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Just came from second opinion at Sloan Kettering MMT carcinomasarcoma

Teamkelly
Posts: 50
Joined: Sep 2012

Some of you may remember me, I started posting about 5 weeks ago. My sister in law Kelly was diagnosed with Uterine carcinomasarcoma 3c1. She was diagnosed in California and had a complete hyst. We were told that it was all the way thru the myometrium and was in one of 24 pelvic lymph nodes, also there were cells in the wash of the abdomen. Luckily Kelly was able to afford to come to NY for a second opinion at Sloan Kettering with Dr. Hyman.

Here is what we found out, this may help someone else. Kelly is 66, no children, perfect weight, no other health problems and works out regularly. Her first doctor recomended carbo taxol and no radiation, after meeting today with SK he is recommending that she join a clinical trial that uses ifosfamide and paclitaxel, this is GOG-0261. He explained to us that when his lab did the pathology they got a different results, they found that it was also in an ovary and in a second lymph node, this does not change the stage or the treatment. This trial is in phase 3 and she will get the ifosfamide and paclitaxel over a 3 day period every 3 weeks for 6 times, along with this she will take Mensa to protect her bladder. No radiation, because at this stage what would you radiate?

They will do CAT scan verses PET scans and after treatment if there is recurrence he said we start all over with a new biopsy, that we won't assume it is the same thing and treat it the same way until they know what it is.

Teamkelly
Posts: 50
Joined: Sep 2012

I posted above post and hoped that I might get feedback from some of you ladies with carcinomasarcoma. What do you think about no radiation?

RoseyR
Posts: 462
Joined: Feb 2011

Dear TeamKelly,

Obviously I am no doctor but I am a two-year survivor of uterine carcinosarcoma (diagnosed two years ago at stage IB with 60 percent myometrial invasion but apparently clear ovaries and lymph nodes of the 19 they looked at.

I was treated at University of Pennysylvania's Abramson Cancer Center ("One of the Top Ten Treatment Centers in the Nation). Penn is renowned as a medical teaching center--like Jefferson, also in Philadelphia.

The treatment Penn recommended was three rounds of taxol/carboplatin, followed by 25 external pelvic radiation sessions, followed by three final rounds of taxol/carboplatin--and I finished all treatment exactly a year ago and am feeling fine. Nor was the treatment very hard on me; other than losing my hair, I had few side effects from treatment.

However, I did seek two second opinions, one from Jefferson's leading gynecologic oncologist and one from Pennsylvania Hospital's leading one. I even got a fourth opinion from Hahnemann Univeristy's radiological oncologists.

The major disagreement was what KIND of pelvic radiation I should have. No one believed I should skip pelvic radiation, by the way, since MMMT notoriously recurs in the pelvic region, and when it does, is often hard to treat. But Jefferson said I should have just vaginal brachytherapy (to minimize chances of recurrence in the vaginal vault) and that I didn't need external pelvic radiation because my pelvic lymph nodes had been clear. (Vaginal brachytherapy DOES deliver some radiation to the entire pelvic region, by the way, just not as much as external beam radiation does.) The expert at Pennyslvania Hopsital told me that recent studies (called "PORTEC") done in the Netherlands, concluded that vaginal brachytherapy has fewer side effects and does just as much good as external pelvic radiation. "It seems counterintuitive," this oncologist told me, "but the vagina has a rich network of nerves that radiate out to the entire pelvis, and that may be why brachtherapy is nearly as effective as external pelvic radiation." He concluded that in his opinion I only needed brachytherapy "but if you want to be really aggressive, you might consider both."

Originally, my own radiologial oncologist at Penn said I might need BOTH. And many women on this board with uterine papillary serous cancer received both.

But when I finished external pelvic radiaiton, my radiological oncologist surprised me by saying, "I am rethinking your treatment. The fact is that your tumor was not that close to your cervix. (I had previously been assured this by another doctor.) And I am seeing too much vaginal toxicity from brachytherapy. Moreover, external pelvic radiation was designed to help target your vaginal vault; you did get some radiation to the vault. So I don't think you'll need additional brachytherapy."

I heard that with relief although of course should I have a recurrence in the vaginal vault, I will resent that advice.

What puzzles me is why, especially at your stage, they are not recommending ANY radiation.

