Six Weeks Post-Op: My Questions

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  • Harmanygroves
    Harmanygroves Member Posts: 486 Member
    edited July 2021 #22
    MoeKay said:

    Operative Report

    My Operative Report states, "the uterus was opened on the table, and did demonstrate a corpus tumor which did not extend to the cervical os, but clearly involved the majority of the upper endocervix."  My Operative Report was extremely detailed (2 1/2 single-spaced pages), so if yours is too, if you haven't already reviewed it, you might find additional details about your surgery there.  I know you mentiond elsewhere that you reviewed your gyn-onc's notes, but I wasn't sure if you were referring to the Operative Report.

    Also, I know on other posts you said that your tumor invaded 83% of your myometrium.  However, your MySpace Page reports that the tumor invasion was "9/13 mm."  Nine-thirteenths is only 69.2308%, not 83%.  Was that 9/13 a typo, or did you have your pathology reviewed by another pathologist who came up with the 83%?  Just wondering.

    probably a typo

    I will review my apparent typo, but 83% of the myometrium. I realize that over 50% of the myometrium "invaded" by tumor / cancer is Stage 1 B, so it may be a moot point, but my percentage is 83%.

  • Harmanygroves
    Harmanygroves Member Posts: 486 Member
    #23
    MoeKay said:

    Operative Report

    My Operative Report states, "the uterus was opened on the table, and did demonstrate a corpus tumor which did not extend to the cervical os, but clearly involved the majority of the upper endocervix."  My Operative Report was extremely detailed (2 1/2 single-spaced pages), so if yours is too, if you haven't already reviewed it, you might find additional details about your surgery there.  I know you mentiond elsewhere that you reviewed your gyn-onc's notes, but I wasn't sure if you were referring to the Operative Report.

    Also, I know on other posts you said that your tumor invaded 83% of your myometrium.  However, your MySpace Page reports that the tumor invasion was "9/13 mm."  Nine-thirteenths is only 69.2308%, not 83%.  Was that 9/13 a typo, or did you have your pathology reviewed by another pathologist who came up with the 83%?  Just wondering.

    PATH report (copied from my original path report)

    Collected 3/24/21

    Synopsis

    Myometrial Invasion: Present

    Depth of myometrial invasion (millimeters): 10 mm

    Myometrial thickness: 12 mm

    Uterine serosa involvement: not identified

    Cervical stromal involvement: not identified

    Other tissue / Organ Involvement: not identified

    Lymphovascular Invasion: Present

    Lymph Nodes

    Lymph Node Status: All lymph nodes neg for tumor cells

    Total Number of pelvic nodes examined: 3

    Number of Pelvic Sentinel Nodes Examined: 3

    Total Number of Para aortic nodes examined: 0

  • Harmanygroves
    Harmanygroves Member Posts: 486 Member
    edited July 2021 #24
    MoeKay said:

    Operative Report

    My Operative Report states, "the uterus was opened on the table, and did demonstrate a corpus tumor which did not extend to the cervical os, but clearly involved the majority of the upper endocervix."  My Operative Report was extremely detailed (2 1/2 single-spaced pages), so if yours is too, if you haven't already reviewed it, you might find additional details about your surgery there.  I know you mentiond elsewhere that you reviewed your gyn-onc's notes, but I wasn't sure if you were referring to the Operative Report.

    Also, I know on other posts you said that your tumor invaded 83% of your myometrium.  However, your MySpace Page reports that the tumor invasion was "9/13 mm."  Nine-thirteenths is only 69.2308%, not 83%.  Was that 9/13 a typo, or did you have your pathology reviewed by another pathologist who came up with the 83%?  Just wondering.

    thx for pointing that out

    I just reviewed some reports and numbers, and I think my "new" clinic at OHSU did a "copy and paste" onto another report that had someone's numbers on it, and something got missed I will contact them immediately! You are a star. (and unfortunately, I am still 83%, lol)

  • Ribbons
    Ribbons Member Posts: 150 Member
    edited August 2021 #25
    Forherself said:

    I'm wondering how do they remove

    a uterus with a robotic surgery.  You seem to know.

    Uterus removal

    I wondered this too, and how did they contain it so no cells escaped. My surgeon said it is put into a bag, internally before extraction.

  • Harmanygroves
    Harmanygroves Member Posts: 486 Member
    #26
    Ribbons said:

    Uterus removal

    I wondered this too, and how did they contain it so no cells escaped. My surgeon said it is put into a bag, internally before extraction.

    That was my understanding

    The hard thing is that bc my gyn onc was so angry about my many questions that now I feel like I will never really know. Also, I have decided that his surgical notes were pretty vague. 

  • Harmanygroves
    Harmanygroves Member Posts: 486 Member
    #27
    MoeKay said:

    Well, the Questions Were Excellent

    Many thanks!  Perhaps he may have addressed hematogenous spread to sites such as the lungs and brain on another part of the tape.  While his above answers to your questions on metastasis appear to focus on lymphatic spread, it's my understanding that metastases to distant sites can also take place via the bloodstream.  https://pubmed.ncbi.nlm.nih.gov/27757531/ 

     

     

     

    Thank You

    It was all new learning on my part, and I wasn't entirely comfortable with some of my questions, but considering I went from zero to sixty as we all have done, I feel like I learned quite a lot very quickly.

    I'm not much of a biologist or scientist, but I know enough to work with specific topics and drill down. The night before my first post op appointment, I sat with the pathology report and kept coming back to two details:

    a. myometrial invasion greater than 50%. Mine was 83%, with a 12-mm myometrium and a depth of 10 mm.

    b. LVSI present. 

    As we sat here in our easy chairs and husband watched something on Netflix, I just researched and read. Before we went to bed, I had figured out that I would be getting brachytherapy, and probably not EBRT. I had also figured out that my endometrioid adenocarcinoma was NOT quite the "easy peasy" issue that everyone had been chatting so casually about. 

    I warned my husband before we went in to the gyn onc's that I would be doing radiation therapy, and tried to prepare him so he wouldn't get upset. He is very afraid I'm going to leave him alone, and we're very close. I have no plan to, but no one does. We can only control so much (sadly).

    My gyn onc confirmed my research, but I was not satisfied--as two weeks post op, we are still exhausted and not that well-equipped. After another four weeks had gone by, I'd researched a lot more and I had questions. 

    I'm just now, especially since I'm mentally and emotionally quieter, addressing my own concerns a bit more lucidly. 

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