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Para aortic lymph nodes

thank you
Posts: 77
Joined: Jun 2009

OK. We all know how important is to have lymph nodes taken during the surgery for staging. Not only the number but also the location of the lymph nodes is important. My mom had 20 lymph nodes taken, 2 of those were positive for micrometastasis. However there was no para aortic lymph node taken - because the surgeon thought that everything is ok and not needed. This will not change the stage, it is still stage IIIc, but it would change the radiation field. She had pelvic radiation while she might needed whole abdomen radiation (if indeed had positive para aortic lymph nodes). Now I just hope that the chemotherapy took care of those.. I would like to hear if you had para aortic lymph nodes taken, were there positive or negative and what kind of radiation you had. Thanks thanks thanks always thanks.
PS: there is always something that makes me think that we were not aggresive enough....

Ro10's picture
Ro10
Posts: 1356
Joined: Jan 2009

I don't know why they did not take the para aotic lymph nodes from the other side. The one side was negative. The radiation onocologist even stated he wondered why they did not take them from the other side. I too have III-C U{SC. I only had the pelvic radiation, and hope too that the chemo took care of any other cells that might have been there. So far the initial CAT scan after treatment was negative for anything. Hope you Mom continues to do well.

Deblittleton's picture
Deblittleton
Posts: 56
Joined: Feb 2009

During surgery they removed 25 lymph nodes. One of them being a suspicious looking para aortic lymph node. All were negative. Had chemo with taxol & carbo then a Pet Scan that showed the suspicious area showed no metabolic activity. Therefore they continued with my pelvic area radiation and decided not to do the abdominal radiation. Then there will be 3 brachy therapies.
Good luck to you and your Mom.

thank you
Posts: 77
Joined: Jun 2009

Ro10 and Deblittleton, thank you for your reply.
I don't understand why something that is considered routine for some doctors is not for others. I suppose the surgeons are afraid of the complications of removing lymph nodes so close to a vessel like aorta. It's always whether the risk outweighs the benefits.
Yes my mom is doing well, now 8 months after the last radiation treatment. She also had MRIs and PET scan 6 months after the treatment which didn't show any lymph nodes - makes me hope that if there was any residual cancer, chemotherapy took care of that.
I know your story since I read all the posts, and I wish you the best,

thank you
Posts: 77
Joined: Jun 2009
irishohiogirl's picture
irishohiogirl
Posts: 10
Joined: Oct 2007

I had 30 lymph nodes removed . 3 were positive for cancer one being para aortic. I received pelvic and abdominal radiation first and then chemo with Taxol and Carboplatin. On September 12th I will be a 2 year survivor of grade 3 stage 3C endometrial adenocarcima.

thank you
Posts: 77
Joined: Jun 2009

2 years NED!!!! I suppose you can't hide your smile every moment.
the first years are the most difficult... You are CURED!!! It is so nice to hear stories like yours.
You have my best wishes!

bonniesue
Posts: 126
Joined: Apr 2009

My mom is 71 years old and never had symptoms but after cat scan for kidney stones showed endometrial thickening in Oct. 2008. Then had an endometrial bx after Christmas and it was positive. had Davince Robot in early feb. 2009, gyne-onc surgeon thought it early but it came back greater than one half mymometrium, lower uterine segment and six pelvic lymph nodes both sides -sampled negative and no paraarotic sampled and neg. washings. No fresh frozen done. Depending on path report(had multiple opinions) some said grade 1 stage 2b or grade one stage 1C. Differences in tx options..surgeon said brachytherapy only, rad. onc said 25 pelvic rdx txs followed by three vag brachy. No chemo suggested. I feel for you as I have been on the website for my mom on and off since January. mom is doing good now with neg pet/Ct, neg MRI. I agree that concensus is difficult and you obviously have gotten your mom good care. I think that standards are regionally influenced and we worry about our loved ones and there is a variety of txs. in a way you want more lymph nodes taken but maybe then worry about lymphedema. More radiation maybe more side affects. I do not know how old your mom is. My thoughts are with you daughter to daughter. I think Uterine cancer is silent and more attention needs to be given. We are mothers, daughters, aunts and need to spread the word about uterine cancer which can and should be detected early. . Blessings to all.

thank you
Posts: 77
Joined: Jun 2009

Thank you so much for your reply. Some times you need to hear from others that you did the best possible. It hurts when you know that people that you love, and they have been always here to help you, now suffer. My mom's illness changed the way I see my life. I came to this country to receive the best training in medicine. I am now done with training and work as a physician. I love this country and all the people here. The american dream still exists, for all of us who come from the other side of the ocean. However, I am now trying to go back to Greece, to be able to take care of my parents as they get older. I learned from all of you - and I can not find the words to show how much I appreciate it - to stop complaining and enjoy every day. My mom is now here with me, very happy taking care of her granddaughter. She will have her follow up appointments here. Hopefully she will be able to stay for the whole year. Thank you deep from my heart for listening.
Chrysoula

daisy366's picture
daisy366
Posts: 1493
Joined: Mar 2009

Your mother is a very lucky woman - to have such a caring daughter and enjoying her granddaughter. And her cancer gave all of you this time together. Her cancer is helping you bring a new dimension to your medical practice.