The only possibility I can think of is that they don't want chemo interrupted by it; maybe they want to douse you with a very aggressive chemo regiment without interruption. Radiaton takes its own toll on the body , of course, but it does allow you a period to recover from the particular assaults of chemo. And there WAS an interval of a week or two between the end of radiation and the resumption of chemo in my case.

Radiation is not said to improve our overall survival; what it does is to prevent or at least delay, recurrence to the pelvis.
On the bright side, should YOU have recurrence to the pelvis, you would be able to be treated with radiation for it because you hadn't had prior radiaiton. Those of us who have had prior pelvic radiation are not, I believe, good candidates for more radiation.

As you can surmise, how to treat our tumor is hardly a science, in part because it is so rare.

But I would at the least ask your oncologist why they are NOT recommending radiation.

Best,
Rosey

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

Hi Kelly,

These are dilemmas. My doc did not recommend radiation after initial treatment with carboplatin and taxol chemo. He said that most recurrences are in vaginal cuff and that he had high rate of success in curing this if it recurred there. He said that "the science didn't justify radiation for me". At the time I worried that I was undertreated but with hindsight I think it was the right decision.

However, I still had recurrence - now dealing with the second in distant lymph nodes. I had chemo and radiation for first recurrence in neck. Now just chemo for recurrence in much of lymph system.

My doctor believes that there should be a target for radiation. The mass radiation of a large area seems like shooting in the dark to me.

I think you will need to do what you feel most comfortable with. I have trusted my doctor's recommendations and not disappointed in this. He believes in giving the least invasive treatment and giving most bang for the buck.

Best wishes. Keep us posted.

Mary Ann

CaCowgirl
Posts: 27
Joined: May 2010

I have been off the boards for over a year. After my surgery I did not have the recomended chemo or radiation. it has been over 2 years now & I seem to be doing fine. I sold my home of 35 years & moved to another state-also retired in Dec. So many of you are fighting so hard & my prayers are w/you. I've known & watched so many go through the treatments, then have a recurrence-you all are so brave. My husband said he would support me no matter what I decided, but he recently told me he could not have watched me go through it. Somehow I knew that. I don't know what will come next. My prayers are w/all of us that have gotten this disease. It seems to be getting more & more widespread.

CaCowgirl
Posts: 27
Joined: May 2010

Sorry for the double post

txtrisha55's picture
txtrisha55
Posts: 423
Joined: Apr 2011

I was dx in April 2011, had surgery and 6 round of carbo/taxol ending in Aug 2011. I am NED for over a year now from the last chemo. My dr said no radiation so I did not have any. I have 3C1 carcinomasarcoma. Itseems that some did have radiation and some did not but looking on the NCI website it states that radiation is a standard protocal. I cannot tell you about since I did not have it done. Good luck and I will be praying that everything turns out ok. trish

Teamkelly
Posts: 50
Joined: Sep 2012

Thanks Trish, you and my sister in law have almost the same diagnosis. Sounds like you are doing great, I am happy for you and pray for your continued health and well being.

Nicki

txtrisha55's picture
txtrisha55
Posts: 423
Joined: Apr 2011

I have carsonoma sarcoma stage 3 c 1. DX in April 2011. My gyn onc dr at UT southwestern suggested a clinical trial comparing ifosimade and carbopaxiel with the addition of paxatexl on both. Gave me the paperwork to study and after reading all I decided against the trial and just took 6 round of carbo/taxal. I asked about radiation and she said that at this time there was nothing in the pulvic area to radiate, so I had no radiation. So far I am doing good I had my last chemo treatment in August 2011. I get 3 month follow up visits and a ca 125 test. I also get a ct scan every 6 months. I know that a lot of the other ladies on this site had radiation. I will be praying for you and you sister. trisha

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jazzy1
Posts: 1387
Joined: Mar 2010

I as well was diagnosed Jan '09 with stage 3c1, MMMT - or carcinosarcoma. Found in 1 lymph node, pelvic area, no where else, outside of uterus, and had not gotten thru the uterine wall. They did test 24 lymph nodes during my total hysterectomy.

