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Endometrial Hyperplasia & Cancer: Questions Endometrial Hyperplasia & Cancer: Questions

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Unread 04-06-2003, 05:42 AM
Endometrial Hyperplasia & Cancer: Questions

I was biopsied and the results were: Complex Endometrial Hyperplasia with Atypia and Dysplasia. My gynecologist said that the biopsy itself did not show cancer cells, but that they wanted to do surgery "right away" and they'd know more after surgery.

But now my surgery has been postponed indefinitely because of SARS outbreak in Toronto where I live? The hospitals are all under quarantine and the only surgery being done is "life-saving" -- you know people hit by cars, catastrophic things.

My question is how long does it take for severe Complex Endometrial Hyperplasia to become Endometrial Cancer?

I know the stats and I know endometrial cancer marches slowly. The last year has been a quick study course in cancer for me because my dad died of lung cancer in April, 2002 and my younger sister is Stage IV lung cancer and getting palliative care.

I know it is a hard question to answer but I am worried. Waiting months is not good for the soul.

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Unread 04-06-2003, 11:05 AM
Endometrial Hyperplasia & Cancer: Questions

I was dx with endometrial cancer stage 1a last July. My dr. said that it had probably been in the cancer stage for about a year before dx....that is pretty scary. The onc/gyn that did my surgery said that it was only superficially attached to the upper wall of the uterus. I had been having painful and heavy periods for some time on and off so I think and the dr. suggested that it was in the hyperplasia stage for a while....probably at least a few years. I wish I had insisted on a sonogram, d and c or some testing earlier...but the dr. thought my heavy periods were just perimenopause starting....I didn't fit the typical endometrial cancer profile so my dx was delayed. Surgery alone took care of my problem and I get frequent check ups now. I would voice your concerns to your dr. They are valid questions that need to be answered.
Unread 04-06-2003, 12:04 PM
Endometrial Hyperplasia & Cancer: Questions

Lia, is your gynecologist a board certified gynecologic-oncologist (gyn-onc)? They are the experts in female reproductive cancers as they receive several years of additional training in diagnosing and treating women's cancers. Before undergoing a radical hysterectomy in May 1999 for endometrial cancer, I consulted with two gyn-oncs. At surgery it turned out that my tumor had invaded the endometrium as well as approximately 80% of the thickness of the myometrium which is the underlying muscle wall of the uterus. When I asked my gyn-onc how long he suspected I had the cancer before surgery, he said there was no way to know.

If I were in your situation, I would definitely obtain a consultation from a gyn-onc. He or she will most likely want to review the pathology slides from the endometrial biopsy or D&C (at least mine did). When I called to schedule the appointment, I was instructed to bring the slides from the lab so that he could examine the tissue removed during biopsy himself.

Good luck and good health to you--

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Unread 04-06-2003, 01:37 PM
Endometrial Hyperplasia & Cancer: Questions

My doctor is simply a gynecologist. I would probably be referred to a gyne/onc if the pathology report after the TAH,BSO was positive for cancer. In the meantime, with all the hospitals pretty much wrapped in quarantine, a referral would not be on. We have a shortage of oncologists so I am sure that would be the situation.

I had endometrial hyperplasia ten years ago and some treatment with depoprovera and then we stopped. I had normal periods for a year or more and then menopause. So I guess like the bear, I'
ll go over the mountain sooner or later to see what we can see.

Thanks for posting. I will be talking to my gynecologist some more. He is very honest with me, but right now has no answers and seems as frustrated as I am.
Unread 04-06-2003, 02:50 PM
Endometrial Hyperplasia & Cancer: Questions

Lia, a friend of mine recently had a consult with a gyn-onc for a complex cyst on her ovary. She did not have a diagnosis of cancer when she saw the gyn-onc but went for a second opinion to see whether he agreed with her gynecologist's assessment of her condition. Another friend had a cone biopsy for cervical dysplasia performed by a gyn-onc a number of years ago. She did not have cancer either.

If it were me, I would not have a hysterectomy based on one opinion only, and if I had your history of hyperplasia, I would definitely be consulting with a gyn-onc. Since in early stage endometrial cancer, often the only treatment required is surgery, what good would a referral be to a gyn-onc after the fact? What would there be for him or her to do at that point? I would definitely be proactive if I were you. While your gynecologist may be as frustrated as you are by the wait, you are the one with the medical issues at this point and not him.

