USPC - how to approach my specialist with questions regarding treatment?

Willow oaks · March 2022

https://csn.cancer.org/discussion/comment/1694938#Comment_1694938

I would do one at least 4-6…my doc at MDANDERSON said standard now for 1a serous carcinoma is wait until symptoms occur. At two years after surgery my local doc wanted a scan I had no real symptoms until right after she planned it then a few months before the time I began to be glad she did. I have extensive peritoneal carcinoma that came from the uterine serous carcinoma. Now in the process of deciding what to do as soon as possible. It’s been a month since I found out I’m guessing I may start at least standard of care Carbo/Tax/Avastin within two weeks. I missed a local trial…I am heading to MDANDERSON fir a second opinion….but that’s a 9 1/2 hour drive one way….not sure if I could get there regularly but will see what that Doc says….the one that said wait until symptoms to CT scan…don’t know who else to work with….or consult & I can get to.

Willow oaks · March 2022

https://csn.cancer.org/discussion/comment/1694524#Comment_1694524

No I didn’t get one 6 months or even a year out…only the follow up post Chemo scan after the one before surgery. My local oncologist wanted to do one sooner I went to hercc BBG every 6 months and MDANDERSON the other 6 months. The only other scan I had was the one the local oncologist ordered at right at two years out….That scan happened just as my CR 125 spiked to 366 it had always been lower the 8 since surgery and declared NED. I wish I had the scan at least each 12 month mark.

SpringerSpanielMom · March 2022

I hear you, but the past is past. Just as I have to let go how my gyn (not my gyn onc) chopped up my cancer believing it was "a benign fibroid, 100% not cancer, you're good to go" using "a neat little machine she had". That kills me, but dwelling on it doesn't help me move forward or make me any better. I do fantasize about suing her and giving 100% of the proceeds to the GCS Project for my cancer, and/or half to the doctor trying to stop ignorant gyn morcellation (chopping up) of tumors. I also feel responsibility for getting the word out to save other women, just as you're doing. God bless and thank you again!!! Back to the here and now, despite the bad news, I'm still so happy you got a scan, better late than never; thank goodness your local gyn onc had a bad feeling. Can't you see many of them just blindly following MDA's lead? Now I wish you strength and success as you fight this recurrence. My neighbor, whose wife survived 10 yrs of fighting melanoma, calls recurrences "flare-ups". For whatever reason that cheered me no end. If I can think of my cancer, which tends to recur, as chronic like MS with "flare-ups" but otherwise normal good life in between, I feel better.

HMcd60 · March 2022

Hi Thanks for all the contributions - really is comforting to see conversations posted. I was diagnosed with early Interstitial Lung Disease Nov 2019 - for the first many months after this I stressed every day and got shingles. I think this is why I am treating this cancer as a third-party. All that stress and fortunately my Lung disease hasn't progressed much, in 3 years. Had many scans last few years, so did it make me more susceptible to getting cancer - questions that I guess we will never know the answer.

My current lung specialist is a wait and see Dr - as she doesn't like the radiation from CT scans. Difficult decision but why don't we have PET scans instead - aren't they less if any radiation? Is it the cost? Or MRI?

Below are some links to research re: Serous 1A uterine cancer.

Also found this recently:

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis Front. Oncol., 28 October 2021 | Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

Background: Many studies have investigated the prognostic role of the C-reactive protein/albumin ratio (CRP/Alb ratio) in patients with gynecological cancers; however, there is lack of consensus owing to conflicting results across studies. We performed a meta-analysis to determine the prognostic role of the CRP/Alb ratio in gynecological cancers.

Methods: We searched the PubMed, Embase, the Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases since inception to April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the prognostic effect of the CRP/Alb ratio in gynecological cancers. Pooled odds ratios (ORs) and 95% CIs were used to investigate the association between the CRP/Alb ratio and clinicopathological features.

Results: The meta-analysis included seven studies with 1,847 patients. The pooled results showed that a high pretreatment CRP/Alb ratio was associated with poor overall survival (HR, 1.84; 95% CI, 1.41–2.40; p < 0.001) and progression-/disease-free survival (HR, 2.58; 95% CI, 1.42–4.68; p = 0.002). Additionally, a high CRP/Alb ratio was significantly associated with stages III–IV disease (the International Federation of Gynecology and Obstetrics classification) (OR, 2.98; 95% CI, 1.45–6.14; p = 0.003). However, we observed a non-significant correlation between the CRP/Alb ratio and lymph node metastasis, tumor size, and histopathological grade.

Conclusions: The CRP/Alb ratio is a convenient and accurate predictor of survival outcomes in gynecological cancers. A high CRP/Alb ratio also predicts tumor progression.

“C-reactive protein as a diagnostic and prognostic factor of endometrial cancer.” https://www.researchgate.net/publication/343070413_C-reactive_Protein_as_a_Diagnostic_and_Prognostic_Factor_of_Endometrial_Cancer

2021 - NCCN Guidelines for patients - Uterine Cancer

https://www.nccn.org/patients/guidelines/content/PDF/uterine-patient.pdf

2018 - Adjuvant chemoradiotherapy versus radiotherapy alone for women with high-risk endometrial cancer (PORTEC-3): final results of an international, open-label, multicentre, randomised, phase 3 trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840256/pdf/main.pdf

https://pubmed.ncbi.nlm.nih.gov/29449189/

2021 - Progress in the pathological arena of gynecological cancers

https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1002/ijgo.13871

2018-2021: PORTEC-4a: Molecular Profile-based Versus Standard Adjuvant Radiotherapy in Endometrial Cancer (PORTEC-4a)

https://clinicaltrials.gov/ct2/show/NCT03469674

2018 Outcomes of adjuvant therapy for stage 1a

https://assets.cureus.com/uploads/original_article/pdf/11283/1612427746-1612427742-20210204-18268-18zrw0z.pdf

2014 An updated clinicopathologic study of early-stage uterine papillary serous carcinoma (UPSC)

https://www.gynecologiconcology-online.net/article/S0090-8258(09)00591-5/fulltext

2016 - Role of Adjuvant Therapy for Stage IA Serous and Clear Cell Uterine Cancer: Is Observation a Valid Strategy?

https://ijgc.bmj.com/content/26/3/491.info