What I can tell you, if this was the garden variety of uterine cancer, possibly treatment would be different, less aggressive. Since this is a very, very aggressive type of uterine cancer it was suggested I endure 6 rounds of carbo/taxol chemo, sandwiched between with 33 sessions of external pelvic radiation. The chemo gets any cancer which they didn't detect during the hysterectomy or pathology, plus the radiation zaps the one area they knew to have had the cancer -- pelvic node. I didn't get a second opinion as Rosey did, but felt this was my best option and my oncologist is well renowned here in St Louis.

I completed all treatments July '09 and have been NED since. I've completely revamped my eating, exercise, avoidance of toxins in toiletries/cosmetics. Have endured a few side affects today, which I feel is due to the treatments...knowing none of the docs will admit treatments caused my issues. It is what it is, so I've learned to go on with life.

My suggestion, when the cancer is found out of the uterine area, we're more prone to recurrence, then top this with our aggressive cancer. We need to hit this aggressively and know all the treatments I had, have, thusfar, kept me living my life. Not to say tomorrow things could change.

Quite interesting how another facility notes a different in your pathology report...makes me wonder. Two sides to every story as we say in life.

Go with your gut feeling, and know all of our bodies are unique, therefore, the treatments must be unique as well. If we both had the same cancer and diagnosis, plus same treatment plans, we might have completely different results in the end.

Best of luck to you and your sister-in-law....keep us abreast on your progress!!
Jan

JMoses
Posts: 7
Joined: May 2012

My Mom tried and abandoned the ifosfamide and paclitaxel combo for one session of the planned 6 and it really knocked her down hard. She was perfectly healthy 70 year old prior to this carcinosarcoma dx in May 2012. She started with 3c and then was determined to be 4C after lymph node in her neck was positive. She has just finished 5 rounds of carbo/taxel and is awaiting CT in a couple of weeks. Whatever Kelly decides she is the driver on the bus; we passengers can lend the support and love. It is a crazy fast, aggressive cancer that needs all hands on. She will know what is right...many prayers with you and your family.

Teamkelly
Posts: 50
Joined: Sep 2012

You are all so brave and unique and it is interesting how each of you found your own path and are surviving, I admire you so much! Thanks for all of your feedback, we leave New York tomorrow for California and I will keep you posted. This is a wonderful place and I am thankful for all of you.

beila
Posts: 97
Joined: Sep 2012

I am considering a consult at Sloan kettering
Would you mind telling me how long it took you to get an appointment?

Thanks,
Beila

Teamkelly
Posts: 50
Joined: Sep 2012

Beila it took about 3 weeks, if you go on the website and call the number for an apptmt you will get an advocate who takes all your info and helps you get to the right doctor. we wanted to see Dr. Hensley who wrote this trial is a world renowned expert, she could not see Kelly for 6 weeks and told us Kelly needed to be seen within 3 weeks so she could start treatment so we saw Dr. Hyman who is on her team and sits on an international board about this type of cancer. Our advocate told us everything we needed to do, we had to overnight all the pathology slides and surgical notes, we hand carried PET, X-RAY, colonoscopy CD's. The apptmt was $716.00 and we will get a bill for SK doing the pathology, the doctor briefly examined Kelly, told us what he came up with about her case, ask her some questions, explained CS to us, told us that her tumor was mostly sarcoma, etc... He answered all of our questions and did not rush us. We left there with a better understanding of her disease and a confidence about the decision she made, he never pushed us one way or the other and helped her make a decision.

Hope this helps, the advocate walks you thru everything in the beginning and then turns you over to the doctors office, it could not have been easier.

CindyGSD's picture
CindyGSD
Posts: 191
Joined: Aug 2011

I was not in a clinical trial but I did receive the same chemo Ifos/Taxol that is being recommended for your sister-in-law. Ifosfamade is highly toxic to the bladder (reason for the mesna) and the side effects can be severe which is probably why most people get Carbo/taxol. I also think that is why they spread it out over three days. I received Taxol only on day one of treatment.

I had no problems with it and worked full time (other than chemo days) during the entire treatment. Do you know if she has to spend three days in the hospital during treatment? Many people do. I think that is so they can administer enough fluids to counteract the effects of the Ifosfamide. Hopefully she will be able to get her treatment as an outpatient as I did. The one thing I can recommend is that she drinks tons of water....I drank at least a gallon a day which was probably a little excessive, but it worked for me and other than severe joint pain (from the taxol) on day four and five, I had no major issues.

