<b> with special reference to Uterine LMS</b>

 Adjuvant treatment is treatment when there is no evidence of disease, after surgical removal with wide clear margins.

It is best to review all the medical articles relevant to your primary site when you make a decision about adjuvant treatment. 

It is NOT adjuvant treatment if radiotherapy or chemotherapy is given because there are surgical margins that are either too narrow, or contaminated with tumor.  In these situations, treatment is NOT adjuvant treatment and usually does extend survival time.   Sometimes when an LMS tumor bursts [another reason to read your operation report], adjuvant treatment is also considered.

For Uterine LMS, the decision to have adjuvant treatment is usually made in the flurry of desperation that accompanies the diagnosis.   Usually it is adjuvant radiotherapy that is offered to decrease possible local  recurrences.  Since the repercussions of having adjuvant pelvic radiation are permanent and serious, we urge that considerable thought and discussion go into the decision.  

The challenge of surviving with LMS involves using appropriate treatments that are proven to have benefit, and avoiding treatments in situations where they will have less or no proven benefit.  The number and type of treatments are limited, and take their toll on the patients.  Choose what will be most effective.  Try to avoid any unnecessary treatment or a damaging treatment with no proven benefit. 

The clinical trials that have been done on whether or not pelvic irradiation is effective,  either show decreased recurrence, or no effect upon recurrence.  They do not show increased survival time.  You can print out the studies, and discuss them with your doctor.  You can also visit the Radiation Damage page, and print out those articles for discussion, as well.

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