Endometroid carcinoma with squamous differentiation

pato58

Hi everyone, I do not post anymore but I keep reading your stories quite often 
When I was diagnosed on July 2018 the Dr told me that I had Endometrioid Stage 1A Grade 1
I read my Pathology report yesterday with more attention and it says Endometrioid Carcinoma with Squamous Differentiation.
I checked online and I've got apprehensive when it mentioned about poorer prognosis for this.
My pelvic wash and lymphovascular invasion were negative. My tumor was small and it said that there was no myometral invasion.
Coud you please share your diagnosis and experiences regarding this issue to ease my mind?
Thank you so much!

Forherself

Hi Pato

I did read the atticle from 2019 that said squamous differentiation means  a higher risk of recurrence.  But stage 1A has several levels.  1A can be up to one half myometrial invasion and you had none.  I have read tumor less than 1cm is less likely to spread.  I don't know what size yours was. Yours must have been confined to the endometrium, which is called minimal.   I would say your recurrence probability was extremely low at grade one, and at 5 times the chance it is still extremely low.  NOt nil but low.  I remember you when we first joined.  I was diagnosed in July 2018.  It is hard to not worry.   I seem to remember that you had no treatment is that correct?

 

pato58

Forherself said:

Hi Pato

I did read the atticle from 2019 that said squamous differentiation means  a higher risk of recurrence.  But stage 1A has several levels.  1A can be up to one half myometrial invasion and you had none.  I have read tumor less than 1cm is less likely to spread.  I don't know what size yours was. Yours must have been confined to the endometrium, which is called minimal.   I would say your recurrence probability was extremely low at grade one, and at 5 times the chance it is still extremely low.  NOt nil but low.  I remember you when we first joined.  I was diagnosed in July 2018.  It is hard to not worry.   I seem to remember that you had no treatment is that correct?

 

Hi Forherself

Thank you for responding!
I believe my tumor was 2.5 mm. But they may have removed more at hysteroscopy?

They even downgraded from grade 2 to grade 1 after the hysterectomy.
Yes, you are right. I was not recommended any further treatment. I went for my 6 months check-up a few weeks ago and he said that everything looked fine. The problem with my Dr is that he is not forward with explanations, even though he is a pleasant person.
Thanks again

pato58

Anybody else

with the same diagnosis as mine to comment on her experiences?
Thanks

MAbound

No Lymphovascular Invasion

What always seems to be the big game changer for treatment of these caught early cancers, even more than location, size, or depth of the tumor, is whether or not any lymphovascular invasion is found. Once cancer gets into the Lymph System, the odds of it showing up elsewhere in the body goes up because this is one of the big vehicles for how stray cells travel from the uterus and show up elsewhere. If lymphovascular invasion has happened, systemic treament (chemo) is warranted no matter the stage because obviously cancer cells are no longer where they originated and local treatment such as surgery and/or radiation can't be counted on to get those stray cells. 

Pato, you don't have that alarm bell and your other parameters are really, really good, so in spite of the type of cancer they found, the pathology still looks really optimal for you not needing treatment beyond what you've already had along with those important follow-up appointments to stay watchful for just-in-case.

I know that it's hard to feel like that's enough given the type of cancer cells that they found, but time NED will help you to believe that you really dodged a bullet. I'm the first to say "throw the kitchen sink at an aggressive cancer", but given your pathology and the costs of aggressive treatment to the rest of your life, this is one time I'm weighing in on the side of the path your doctor has you on. It's not a guarantee, but the odds weigh pretty heavily in your favor, so I feel pretty good sticking my neck out to say this. Hope that helps, but I know that it's probably going to take another couple of years for you to truly believe it. Hang in there!

pato58

MAbound said:

No Lymphovascular Invasion

What always seems to be the big game changer for treatment of these caught early cancers, even more than location, size, or depth of the tumor, is whether or not any lymphovascular invasion is found. Once cancer gets into the Lymph System, the odds of it showing up elsewhere in the body goes up because this is one of the big vehicles for how stray cells travel from the uterus and show up elsewhere. If lymphovascular invasion has happened, systemic treament (chemo) is warranted no matter the stage because obviously cancer cells are no longer where they originated and local treatment such as surgery and/or radiation can't be counted on to get those stray cells. 

Pato, you don't have that alarm bell and your other parameters are really, really good, so in spite of the type of cancer they found, the pathology still looks really optimal for you not needing treatment beyond what you've already had along with those important follow-up appointments to stay watchful for just-in-case.

I know that it's hard to feel like that's enough given the type of cancer cells that they found, but time NED will help you to believe that you really dodged a bullet. I'm the first to say "throw the kitchen sink at an aggressive cancer", but given your pathology and the costs of aggressive treatment to the rest of your life, this is one time I'm weighing in on the side of the path your doctor has you on. It's not a guarantee, but the odds weigh pretty heavily in your favor, so I feel pretty good sticking my neck out to say this. Hope that helps, but I know that it's probably going to take another couple of years for you to truly believe it. Hang in there!

Thanks MAbound,

for the encouraging words 
After I read this article https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220086

I could not believe my eyes and every little concern came back to me like, did I really dodge the bullet?
Hope everyone is doing OK!