As for radiation, I received 25 rounds of external pelvic radiation with chemo sandwiched around the radiation. I also had 3 rounds of internal. With regards to what they are targeting, if there are no residual tumors, its my understanding they are targeting the area where the original tumor was found.

I am currently seven months out of treatment (CT scan upcoming), and basically feel pretty good. Now that your sister-in-law has a plan, I think she'll find it a relief to start treatment.

Keep us updated.

Take care
Cindy

Teamkelly
Posts: 50
Joined: Sep 2012

Cindy,

Thanks for the encouragement I am reading the CT papers tonight and have emailed them to Kelly to start reading, we started the ball rolling for this trial last Friday and still have not heard back from them, she is anxious to get started now that she has made a decision. My understanding from reading tonight is that she will receive the treatment over a 3 day period, not sure if she will be hospitalized or not. We will definetly do the water. Do you have any long term effects from the chemo? What about the radiation?

Glad to hear you are doing so well, Hope you get a good CAT scan.

Nicki

Teamkelly
Posts: 50
Joined: Sep 2012

After finding out what the clinical trial and ifosamide (3 days and then shots for 10 days) Kelly decided to do carbo/taxol. She asked mewhat I thought and I said "this is your life you have to choose how you want to live it."
she had her 1st chemo last Thursday and has been great, walking everyday, drinking tons of fluids, only problem so far has been constipation. Question - is the 1st treatment indicative of the rest of treatment?

Now me, I cannot believe this, I am 56and have not had a period in 5 years, tomorrow is my 57th birthday and I started bleeding tonight, how concerned should I be??

CindyGSD's picture
CindyGSD
Posts: 191
Joined: Aug 2011

Even though I didn't get it...carbo/taxol is pretty much the norm around here...I'm sure she will do fine on it. My worst...absolutely WORST side effect was constipation and the very first treatment also was the worst because I wasn't prepared for it. There are plenty of natural laxatives that she can take starting the day she gets her chemo (or even the day before), and i'm sure she'll quickly figure out what works best for her.

I'm glad to hear she is doing so good....its amazing how you build something up in your mind...imagine how absolutely horrible it will be...and then...at least for many of us...its not really all that bad. Chemo will become more debilitating with each treatment....but if she's on a three week cycle she'll figure out pretty quickly which days will be the bad ones. My bad days were days four and five after receiving chemo...

I can't really speak to what you're experiencing now....I was still having periods...but from what I've read, I would consider making a doctors appointment just in case....bleeding can be a symptom of something....or not.....better to just put your mind at ease and get it checked out.

Take care,
Cindy

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CindyGSD
Posts: 191
Joined: Aug 2011

duplicate

beila
Posts: 97
Joined: Sep 2012

Dear Teamkelly (?nicki)

I am so sorry this lousy trick of fate caused you to bleed on the eve of your birthday.

I hope you are able to enjoy your birthday after you make an appointment with your gynecologist or family MD
1st step is a pelvic and transvaginal ultrasound
2nd step is an endometrial BIOPSY

Do not settle for anything less
For example, my late beloved mother had post menopausal bleeding with a normal ultrasound
which turned out to be USPC, which I now have

Hopefully yours will turn out to be nothing serious,
but, as we learned in medical school
"POST MENOPAUSAL BLEEDING IS CANCER UNTIL PROVEN OTHERWISE"

Happy Birthday
wishing you negative results,

Beila

Shell bug's picture
Shell bug
Posts: 68
Joined: Nov 2011

Thank you for your statement Beila! I so wish my doctor would have had that stance. I was only 38 and healthy, so she let me bleed profusely for 9 months. I just didn't have the word biopsy and kept trying different birth control pills. Luckily she finally did a biopsy but continually told me there was not way it was cancer. It was.

I know doctors are only human, but a simple biopsy may have saved me so much heartache. So, again, thank you for being outspoken.

