Path Report

Hello to all,

It was suggested that I place this post here, I posted it in a general area, I am new! Had a radical hysterectomy on March 8th for uterine cancer and received the final path report yesterday. It was a grade 1, stage 1B with no nodal involvement. Howerver the cytology report showed some "atypical cells". The doc said no chemo at this time and that she will do cat scans peiodically. She is from a big teaching hospital and a tumor board makes decisions, but I am a bit worried. Anyone else have this experience? I will follow up every 3 months for the next two years at least.

Thanks,
Megs1128

Hi megs.

Welcome to the board. Unfortunately I can't answer you directly about your question, but wanted to stop by and send you some s. Hopefully someone will be along soon to give you their experience. But from what I have read on this site, everything seems to be in order. You have a good early stage cancer and with no follow up treatments (which is fantastic news). Your doc is correct in doing the periodic cat scans as well as a 3 month checkup.

I hope that you are recovering well from your hysterectomy.

s
Jan

Thank you for your kindness and good luck with your chemo.
Megs1128

Hi Megs1128,

Yes, as Jan says, that's a very good report. It sounds like your doc is following the protocol and checking you every 3 months. Is your surgeon a gyn/oncologist, and did she sample lymph nodes during your surgery?

If you would feel more comfortable having more information, you could talk with someone from the tumor board, or a gyn/onc from a different hospital or group practice.

Good luck and let us know how it goes.

Yes there is a fine line that is drawn about who gets further treatments, especially when the stage is in the 1's for the uterine cancer category. I think it is because usually and most often the surgery alone takes care of us as the cure at this stage. Other factors like history and potential risks add to the further deciding factor if there is to be more treatment. It is not uncommon for frequent followups for the next couple of years to be the rule of thumb, and not to have chemo or radiation. The "atypical" cells you mention... were they a part of your pathology? In the uterus? Are they now out of your body? Atypical cells are usually associated with pre-cancer, as in complex hyperplasia with atypia. But this would be removed with the hysterectomy operation. Hopefully your operation and followup is being done by a gynecological oncologist. They know what to possibly look for in followup checks. Your stats are good! Hopefully that will be that and you will have a happy and healthy lifetime to look forward to!

That is exactly my stage when I had my first surgery. I also had the positive wash (cells in the fluid taken from the abdomen). I also had no further treatment.

Can you find out if the tumor receptors were positive or negative? If positive perhaps she could be put on Megace. She would have to consult with her doctor.

Also, she needs very close follow up. I know many doctors do not give CA125 blood tests for endometrial cancer but it can be a good tool in detecting recurrence of the cancer. If the results would happen to be negative that does not mean you would totally depend on the results....BUT....if the CA125 should be elevated then scans would be in order.

I am writing from personal experience. I had the positive wash and a CA125 revealed my recurrence when it elevated to 58.

I used to say I did not want to scare but this is very serious at any stage and agressive followup is needed.

I have lived with this thing for 7 years and have had 3 surgeries, chemo.rad and am starting more chemo. And this all came from an original stage of 1b.

Also, if she had cells in her cytology she is automatically elevated to Stage 3a....SIMPLY BECAUSE THE CANCER SOCIETY DOES NOT KNOW WHERE TO PLACE THESE CASES.

Also, did the dr explain what he meant by A typical cells....cancer cells or not? If just funny cells then that is a whole nother ballgame and I would not know what that means.

All the above is just my opinion and personal experience. We are all different.

All the odds are in her favor and I wish good luck,
Juanita

Hi Megs, as you're seeing there may be different follow-up procedures for a variety of reasons including fact individual cases vary, doctors' educated preferences differ, etc. My doctor team and the hospital board decided against chemo or radiation; my dx was grade 1B too. While a CA125 test as well as a CTscan were done prior to surgery, and a CTscan repeated one year post-op, I do not get CA125 test. My follow-up doctor advsised she does not use the CA125 test for monitoring endometrial cancer and advised it can rise considerabley when there is inflammation, infection; she said it generally was not considered very accurate for detecting of endometrial cancer but was a good tool for monitoring for ovarian cancer return. She thinks thorough internal exams are the key to detecting a recurrence as the most frequent recurrence site is the vaginal cuff. Also, I've been advise to immediately report between check-ups any unusual occurence such as pelvic pain, spotting, etc.
I am not certain where the atypical cells you mention exist/existed (in the cancerous growth removed or perhaps in the washings?) but they are considered pre-cancerous and if in the washing may up your cancer dx numbers.
Please keep us posted and may your recovery continue without a hitch.
s,
peggiesue

Hi Megs,

I had uterine stage 1b grade 2, and was told my surgery was my cure. I'm not sure what you meant about atypical cells, which are normally precancer cells. Where were these found?

Your Doc is taking good care of you by keep track of everything and having continue to keep coming in for check ups and things. Make sure you keep getting checked for any recurrence to catch it early should it recur, I pray it never does!

I am 6 months post op now from my cancer surgery, but I find I am still confused on things. You read so many different things from different people and it can get overwhelming to absorb it all. What one doc tells one person another doc is telling a different thing to another person. I think the best thing we can do is just be proactive in our healthcare. Get the necessary tests to watch things, and pay attention to what your body is feeling. And for me, I put it all in God's hands and pray each day and ask him to keep me cancer free.

Best of luck to you. Keep us posted!

Hugs
SA

Hi!
Bieng proactive is good advice. As I was looking over my path report I noticed that the cancer was T2a (Stage IIa) not stage 1B as the gyne/onc had said. I called her and she was very apologetic and said yes the report differed from what she told me. The slides now go back to the tumor board for further review. I have lost total faith in the doc and the tumor board and will now get a second opinion at the very least. Thankfully this site helped me decipher the report and I caught the discrepancy. Had I not been proactive who knows how long it would have taken for them to catch the mistake!
I am very distraught this evening!

Oh megs,

That is just awful. I am so sorry that you have discovered that. We won't more than anything to believe in our doctors and find out that they have made such a huge mistake is unforgivable. You are fully entitled to a second opinion and in the circumstances I would definitely suggest it.

However, stage 2 is still not the end of the world. I would imagine there would be additional treatments, but as the other woman will say, you will get through them.

It is totally normal to be feeling very distraught (any normal person would be). Do something to treat yourself right now. And have a good cry - it will probably help.

You will be in my prayers and thoughts.
Sending you so many, many s
Jan