Wait until there is vaginal bleeding?

I had an episode of spotting and saw a gyn. She referred me for endometrial biopsy. My endometrium was only .52 cm and I had a calcified polyp. The gyn said polyps are usually benign and was sure the biopsy would be negative. Unfortuneately,  I was diagnosed with papillary serous endometrial carcinoma, a very aggressive type of EC. I underwent a full hysterectomy with tubes, ovaries and omentectomy. I was stage 2, grade 3, I have now started chemo. If I had waited a few more months, it would have been stage 3 or worse. If there is any abnormality at all, especially a polyp, I would insist on an endometrial biopsy. If diagnosed early, the outcome is much better.

No!  I told my GYN about a new clear discharge, and she said that if there was no bleeding, it was fine.  It WASN'T fine!  It was a highly aggressive uterine cancer, and it took a year of discharge before there was blood.  I wish I hadn't listened to her.

5% of all women will have a GYN malignancy in their lifetime.  Post-menopausal lining I understand should be mm.  If I were you, I'd have a biopsy done.  In fact, if I were you, I'd have a complete hysterectomy done, because biopsies can miss the cancer.  You could have a dilation and curretage done, which would be more likely to find anything that might be there.  But my views regarding, "When in doubt, take it out!" are considered extreme.  You have to realize, you're dealing with an entire cohort of women here who all wish that they'd had a hysterectomy done BEFORE they developed uterine cancer.

The one thing I would NOT do is wait!  At the very least, get a second opinion from a GYN oncologist.

spots a few weeks apart, almost invisible. After the second one, 15 years after menopause, with zero bleeding, I was eventually dx with UPSC. Also, the cancer was in the polyps I did have as well as in the uterus. Waiting for overt symptoms to develop is what many women here were told to do, and then they were dx sometimes years later with stage 3 or 4. Those were my only smptoms and had I dismissed them or missed them I would have a much worse case. Most GO will not accept you as a patient without a dx of cancer, but you can try to be treated by a gyne with cancer experience at Dana Farber than at your local doc who may deliver babies more than dx cancer. My gynecologist did not see a lot of the lesser aggressive cancer, much less UPSC, and he did not prepare me for what might be coming. A second opinion by people who actually dx and treat cancer is the wise choice here. We sadly have too many heartbreaking stories here of women whose doctors dismissed their symptoms. Good luck to you.

Denise 

Listen to your body.  If you feel you should do it.  The only symptom I had was bloating and lower back pain and down my left leg.  The paind was so bad at times.   I had an ultrasound which only showed a tilted uterus.  A colonoscopy which said it was fine.  I had a laproscopy which indicated I had endometriosis and that my uterus was very scarred.  They indicated I needed a hysterectomy. I wanted surgery right away but instead they put me on lupron for six months to ease the lesions to make the surgery easier for the doctor.  I had to wait one more month for the doctor for surgery.  The surgery went well all except for a knicked bladder which I had a catheter for a week.  When I went back to the doctor to removed catheter and for my check up I was told they found cancer.  I then had to go back into surgery a month later for staging.  I was staged at Grade 2, Stage 3A endometrial adenocarcinoma.  It was in my uterus, cervix and left ovary.

I had been seeking help for over a year before surgery.  I was told I was depressed by my PCP.  I also asked my Gyne for a scan.  He indicated it would only show endometrios.  If they did a scan, it probably would have saved me from a second surgery which I ended up getting an infection in my incision!

Sorry I go so long!   What Im trying to say be your own advocate!   

I wish you all the best.

Kathy

PS  I was 45 at the time.

Ask lots of questions.  Take a note book or ask if someone can come with you to take notes, although that might be a challenge right now, and if someone can't come will they be ok with you recording your conversation.  This is good for any appointment you have should this be something more.  Information overload!  

Lots of good things already mentioned by those before me.  

Glad you have decided to be proactive! I had such a tiny bit of bleeding that I thought it was a UTI, then a few weeks later the same thing. Finally I saw three pea sized blood clots in the toilet and immediately contacted my nurse practitioner. I was 65, 15 yrs postmenopause. It ended up being a polyp based uterine serous cancer that had barely invaded the myometrium. Later I did get a second opinion and am a strong believer in second opinions!!!

Keep us informed!

I've never been able to tolerate an endometrial biopsy. My first D&C/hysteroscopy about a year after menopause removed a benign polyp that was causing the vaginal bleeding at that time. The second D&C/hysteroscopy for vaginal bleeding years later showed that I had uterine cancer. So I'm personally a proponent of having the D&C/hysteroscopy since that procedure can deal with any benign conditions like polyps as well as more accurately identifyicancer, if any.

cmb said:

Biopsy vs D&C

I've never been able to tolerate an endometrial biopsy. My first D&C/hysteroscopy about a year after menopause removed a benign polyp that was causing the vaginal bleeding at that time. The second D&C/hysteroscopy for vaginal bleeding years later showed that I had uterine cancer. So I'm personally a proponent of having the D&C/hysteroscopy since that procedure can deal with any benign conditions like polyps as well as more accurately identifyicancer, if any.

Yep, I'm with you cmb.  The endometrial biopsy was proving to painful so gyn scrapped it for the D&C.  I really don't know if the biopsy would have found the polyps, but I credit the change to the early catch of a bad cancer.