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For new members, treatment recommendations

Forherself's picture
Forherself
Posts: 503
Joined: Jan 2019

https://www.mdanderson.org/content/dam/mdanderson/documents/for-physicians/algorithms/cancer-treatment/ca-treatment-endometrial-web-algorithm.pdf

 

This is a good link to current treatment recommendations for endometrial cancer

cmb's picture
cmb
Posts: 646
Joined: Jan 2018

I read this algorithm and I must admit that I'm puzzled by how a doctor could determine that the disease is confined to the uterus before doing a Hysterectomy/BSO and SLN mapping (Page 1). My ultrasound and preoperative CT scan of the chest, abdomen and pelvis didn't show any sign of cancer outside the uterus, presumably making me Stage 1. But cancer cells were found at the surgical margin on the left parametrium, upping me to Stage 3B after the surgery's pathology was completed.

And the algorithm recommends skipping the D&C (with no mention of the hysteroscopy) in cases where a patient is okay with a hysterectomy. I never could complete an initial endometrial biopsy and, based on other members' experiences, I'm glad that I had the D&C/ hysteroscopy before the hysterectomy, as we've learned that some biopsies can miss cancer if the sampling doesn't grab cells from the right spot. Knowing that I had an aggressive form of uterine cancer before surgery helped my surgeon to plan for a radical hysterectomy right from the start.

While I know that MD Anderson is a very well-respected cancer center, I must admit I'm happy that my doctors did things differently than this algorithm recommends.

Forherself's picture
Forherself
Posts: 503
Joined: Jan 2019

means on physical exam.   So just what they can find before surgery.  And I think it is included because some patients want to have children after the diganosis, so the path is included.  it does say MRI to rule out myometrialinvasion if someone wants to have a child.  If it is endometrioid with no invasion or lesion seen in the cervix, it looks like they  do not do surgery.  If on the other hand, no more children, which is the majority of patients, they follow the surgery route.  

I like this chart because it is organized in a way that is easy to follow.  And includes all scenarios.

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