AboutJuliet Seigle, MD Expertise I am a fully trained radiation oncologist and can answer many questions about cancer and its treatment. I can't answer questions about specific chemotherapy agents. I have also worked in general medicine and emergency medicine, so I can give advice about these areas as well. I would like to do this based on my very positive experience with one of your experts (real estate).
Experience I currently am working as a radiation oncologist in the DC metropolitan area. I have done research and given talks on neurooncology (tumors of the nervous system) at national meetings. I have been trained in use of a new technology, the CyberKnife. I was emergency physician at a busy communicty hospital (Calvert Memorial Hospital) in Maryland for 3 years (1989-1991).
Organizations ASTRO (American Society of Therapeutic Radiation Oncology)
Education/Credentials Georgetown University Hospital: fellowship radiation oncology 2005-2007
Georgetown University Hospital: residency radiation oncology 1991-1994
Georgetown University Hospital: residency neurosurgery 1984-88
Awards and Honors Award for best abstract - CyberKnife Users meeting 2005 (topic: chordoma)
ASTRO research award $30,000, 1993
Question I am a 44 yr. old woman, who has lost her left breast to DCIS after a 8yr. battle including surgeries and radiation treatment. I am now faced with the possible question of precancerous uterine cells. Due to excessive and irregular bleeding my doctor has recommended a D&C and removal of my fibroids. Depending on what comes back from pathology, I may have to have a hysterectomy (but I am opting to keep my ovaries and cervix if possible). My question is if the cells are only "precancerous" should I consider a hysterectomy or elect to keep the uterus and wait and see? Are precancerous cells like DCIS? Can they still be dangerous and ultimately cause cancer? Or in most cases are they harmless? I should include to be thorough, that I have waited over two years to follow through on my doctor's recommendation and see my condition getting worse and worse not better. Any assistance in understanding what I am up against is greatly appreciated. Thank you.
Answer Edith,
DCIS is cancer, not 'precancer.' Precancerous cells do not necessarily progress to cancer - they can return to normal. However, they can also get worse and become cancer. This is part of the difficult uncertainty of your situation: you do not know which way things are going to go. It is important to find out: are the abnormal cells coming from the cervix or are they coming from the lining of the uterus (endometrium)? If they are coming from the cervix, a relatively minor procedure called 'conization' can be done, in which a portion of the cervix, and not the entire uterus, is removed. This is much simpler than a hysterectomy and does not involve making an abdominal incision. I suggest you see a gynecologic oncologist for a recommendation. Ask your gynecologist to suggest someone. I would do this even if it means traveling a bit, as not all areas, especially small towns or rural areas, have gynecologic oncologists. You could then get a highly specialized opinion as to how to proceed. In any event, you will need to have the D&C. I cannot emphasize enough: if you continue have dysplastic (precancerous) cells but not overt cancer, make sure you have regular check ups (perhaps as often as every 3-6 months)! Do not, not, not allow years to go by! Cancer of the cervix and uterine lining are almost always curable when detected and treated early. If given the chance to progress without treatment, these same cancers can be deadly.