Rachelle

txtrisha55's picture
txtrisha55
Posts: 423
Joined: Apr 2011

It could be a lot of different things, stress for one. i would go and ask a gyn dr to do an ultrasound or some other kind of test to to make sure. I had not had a period for several years and started flooding one day within two days I was at my gyn office and scheduled a D&C. That caused me to dx with uterine cancer 1 April 2011. I wouild get tested though, knowing what little bit I know now. Good luck. trish

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nancibee
Posts: 48
Joined: Sep 2012

I had my last period 10 years ago. I had a normal PAP in January of this year. Then in the beginning of April, I experienced heavy bleeding which gradually tapered off. I was not going to go see a doctor because I figured it would stop on its own. But I decided to see the gynecologist anyway and was surprised when she told me I could have either a transvaginal ultrasound or an endometrial biopsy. I chose the latter. A week later she called to tell me that the results were positive for cancer and that the GYN oncologist would be contacting me. I have UPSC and had a complete hysterectomy on 5/1, 6 rounds of carbo/taxol and will finish my vaginal brachytherapy this Friday in time for my 60th birthday on Saturday.

When I told my GYN oncologist that I almost did not have my bleeding checked out because it was stopping, she told me that is the nature of endometrial cancer. It tricks women because it stops and they think they are going to be fine.

It wouldn't hurt to be on the safe side and have your bleeding checked out. Hopefully, it will turn out to be nothing serious. I did not have any problems with the biopsy. I didn't even feel it. I have heard that it can be painful though.

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

In reference to your sister-in-law and her first treatment....generally the first is easier on the body as not cummulative. GENERAL RULE, per my oncologist, as the treatments go, you see more intense side affects. Now...that doesn't mean she'll be in bed or not keeping her food down, just more intense "possibly". Nothing is for sure, but this is a generalization as all our bodies are different and therefore, react to treatments differently.

In your case with bleeding....see your OB!!! I was pre-menopause and you're post...correct? No one knows until have a test/procedure, then docs are sure. I see way too many gals who have this and see the doc who does nothing...hoping it'll resolve itself. By the time they come back with SAME ISSUE, it has now become serious.

Good luck and we'll be thinking of you both...
Jan

Cancer is not a sentence, it's a word~

Teamkelly
Posts: 50
Joined: Sep 2012

Thanks Jazzy, went to primary on Thurs., she set me up with the Gyno for this Tuesday. She said they will do an ultrasound and biopsy, but I know with Kelly the biopsy was negative. Do you know what they biopsy? Kelly continues to amaze me, plenty of energy, no side effects, she goes back for 2nd treatment next Thursday, hope this continues.

Nicki

Double Whammy's picture
Double Whammy
Posts: 2267
Joined: Jun 2010

I can't comment on your sister in laws' situation, but re your post menopausal bleeding, physicians do take it seriously, and I'm glad you did. That being said, even if this should turn out to be cancer, 70% of endometrial cancers are endometroid adenocarcinoma, which if early stage, low grade, often need only surgery. I had this type, Stage 1a, grade 1, a little over 2 years ago, had a hysterectomy, bilateral salpingo-oophorectomy, lymph node sampling and pelvic wash. I needed no further treatments other than follow up exams and Pap smears. I'm now down to 6 month gyn oncology visits. Yes, it's cancer, and yes, it can come back, but the odds are highly in my favor that it won't. I hope this is the case for you - if it's cancer, which I hope it's not.

Keep coming here for support for both you and your SIL.

Best wishes,
Suzanne

beila
Posts: 97
Joined: Sep 2012

they biopsy the endometrium, the inner wall of the uterus

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

plse excuse this mis post

txtrisha55's picture
txtrisha55
Posts: 423
Joined: Apr 2011

Nicki,
How did your appointment go? Do they have the results of the biopsy yet? The only problem I have witha a biopsy is, the dr may not hit the right spot to get the sample. Praying that all does go well with you and you get good results. Glad to know that Kelly is doing ok with the chemo. trisha

Teamkelly
Posts: 50
Joined: Sep 2012

I saw the ob/Gyn on Tues. He did a vaginal ultra sound himself right in his office, saw a 1 cm polyp, scheduled me for an outpatient surgery center on Thursday and He went in with a camera looked all around, removed the polyp (it had a stalk) it was 1 cm wide, 2 cm long. I will get pathology back on this Thurs or sooner. He said my uterine wall was thin and everything else looked good. He told me that 97% of the time these are benign, he said the cramping was coming from my body trying to expel it, which must be true because that has pretty much stopped, but my stomach looks like I swallowed a pumpkin, guess that is the air/gas they used, he could only see one of my ovaries with the ultrasound and it was very small, which he said was good, oh, he also,did a PAP.

