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Sloan Kettering or Johns Hopkins

PigletsMD
Posts: 6
Joined: Aug 2018

Feeling a bit overwhelmed.  Will have biopsy next week.  No matter biopsy results, given family history of uterine cancer, I will likely seek a second opinion.

I live on the East Coast.  If you had a choice of either Sloan or Johns Hopkins for a second opinion or treatment, which one would you pick?  Is there a surgery and oncology team you would recommend?  

PigletsMD
Posts: 6
Joined: Aug 2018

Would you recommend that an endometrial biopsy and sonohysterogram be done by a regular ob/gyn or am I just wasting time.   Endometrial lining is 29 mm.   Thank you so much.

NoTimeForCancer's picture
NoTimeForCancer
Posts: 2547
Joined: Mar 2013

piglets, can I ask you a few questions?  Are you having issues or are you looking in to a biopsy because of your family history?  

I think most of us have had irregular bleeding and had a biopsy - not a pleasant experience - or a D&C.  I think most of us agree that the D&C is more complete of a test.  My D&C was with my gyn, and when the cancer was detected I was turned over to a gyn onc.  

Even with your family history, try to take a breath.  Wait for the results and see what you are dealing with.  

Armywife's picture
Armywife
Posts: 266
Joined: Feb 2018

Those are two pretty amazing choices of treatment centers!  I can't speak to either, but just wanted to welcome you.  My cancer was found with just a plain old pipelle biopsy.

abrub's picture
abrub
Posts: 2079
Joined: Mar 2010

I go to Sloan Kettering for my appendix cancer care.  They see more rare cancers.  JH is superb (and starting to see appendix cancers as well) but the more uncommon cancers go to cancer specialty centers.  If JH has specialists in your cancer, then you should be good there.  Convenience does play into things (tho I travel 175 miles each way for my scans/checkups)

PigletsMD
Posts: 6
Joined: Aug 2018

Thank you so much for your responses!  This is such a helpful and caring community.  

Yes, I skipped a month and then a few weeks later, after a Pap smear, spotting started and has continued for about a month. 

I will try to take a deep breath.  I really appreciate all of the advice.  

 

 

pato58's picture
pato58
Posts: 97
Joined: Jun 2018

when I had the results of my biopsy, grade 2 endometrioid adenocarcinoma, the first thing I asked my regular gyn if he thought I should go to Sloan (I live in S. Jerssey) and he said that IT WAS NOT REALLY NECESSARY as we have good Drs in our area. My endometrial thickening was borderline, 5mm, and my hystology type was not very agressive. With that said, if you can make an appt directly with a gyn-onc, I would think it is the best way. In any case, ask to go directly to a hysterescopy with D&C and according to the results you can decide to be treated locally (if you do not mind, where in the east coast do you live?) or not. Sloan and JH have both excellent reputations.
I was treated at Cooper-Anderson. Take care and let us know

PigletsMD
Posts: 6
Joined: Aug 2018

Thank you, pato58!  I hear where you are coming from.  I was wondering what you all thought if I just ask for a hysteroscopy instead of the sonohysterogram?

Can a hysteroscopy accompany an in-office endometrial biopsy? 

CheeseQueen57's picture
CheeseQueen57
Posts: 781
Joined: Feb 2016

My opinion:  Go directly to D&C. Do not pass go, do not collect $200. Endometrial biopsies rarely tell you anything meaningful, often do not get enough tissue, and I’m not exaggerating HURT LIKE HELL!  

pato58's picture
pato58
Posts: 97
Joined: Jun 2018

Sonohysterogram is more appropiate for polyps, I believe. Go ask directly for hysteroscopy with D&C.
Regular endometrial biopsy is very random. 
Let us know :)

PigletsMD
Posts: 6
Joined: Aug 2018

Thank you for the advice!  I will ask about the D&C and the hysteroscopy.  For all of these procedures, should I be worried about the disseminarion of cancerous endometrial cells?

https://www.ncbi.nlm.nih.gov/m/pubmed/17610939/?i=2&from=/17689177/related

https://www.ncbi.nlm.nih.gov/m/pubmed/17689177/

 

pato58's picture
pato58
Posts: 97
Joined: Jun 2018

It is controversial and I had the same thoughts as you.

https://peoplebeatingcancer.org/articlehysteroscopy-may-disseminate-endometrial-cancer-cells/

In the past, upon hysterectomy, they used to cut the uterus inside for easy extraction using morcellation and they discovered this could disseminate cancerous cells.

I wish I could give you a clearer picture.

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