I sometimes have to think of the positive things cancer has brought to my life. My marriage is better than ever. I appreciate things much more. I stay positive longer and negative shorter. I take time to be nice to myself and others. I don't save things and use the good china!!

I have a Question for you the doctor: how do we go about getting resaerch for UPSC? Can you give some names or tell us how the process works??

Thank you, Chrysoula, Mary Ann

thank you
Posts: 77
Joined: Jun 2009

There are 2 different types of research.
- the investigator initiating research: a physician is starting a research
- drug company research: to evaluate a new drug.

To start a research you need to have a specific question: What are you researching about? For example: Should we do a vaginal US every year (same as we do PAP test) to diagnose gynecologic cancers early? OR: Patients with uterine cancer stagge II: how many chemo and how many radiation is needed? OR: early signs of uterine cancer that a gynecologist should ask to diagnose in early stages. Those are just examples

Then, the physician who has this question, needs to review the literature (since this question might have been answered in the past). He submits his request to a local IRB (Investigation research board), those are the people who make sure that the patients rights will be respected (for example, consents, privacy regulations etc).

This is what happens in my field (rheumatology). I haven't heard of any research that was initiated by patients - but there is always somebody to start first!

I think the best is to find a physician who is interested in research in uterine cancer. And who is experienced. It's more than I wrote above. You have to find inclusion- exclusion criteria, and to find many patients to have results that worth to publish. So, if any of you is followed by an oncologist in a cancer center can ask if there are any trials or research projects that you want to participate. Or if you have an idea of what you want to search about, you can ask your oncologist if this can become a research subject. Keep in mind: something that we - as patients - think it is interesting, but not be interesting at all to the doctors and researchers.
I don't know if I answered your questions - I am mostly a clinical rheumatologist, a researcher would give you a better answer.

Take care

bonniesue
Posts: 126
Joined: Apr 2009

Interest**** that you commented on me going for a check up. A month ago I went to my gyne with irregular heavy periods and asked her for a pap (which I never miss yearly) and also asked for a transvaginal ultrasound. She did that and a hysterosonogram which showed a 3.8 cm uterine polyp(no endometrial thickening) in the uterus and could not biopsy in her office.. So I had surgery 2 weeks ago supposed hysteroscopy d/c. However after surgery the surgeon said he could not get it out as it was too hard and biopsy was performed. no d/c. He thought fibroid however the path report said benign polyp. he says not to worry come back in 3 months. I only had the transvag US due to my mom's history. I feel somewhat unsettled because of my mom and her uterine cancer and also them thinking it was so early for her. I also had the same thought as you Patricia regarding Davinci with my mom. she did have that but I have to wonder if a fresh frozen might have been done if it were done open and more lymph nodes taken. Tonight I just feel overwhelmed. Interesting to note the tech that did my ultrasound said in Europe that transvaginals are done routinely in those over 40. I know I am rambling but prevention is key and people seem to know about paps and cervical cancer but not uterine -even doctors.

california_artist
Posts: 850
Joined: Jan 2009

Rambling is totally encouraged here, otherwise how would we figure things out.

Ah, I have a thought about the wait and see approach. My cancer was confined to a polyp. But it seems to me, that unless they took out the whole polyp, they might not have biopsied the part that might contain cancer cells.

Especially with your mom's history, I might also encourage you to get a second opinion as was suggested earlier. Did they happen to check your CA-125? Also there is a very inexpensive test for C-RP ( c reactive protein) that, when high encourages cancers to grow.

Just some thoughts, or you could just make some tea, watch a little tv and relax for a spell. Relaxing is very good for what ails you.

Love and heartfelt wishes for all things good,

claudia

bonniesue
Posts: 126
Joined: Apr 2009

I took your recommendation and did just that (me and my dogs) and watched larry king that I had taped which had Dr. Weil talking of health care and prevention. When I was in my teens used to oil paint which was the most calming(never formally trained). I have not done that for 30 years. Always feel peace when I see your beautiful art.

bonniesue
Posts: 126
Joined: Apr 2009

Have a second opinion this week as the path report came back polyp so I read the operative report and it was a large mass but too high to be able to remove and too big and not all of it could be biopsied so also my family doctor recommended an MRI next week and he also says he would promote a hysterectomy. the second opinion is with a gyne.

bonniesue
Posts: 126
Joined: Apr 2009

Thanks for the reply. The second opinion today said to go back in for yet another hysteropscope but using cautery and electrical loop. I asked about the morcellator and he said too new and does not want to use me as a teaching tool. He feels he could get it however my last hysteroscope done by a gyne onc says he does not use those tools and only biopsied it-said it was hard like a fibroid big but path report says benign polyp fragments. I also asked about genetic testing today due to my mother's uterine endometrial adeno-ca, grandma's colorectal cancer, uncle's colorectal and my grandpa's pancreatic cancer. He said I do not need it. these cancers are split on my dad and mother's side. Have not had an MRI yet but family doc says your in your late 40's get a hyst....gyne today says. no.

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