hard!

This sounds like a really encouraging pathology report with the clean lymph nodes and no signs of spread. Treatment decisions after surgery for early-stage endometrial cancer can vary based on many factors that only your oncology team can fully evaluate. Many people in similar situations find it helpful to discuss the specific risk factors and benefits with their medical team to understand what approach might be best for their unique case.

F all this we go through menstrual cycles to having to deal with all this. And I have no one to be with me! 67 yrs old still working because of $$$. Prayer for over 20 years for a husband after divorce from a emotionally abusive one and instead I get to be alone and deal with all this. I'm not going to be able to!