Endometrioid Cancer - question about chemo treatment for Grade 1-2

 Dear Kim:

 After reviewing info from links below my name, I will be glad to offer my suggestion.  Speaking as a Stage IV Ovarian Cancer patient myself, I would “take no chances” and have the chemo your gynecologic oncologist is recommending.  After all, he is the specialist when it comes to the female anatomy.  He went to school an extra number of years just to have the expertise to make these calls.  He obviously likes “black and white” situations rather than to deal in “gray areas.”  If it were me, I would immediately take the recommended chemo.  You never know if some of the cells from the ovaries lie dormant and may later develop into Ovarian Cancer.  See the Mayo Clinic article below.  One can get Ovarian cancer years later after they have had their ovaries removed.  I’ve only copied excerpts from the NIH link, but it has some excellent drawings that help you to understand what the oncologist sees when he looks “inside.” 

 If you decide to have the chemo, you might like to see a letter I wrote to “Brian from the North” when he asked about tips on coping with chemotherapy.  http://csn.cancer.org/node/301646

 You may think “Why did I ever commit to this chemo because it can drain you of energy.  But each one of us are different.  But I think your gyn/onc wants to “nip it in the bud” relative to possible future metastasis.  I say, “Better to have the chemo—better to be “safe than sorry”.

 Loretta

 Peritoneal Carcinomatosis/Ovarian Cancer Stage IV

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 1.  http://chemocare.com/

 A good site to use if you choose to have the chemo.  It will tell you the side effects of your particular drug and how best to cope while taking them.  I would request a “medi-port” prior to starting the infusions.  No doubt your doctor would already use that.  But it’s far more manageable than “searching for a vein” for each treatment.

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2.   https://www.mskcc.org/cancer-care/patient-education/your-implanted-port

Info about medi-ports and their uses

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3.  http://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq

 “General Information About Endometrial Cancer

 KEY POINTS

 Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.

• Obesity, high blood pressure, and diabetes mellitus may increase the risk of endometrial cancer.

• Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can increase the risk of endometrial cancer.

• Signs and symptoms of endometrial cancer include unusual vaginal discharge or pain in the pelvis.

• Tests that examine the endometrium are used to detect (find) and diagnose endometrial cancer.

• Certain factors affect prognosis (chance of recovery) and treatment options…..

  The endometrium is the lining of the uterus, a hollow, muscular organ in a woman’s pelvis. The uterus is where a fetus grows. In most non-pregnant women, the uterus is about 3 inches long. The lower, narrow end of the uterus is the cervix, which leads to the vagina.  Anatomy of the female reproductive system. The organs in the female reproductive system include the uterus, ovaries, fallopian tubes, cervix, and vagina. The uterus has a muscular outer layer called the myometrium and an inner lining called the endometrium…

  Certain factors affect prognosis (chance of recovery) and treatment options.

  The prognosis (chance of recovery) and treatment options depend on the following:

 The stage of the cancer (whether it is in the endometrium only, involves the whole uterus, or has spread to other places in the body).

• How the cancer cells look under a microscope.

• Whether the cancer cells are affected by progesterone.

  Endometrial cancer is highly curable…

  Stage II endometrial cancer. Cancer has spread into connective tissue of the cervix, but has not spread outside the uterus…

  Recurrent Endometrial Cancer

  Recurrent endometrial cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the uterus, the pelvis, in lymph nodes in the abdomen, or in other parts of the body…

  Treatment Options by Stage

  Stage I Endometrial Cancer

  Treatment of stage I endometrial cancer may include the following:

 Surgery (total hysterectomy and bilateral salpingo-oophorectomy). Lymph nodes in the pelvis and abdomen may also be removed and viewed under a microscope to check for cancer cells.

• Surgery (total hysterectomy and bilateral salpingo-oophorectomy, with or without removal of lymph nodes in the pelvis and abdomen) followed by internal or external radiation therapy to the pelvis. After surgery, a plastic cylinder containing a source of radiation may be placed in the vagina to kill any remaining cancer cells.