Kelly just had her second chemo and her joints are really aching, she is still walking everyday and works out with her trainer twice a week, I told her to try 3 Motrin and hot tub or bath, do any of you have more suggestions, she had her treatment on Thursday, no nausea, very little constipation, she says the pain level is a 5, I told her maybe she should not work out with trainer this week (she does weight machines to fatique) and just walk. The lab sends me all her lab reports and of course her numbers were starting to drop right before this round, still waiting for CA-125 but not sure how important that is with MMT/carcinomasarcoma.

jazzy1's picture
jazzy1
Posts: 1387
Joined: Mar 2010

Sounds like with your issue it might be nothing. Like the idea of thin uterine wall, as in many cases when our cycle stops the wall gets thicker. Plus your doc sounds quite positive it's benign...ride out the positive vibes from doc.

Kelly sounds a lot like me...always moving and ready to keep a normalcy. But...with me I learned quickly from an RN oncology friend we need time to rest...especially for few days after chemo. Our bodies are bombarded with toxins and fighting cancer, then adding on lots of fatique with workouts... hard to recover. Our bodies can only do so much...best to keep it strong to fight the cancer battle. Suggest as well taking whey protein powders and drinking lots of fluids. The chemo breaks our systems down and the protein and water help keep it fluid and strong.

I was a big workout gal and simply learned to take 3-4 days after chemo to rest. If I felt up to it, walk a bit outside for some fresh air and change of scenery.

CA 125 is a tumor marker and not everyone can use for guidance. Luckily in my case doc can as it was very high priot to chemo 550 and after EACH chemo it fell and stayed at the low of 4-6. But...as with anything we still follow other tests/scans.

Keep your chin up as sounds like things are falling into place for both of you. Who said life would be easy?

Hugs,
Jan

Teamkelly
Posts: 50
Joined: Sep 2012

Yeah, it was just a polyp 1 cm wide, 2 cm long, everything else looked great.

Kelly is having third chemo this Thursday, still going strong, no real symptoms, food taste fine, very few aches, has not needed anti nausea mess. Her blood work did show that she needs to avoid crowds and stay at home more, so she did not go to the mall and will not go to church today, but overall she could not be more pleased. Thanks for the heads up on the rest Jazzy, I always encourage her to listen to her body, but will remind her again after Thursday. she has always had a whey shake for breakfast, and continues to do that, she also drinks a ton of water and some recommended juices everyday.

Teamkelly
Posts: 50
Joined: Sep 2012

Yeah, it was just a polyp 1 cm wide, 2 cm long, everything else looked great.

Kelly is having third chemo this Thursday, still going strong, no real symptoms, food taste fine, very few aches, has not needed anti nausea mess. Her blood work did show that she needs to avoid crowds and stay at home more, so she did not go to the mall and will not go to church today, but overall she could not be more pleased. Thanks for the heads up on the rest Jazzy, I always encourage her to listen to her body, but will remind her again after Thursday. she has always had a whey shake for breakfast, and continues to do that, she also drinks a ton of water and some recommended juices everyday.

Thanks,
Nicki

janh_in_ontario
Posts: 109
Joined: Sep 2010

I am so happy it was just a polyp - but be warned polyps turn to cancer so make sure they remove the polyp and that you continue to get regular checkups including trans-vaginal ultrasounds to ensure no future polyps form.
Wonderful to hear someone has escaped this nightmare!
JanH

debrajo's picture
debrajo
Posts: 732
Joined: Sep 2011

That is great news on Kelly! Hoping she continues to do well!

I agree with Jan-in-Ontario though about the polyp. Would you consider a complete hysterectomy? I know, it's drastic, but I had much the same, just a polyp,bleeding,into menapause,no big deal. Fast forward a few years and while polyp is still the and inflamed, next to it and on it...UPSC. I begged for a hysterectomy from the first, but no, "healthy organs", ect. Probably no connection, but Had I pushed it would have saved so much. I know it may not be correct but I am of the school of"if you don't need it and it's giving you trouble, get it out"! Ok, I'll stop preaching and let you enjoy your good news! Best, Debrajo

janh_in_ontario
Posts: 109
Joined: Sep 2010

I had polyps and ended up with cancer too... so be careful.
JanH

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