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Gyn appt today and appt Monday with gyn/oncologist - pathology report Gyn appt today and appt Monday with gyn/oncologist - pathology report

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  #1  
Unread 02-24-2006, 02:09 PM
Gyn appt today and appt Monday with gyn/oncologist - pathology report

I went to my gyn today (3 weeks post-op TAH). My husband thought he had noticed an opening in the incision area, very small but wanted to get it checked out. Everthing turned out ok. Urine has an odd odor and they did a urine test. I found out I had stage 1 end. cancer after the hyster and they are referring me to a gyn/onc this Monday, 2/27. I never did get the pathology report until today. I got talking to the gyn (who was the assistant with my surgery) and she was looking over my report. She said they are sending me to get a second opinion - maybe I would have to have radiation or maybe they would want to go in and CHECK MY LYMPH NODES!! All I could think about was I should have gone to the gyn/onc in the first place. I had no idea what one was until I came to these boards and was never given this option. I know what's done is done, but he knew I had atypical endometrial hyerplasia from the D and C done 2 weeks prior. I also still have my ovaries - I am 41 and he told me that he would keep them if they looked ok during surgery. Here's the info from my path report:
Adenocarcinoma of Endometrium, Endometrioid Type, NOS.
- Figo Grade: 1
- Nuclear Grade: 1
Dept of Invasion: 3mm (see comment)
- No endocervical invasion identified.
- No vascular invasion identified.
- Endometrium showing following abnormality (IES):
- Complex hyperlasia without atypia
- The myometrium shows following abnormality (IES):
- Adenomyosis
- All adnexae are unremarkable
- Lymph node status : NONE

Comment:
The sections exhibit well differentiated enometrioid adencarcinoma in assoication with atypical complex hyperplasia. Tumor appears to involve myometrium superficially; the maximum thickness of myometrial invasion is 3 mm, which the thicknes of myometrium in the area of maximal tumor invasion is 2.7 cm (3/27 mm).
------------------------------------------
TNM staging is T1b, NX, MX.
Does anyone know what this means?
------------------------------------------
I know I will find out more on Monday - the 2 and a half weeks of not knowing what's next has been hard. I know he's the only one who will answer my questions, but it feels good to share with others who are going through this/went though this, etc.. My husband snapped at me last night - after 3 weeks of being great and he's not speaking to me right now.

Thanks for your support.
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  #2  
Unread 02-24-2006, 03:18 PM
Gyn appt today and appt Monday with gyn/oncologist - pathology report

Hi Hon, Sorry you have this worry, and more waiting!
I dont know much about endometrial cancer staging, but I did find this on the 'net. I hope it helps you. Glad you are going to see a gyn/oncologist....you will be in good hands with the pros! btw...well differentiated is good!

k9
http://www.webmd.com/hw/health_guide_atoz/uh1382.asp

T1b (Stage IB). Tumor has spread to the myometrium but is in less than half of the myometrium.

NX. Lymph nodes near the primary tumor cannot be evaluated.

MX. Distant metastasis cannot be assessed
  #3  
Unread 02-24-2006, 03:39 PM
Gyn appt today and appt Monday with gyn/oncologist - pathology report

Dear Sam,

My initial diagnosis after a D&C was complex hyperplasia with atypia . Upon surgery a small 'foci' of cancer was found ( and is often suspected with this diagnosis) My final diagnosis was the same as yours.

I did not have any lymphvascular invasion either ( the pathways to the lymphnodes) which is a good sign. I also had my regular gyn do my surgery because I had not found this site beforehand and did not know I needed one. Dang it!!! I have sure learned a thing or two since then....

After my TAH/BSO I was sent to an onc/gyn who wanted to go back and take my lymphnodes in another surgery. eeeeeks!! However, I finally ended up only having a CTscan which looks for enlarged lymphnodes ( a sign of possible spread). They looked ok so I did not have a second surgery. Your low stage and grade plus no vascular space invasion bodes well for no lymphnode involvement. I think there is less than a 2% chance of it being found there with your low stage and grade.