• Radiation therapy alone for patients who cannot have surgery.

• Surgery followed by adjuvant chemotherapy with or without radiation therapy in stage I endometrial cancer that is likely to recur (come back).

• Clinical trials of new types of treatment.

  Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.

  Stage II Endometrial Cancer

  Treatment of stage II endometrial cancer may include the following:

 Surgery (radical hysterectomy and bilateral salpingo-oophorectomy). Lymph nodes in the pelvis and abdomen may also be removed and viewed under a microscope to check for cancer cells. Radiation therapy may follow surgery.

• Surgery followed by adjuvant chemotherapy with or without radiation therapy in stage II endometrial cancer that is likely to recur (come back).

• Clinical trials of new types of treatment.

  Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website…

 ·         Updated: July 14, 2016

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 4.  http://www.mayoclinic.org/diseases-conditions/ovarian-cancer/expert-answers/ovarian-cancer/faq-20057780

 “Is ovarian cancer still possible after a hysterectomy?

 Answers from Shannon K. Laughlin-Tommaso, M.D.

 Yes, you still have a risk of ovarian cancer or a type of cancer that acts just like it (primary peritoneal cancer) if you've had a hysterectomy.

 Your risk depends on the type of hysterectomy you had:

 Partial hysterectomy or total hysterectomy. A partial hysterectomy removes your uterus, and a total hysterectomy removes your uterus and your cervix. Both procedures leave your ovaries intact, so you can still develop ovarian cancer.

• Total hysterectomy with salpingo-oophorectomy. This procedure removes your cervix and uterus as well as both ovaries and fallopian tubes. This makes ovarian cancer less likely to occur, but it does not remove all risk.

  You still have a small risk of what's called primary peritoneal cancer, which may result from ovarian cells that migrated to the peritoneal area during each menstrual cycle before your ovaries were removed. These cells can become cancerous later on. Alternatively, since the peritoneum and ovaries arise from the same tissues during embryonic development, it's possible that cancer could arise from the cells of the peritoneum.

  Currently, there are no effective screening tests for ovarian cancer in women with an average risk of the disease. If you're concerned about your risk, discuss your options with your doctor.

  With  Shannon K. Laughlin-Tommaso, M.D.”

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 5.  http://www.mayoclinic.org/diseases-conditions/endometriosis/expert-answers/endometriosis/faq-20057966

  Endometriosis: Risk factor for ovarian cancer?

  “…Ovarian cancer occurs at higher than expected rates in women with endometriosis, but the overall lifetime risk is low to begin with. Some studies suggest that endometriosis increases that risk, but it's still relatively low. Although rare, another type of cancer — endometriosis-associated adenocarcinoma — can develop later in life in women who have had endometriosis…”

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  6.  http://www.cancer.org/cancer/endometrialcancer/detailedguide/endometrial-uterine-cancer-treating-chemotherapy

   “…Chemotherapy for endometrial cancer

 Chemotherapy (chemo) is the use of cancer-fighting drugs given into a vein or by mouth. These drugs enter the bloodstream and reach throughout the body, making this treatment potentially useful for cancer that has spread beyond the endometrium. If this treatment is chosen, you may receive a combination of drugs. Combination chemotherapy sometimes works better in treating cancer than one drug alone.

 Chemo is often given in cycles: a period of treatment, followed by a rest period. The chemo drugs may be given on one or more days in each cycle.

 Drugs used in treating endometrial cancer may include:

 Paclitaxel (Taxol^®) - Carboplatin = Doxorubicin (Adriamycin^®) or liposomal doxorubicin (Doxil^®) - Cisplatin…”

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Kim, like Loretta, I didn't want to take any chances either and had the full monty treatment for cancer.  With an agressive form of uterine cancer,Grade 3, Stage 1A, they thought they got it all with the hysterectomy since the lymph nodes taken, and they took a lot, were all clear.  I think a mass is either benign or not, and if it is not, it is cancer.  Find the treatment best to kill the beast.  

Loretta is always very informative with her posts.  No doubt we can all learn something from her.