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Gynecologic (GYN) Cancer Diagnosis | What Now?

From the GYN Cancer Articles List

I was recently diagnosed with cancer. What do I do now?I was recently diagnosed with cancer. What do I do now?

First, we want to offer you hugs as you begin a journey that no one expects to take.

If you haven’t seen a gynecologic oncologist, we highly recommend you see one since they are the experts in female reproductive cancers. At the very least, you'll want your gynecologist to have an oncologist in attendance at your surgery to do all the necessary oncology tests and reviews.

Make sure that you write down your questions prior to any visits with your doctors. It can also be extremely helpful to take a person with you as an extra set of ears. Some women even take a personal recorder so later, when their emotions have settled, they can re-listen to what was said during the appointment.

For general pre-op questions, a great place to start is the Pre-Op Articles list. There are also several videos on gynecological and other related cancers that may help you as you start your journey.

As for questions related to your gynecologic cancer diagnosis and treatment, here are a few with which to start:

General Questions:
  • Can you refer me a gynecological oncologist?
  • Will you be handling all of my care or just the follow-up related to cancer?
  • If only the cancer care, who will help me with other possible items such as depression and hormones?
  • Is possible for me to have a minimally invasive laparoscopic vs. open surgical procedure?
  • What are the benefits vs. risks between laparoscopic and open procedures?
  • What is the difference between standard laparoscopic surgery vs. robotic laparoscopic surgery?
  • Is there a difference in the chance of recurrence with different types of procedures?
  • Is this actual cancer or pre-cancer (complex hyperplasia with atypica)?

Overall Surgery Questions:
  • What organs will be removed and how will you determine what needs to be removed (prior to surgery, during surgery)? Total uterus with cervix? A portion of the vagina? Ovaries and Fallopian tubes?
  • What is the reason for some organs to be removed and others to remain?
  • Will a pelvic wash be done?
  • Will lymph nodes be tested?
  • Which lymph nodes will be tested?
  • If lymph nodes aren’t tested, why don’t you consider this to be necessary treatment?
  • How many lymph nodes will be taken?
  • What is the risk of my developing lymphedema with the removal of the lymph nodes?
  • If lymphedema does occur, what resources are available to help me deal with it.

Minimally Invasive Laparoscopic Procedures:
  • What safeguards are taken in a laparoscopic surgery to prevent spread of cancer cells?
  • Will all organs be removed in one piece? Will they be bagged prior to removal?
  • How many laparoscopic surgeries have you done for cancer?
  • How many of your laparoscopic surgeries have converted to abdominal ones?
  • Why did your procedures convert?
  • If we opt to do the surgery using the robotic system, what happens if the robotic system is unavailable the day of my surgery? Will the surgery be rescheduled or will it be done via standard laparoscopy or as an open abdominal surgery?

Fertility Preservation:
  • Are there any non-surgical treatment options, such as Megace, for my cancer or pre-cancer?
  • If I choose a non-surgical option, how will we determine if my cancer is advancing or is in remission?
  • Can I do egg harvesting prior to my surgery?
  • For my type of cancer, is it required that I will have my ovaries removed? If yes, why?
  • For cervical cancer, can only the cervix be removed and the ovaries, tubes and uterus preserved? What complications, issues, or risks would this entail?
  • If I keep my ovaries and radiation is required, is there a way to protect them?

Pathology & Follow-up Treatment:
  • Do we know what type of cancer it is at this time?
  • Do we know anything about the stage (progression) or grade (deviation from normal cells) about the cancer or will that have to wait until post surgery?
  • Will pathology be done during or after the surgery?
  • When will I receive final pathology?
  • Is there the chance that if something shows up in final pathology that you weren’t expecting we will have to go back in for additional surgery?
  • When will we determine if additional treatment, such as radiation or chemotherapy, is required?
  • If my cervical cancer was HPV related, will there be ongoing HPV issues following treatment?
  • If my cancer would recur, where is it most likely to recur?
  • What is your protocol for follow-up for the initial surgery? Long-term follow-up?
  • For endometrial/uterine cancers do you do a rectal exam during your follow-up procedures?

Family History:
  • Does my cancer increase the risk of my developing breast cancer?
  • I have family members who have had breast cancer should I be tested for BRCA?
  • My family has a history of colon cancer, should I have a colonoscopy prior to my surgery to ensure the cancer hasn’t spread?
  • I have family members who have had colon cancer, should I bet tested for Lynch Syndrome?

Sexual Intimacy:
  • Will radiation, chemotherapy, or the surgical procedure affect the size or condition of my vagina?
  • What are my options for staying sexually active? Will I be allowed vaginal estrogen since it doesn’t go systemic like oral or patch estrogen? What about physical therapy or dilation therapy to prevent vaginal adhesions?
  • I am pre-menopausal and I have heard that surgical menopause is more difficult and women who have gone into surgical menopause have more sexual issues post surgery. How and who will help me deal with that if it happens?

Other questions:
  • Do you know of any resources that can help me deal with side effects, such as depression, that may develop as a result of on-going treatment or surgical menopause?
  • Would I benefit from a PET scan now or will it be used during my follow-up?
  • Would I benefit from a CT or MRI now or will it be used during my follow-up?
  • Will I be allowed to take hormones for any reason?
  • What drugs or supplements should I avoid prior to surgery?
  • If I undergo radiation or chemotherapy, are there drugs or supplements that I should avoid that might make the additional treatment less effective?
  • Are there supplements that could make the treatment more effective?
  • Long-term, are there supplements or dietary changes that could reduce the chance of recurrence?

This may not be a comprehensive list, but it will get you on the road to understanding your treatment and follow-up.

This content was written by staff of HysterSisters.com by non-medical professionals based on discussions, resources and input from other patients for the purpose of patient-to-patient support.

11-09-2011 - 10:02 PM


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HysterSisters Articles

Options to Hysterectomy
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Pre-Op Hysterectomy
Post-Op Hysterectomy
Separate Surgeries
Hormone and Menopause
Intimacy after Hysterectomy
Pelvic Floor
Separate Surgeries
Fitness after Hysterectomy
GYN Cancer
Breast Health
Grief and Loss
Uterine Fibroids
GYN Genetics
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