At any rate, my onc/gyn took my path report/my CTscan/a CA125 test on to the 'tumor board' ( a group of specialists) who recommennded NFT ( no further treatment)

This particular diagnosis has a 95% to 97% chance of non-recurrence. You may be asked to weigh the odds of treatment with radiation. I would have had the option to choose that if I wanted. Usually at this low stage and grade it would only be brachytherapy ( 3 or 4 internal treatments at the vaginal cuff). However, there are side effects and you would have to think about the benefits vs. the possible side effects since your prognosis is already excellent.

I am older than you and did have my ovaries removed. The reason being that endometrial cancer is usually estrogen driven and remaining estrogen could encourage any errant C cells that are left behind. However, this may be more of an issue if your grade and stage were higher. A stage 1b is less than 50% percent invasion into your uterine wall. A grade 1 is less than 5% of cells looking abnormal/cancerous. I am not a Doctor but this is according to my experience and research.

It is interesting that you have the depth of your uterine thickness on your path report. Now, I am not sure about this....but I 'think', if your myometrium is a 2.7 thickness and your invasion is 3mm... that would mean you had approx. 11% invasion. If I have that right?....it would mean your invasion would be considered very minimal.

Of course, your new onc/gyn would need to explain all this to you. I have some interesting and informative articles that I can send regarding protocol of treatment for different grades and stages. I would be happy to send them along if you would like to pm or email me.

I know that this can all get a bit overwhelming. I remember it well. It has been over two years for me since surgery.

Hugs, Diane (baylee6)
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  #4  
Unread 02-24-2006, 05:09 PM
thank you

K9 and Diane,

My heartfelt thanks for your replies. On thing I forgot to mention: I guess I am considered a "fluffy gal"? Anyway, my gyn told me today that I should loose weight, as this cancer is estrogen driven.

My best wishes to you and everyone here!
  #5  
Unread 02-25-2006, 04:55 AM
Gyn appt today and appt Monday with gyn/oncologist - pathology report

Sammaria,

I am sorry to hear of your worries. Please try to take some comfort in the advise the "sisters" will give you. From your pathology report, it sounds like encouraging news. It appears to be early and low grade; a very good thing here in Cancer City!

Try not to linger over the fact that you had this done without a gyn/onc. That chapter is closed. What is important are two things; first, your pathology has been reviewed by specialists who do this all day long. You should have very accurate information in regard to your tumor. This information will lead to great direction on follow-up. The second take-away here is that you now can be an advocate for other women in your shoes. You will be able to reach a whole new group of women and be able to share the knowledge of when to consult a gyn/onc.

Some folks do get a second pathology opinion. If your slides were not reviewed at a cancer center, you may consider sending them to an institute like Johns Hopkins, MD Anderson or a cancer center like these. You can request to have this done yourself or organize it through your doctors office.

It makes me nuts to hear that a Dear Husband (DH) has lost his patience with a sister However, it is not uncommon for the boys to "act out" this way. It would be great if we were in a perfect world and they could find the fortitude to be there for us 100% in these stressful times; but you'll find that most (not all) sisters DH's have snapped along the way. No excuse, mind you, just explaining that it can be hard on them too. Some men also have a built in time limit. They decide up front how much time is alloted to your surgery & recovery. When things do not go as planned, they get cranky. Funny creatures.

If you are stressing out too much during the wait to see the gyn/onc, try to ask your doctor for some anti-anxiety medication. This could really help to manage your stress level. Do not be afraid to ask for the things you need!

Good luck and keep us posted!

beachball
  #6  
Unread 02-25-2006, 10:50 AM
Gyn appt today and appt Monday with gyn/oncologist - pathology report

It is always scary to hear one has a cancer DX but based you path report it appears you had a very early stage and grade and surgery alone often is the cure. I'm glad you soon will consult with a gyn/onc and of course he/she can explain the details of your path report and suggest any additional treatment if necessary and perhaps be the one to do your follow-up check-ups,etc.
As others already have noted your DH reaction can be typical for many men; they often cannot cope well with illness or things beyond their control and perhaps in their frustration anger takes over when compassion is needed. Pls come here as often as you like to vent,etc.; there always seems to be someone around to listen.
s
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