Good luck!

Unread 04-06-2003, 02:52 PM
Endometrial Hyperplasia & Cancer: Questions

One point I would definetly bring up with your gyn is that you want a sampling of your lymphnodes in the pelvic area during your hyst....There have been ladies on the board that went in for a hyst, there path showed cancer and then they had to go back in and have a second surgery to check the lymphnodes....
Unread 04-07-2003, 07:30 PM
Endometrial Hyperplasia & Cancer: Questions

A couple of ladies here referred me to an excellent gyn oncologist in San Antonio, TX, but I hit a brick wall when I tried to get in to see him PRIOR to receiving a cancer diagnosis.

I'm sure they're great for second opinions if you can get in the door to see them.
Unread 04-08-2003, 01:30 AM
Endometrial Hyperplasia & Cancer: Questions

Lia, If you are going to have to wait a while for your surgery, If I were you, would definately want to spend my time constructively and try to get an appointment with a gyn-oncologist. They are the experts in gynaecological cancers and I believe they are the only ones who can do lymph node biopsy at the time of your hyst. I am assuming they will probably do a frozen section during your surgery and IF they find the tumour is cancerous then a gyn-oncologist can follow on from there without putting you through a second surgery at a later time (waiting for that would be very stressful). I had my surgery done by a gyn-oncologist on a SUSPICION of Endometrial stromal sarcoma and he was very happy to consult with me and do the surgery. My gyn assisted.

I know how frustrating and stressfull it can be waiting for this surgery when you don't know what diagnosis you are going to come out with at the end. I had to delay my surgery by about 2 months because I badly injured my knee after my first diagnosis.

s from :

Unread 04-08-2003, 03:29 PM
Endometrial Hyperplasia & Cancer: Questions

Seeing another specialist is probably not on. The supply of oncologists is short and demand long. It is completely normal to wait 3-4 months to see an oncologist -- and that was before the SARs outbreak completely fouled up the hospitals here. Thousands of people are in quarantine, including lots of medical staff. I am grateful my gynie finds the time to call me.

If I prove to have cancer, and if my doctor and I feel it is necessary, I would then see a gynie/onc. Anyhow, I don't have a lot of choice in that. The hospitals are still restricted and no non-life-saving surgery is happening. The exception is the hospital that specializes in cancer treatment. It had no SARs patients so it is functioning normally.

I waiting 3 months to see the gynecologist. I only wish they had done the hysterectomy ten years ago when I first developed hyperplasia. I wanted a hysterectomy then because months of bleeding left me not well. I can not tolerate provera so surgery is a good option. I am not willing to go through months of bleeding and fear of CA now that I am menopausal.

Thanks for your responses. They gave me something to think about. I'll know what I know when they do the pathology after the surgery and I will deal with it then. It is good to pick your minds though and I appreciate it.

Unread 04-08-2003, 07:19 PM
Endometrial Hyperplasia & Cancer: Questions


After reading your message, I gave up all illusions of ever becoming a Canadian citizen! All kidding aside, I really like Canada, but would probably be dead if I had to wait three or four additional months to see a gynecologist and oncologist. My former gynecologist did try to tell me I needed to wait close to four months, and I proceeded to call another one a mile from home who saw me within a week. I was also able to schedule an appointment with the gyn-onc within ten days from the day I called. And even with those prompt appointments, my endometrial tumor had invaded 80% through the thickness of my myometrium. Of course, no one anticipated the extent of my cancer until I was opened up on the operating table. Then the gyn-onc determined that I needed more extensive surgery than usual, including a radical hysterectomy, which regular gynecologists are not qualified to perform (at least in the United States). He also removed 30 lymph nodes and a block of tissue surrounding some of the lymph nodes because he suspected the tumor had invaded the nodes. Luckily, the pathologist's report determined that although the lymph nodes were palpably enlarged, they were tumor-free.

I'm curious; I know Americans go to Canada to buy prescription drugs, can Canadian's seek medical care in the States to avoid such lengthy waits, especially in cases where cancer is a possibility and time is of the essence?


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