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John Hopkins report

california_artist's picture
Posts: 865
Joined: Jan 2009

Has anyone ever heard the comment on chemo not working from a major medical center before. I know I haven't. Here's their report on uterine cancer. I also think they should mention that often there is just most minor of spotting, and women should not wait til it gets heavier. I'm glad they mention that one should not rely in any way on a pap for diagnosis.

Uterine Cancer

What is it?
Uterine cancer is the growth of malignant cells in the uterus. The term uterine cancer is often used interchangeably with endometrial cancer, because uterine malignancy most often develops in the endometrium, or uterine lining.Malignant tumors may also develop in the muscular wall of the uterus (uterine sarcoma), although this is relatively rare. Endometrial cancer is the most common pelvic gynecological cancer; it most frequently affects postmenopausal women between the ages of 50 and 70. Younger women whose ovaries produce estrogen but don't ovulate and women with polycystic ovaries are also prone to develop endometrial cancer. Endometrial cancer tends to grow and spread slowly; with early detection and treatment, it is highly curable.
What Causes It?
· The cause of uterine cancer is unknown.
· Obesity, high blood pressure, diabetes mellitus, endometrial hyperplasia, endometrial polyps, polycystic ovary disease, and a late menopause with heavy bleeding are all associated with an increased risk of uterine cancer. (See these specific disorders for more information.)
· Long-term use of unopposed estrogen replacement therapy (without a progestational agent) in postmenopausal women is associated with a higher incidence of endometrial cancer.
· Tamoxifen, a drug used in the treatment of breast cancer, increases the risk of uterine cancer.
· Endometrial cancer is more common in women who have had few or no children; it is less frequent in those who have used oral contraceptives.
· In high-risk (non-ovulating) women, uterine cancer may be prevented with cyclical use of progestational drugs.
· Regular pelvic examinations during and after menopause are advised to aid in early detection and treatment of any abnormalities.
· Postmenopausal estrogen replacement in women who have not had a hysterectomy should be accompanied by a progestational agent. If not, annual endometrial biopsies should be performed.
· Patient history and gynecological examination are necessary.
· Diagnosis of endometrial cancer requires an endometrial biopsy or dilatation and curettage (D&C) to obtain endometrial tissue.
· Pelvic ultrasound scans may be done to detect tumors.
· A Pap smear (performed during a pelvic examination) reveals the presence of malignant cells from the cervix (see Cervical Cancer), but the Pap smear is not reliable for detecting endometrial cancer.
How to Treat It
· Primary treatment is a total hysterectomy (surgical removal of the uterus). Fallopian tubes, both ovaries, and a portion of the upper vagina, and neighboring lymph nodes may also be removed depending on the extent of the cancer.
· Cancers in their earliest stage (noninvasive and with normal-appearing cells) may be treated by hysterectomy alone, without further measures.
· If cancer is believed to have advanced beyond the earliest stage, radiation therapy (both external and internal radiation) may be used in addition to surgery; in internal radiation, small radioactive pellets are implanted in or near the tumor site for 48 to 72 hours at a time.
· Progestational agents can be used in the treatment of endometrial cancer; chemotherapy has not proved to be effective in most cases.
*I had never seen this comment before.
When to Call a Doctor
· Call a gynecologist if you develop heavy vaginal bleeding or if you experience vaginal bleeding between periods or after menopause

For more Johns Hopkins health information, please visit Johns Hopkins Health Alerts.
For medical appointments at Johns Hopkins, please call 866-386-1617.

All information contained within the Johns Hopkins Symptoms and Remedies website is intended for educational purposes only. Consumers should never disregard medical advice or delay in seeking it because of something they may have read on this website.

Copyright © 2008 Medletter Associates, LLC

Posts: 54
Joined: Jul 2009

This just makes my head spin. I'd really like to think all I went through recently was giving me better odds vs. doing nothing at all.


daisy366's picture
Posts: 1493
Joined: Mar 2009

I think UPSC (papillary serous carcinoma) falls in the cases where it does work. MOST people with endometrial cancer do NOT have UPSC.

The NCCN (national comprehensive cancer network)guidelines which is used by my oncologist and probably many others does not recommend chemo as the primary therapy for endometrial cancer EXCEPT for UPSC. For ALL stages of UPSC chemotherapy is recommended.

It is interesting to go online and see these guidelines. There is are decision trees for all kinds of cancer. This may be a good discussion for us to have with our oncologists.

There are so many other things to worry about. I'm deciding not to worry about this one.

Posts: 126
Joined: Jul 2009

This is scary stuff as I am about to start chemo. Am going to take it to my Doc appointment day before first chemo. Thanks for sharing. It probably won't change anything, though.

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