Oncology (General Cancer)/Uterus : Endometrial Adenocarcinoma
QUESTION: Dear Nordquist,
Good day to you. My mother had a surgery of UV prolapse on 15JAN, 16. She is getting better by the grace of ALMIGHTY after surgery. A piece was taken out from her Uterus (probably) and was sent for biopsy. The biopsy report received this morning and I just have back from the consultant who conducted that surgery and she has told me after having a look on that report (enclosed) that there are cancer symptoms found in the report. This is really shocking for me and I know how I am writing this email to you. She has further suggested for the CT Scan of Abdomen and Pelvis for further clarification.
Before, going for the surgery, we were suggested by the surgeon to visit Cardiologist as my mother is also a patient of high blood pressure too. Cardiologist gave green signal to my mother for the surgery.
Actually, she is my step mom and I love her so much. She has sacrificed alot to get me and my sister. She forced her husband (my father) for the second marriage for the kids. My real mother and we all live together even after a decade has passed of my father's demise and I love my step mom more than my real mom.
My step mom didn't had kids and for this reason she got operated 3-4 times. Last time she got operated in 1989-90.
UV prolapse issue was started almost a year ago and she went for the check up to the Gynea consultant who told her that this is an infection as well for which she was given CEFIXIME 400 mg (Daily one capsule). We went for Umrah (our holy pilgrimage) in Saudia this May where we use to walk 5 km daily (approx). We stayed there for 15 days and since we are back she didn't face prolapsing issue (means irritation). This was re-occured in Dec, 15 again and we went for the surgery option.
I hereby enclosing the reports of the Bio Chemistry conducted before surgery and histiopathology report for your kind perusal. Request you to advise the treatment and precautions (specially about meal) according to you vast experience. I shall be very grateful to you if you could advise me your email id so that I can send you all her medical reports for detail view. Awaiting your reply.
ANSWER: The pathology report does show endometrioid carcinoma. Very often a complete hysterectomy removes it and there may be no other problem. However, if the cancer had been diagnosed before the surgery, most surgeons would have done a radical hysterectomy, removing not only the uterus but the lymph nodes, ovaries and tubes, since those areas might contain cancer cells. The biochemistry report is of concern. She has an elevated alk phos which could mean bone disease or some kind of inflammation of the ducts in the liver. The SGOT elevation suggests some liver process. The slight elevation in bilirubin also suggests a liver process. You might see this in older women with silent gall stones. We would first do a simple abdominal ultrasound, and if stones were found in the liver and nothing else, would probably watch and repeat the lab tests in six months. If nothing were found we'd want to think about a CT scan of the abdomen with and without contrast, which might also be a good idea based on the endometrioid carcinoma. I don't know how old she is, but if she's in her fifties or sixties, and in good health and nothing can be found by scans, etc, completion of the radical hysterectomy might be considered.
I hope this helps.
---------- FOLLOW-UP ----------
QUESTION: Hello Sir,
Good day to you. Today I have received CT Scan report (contrast), LFT and Calcium Serum Test of my mother. I went to the relevant surgeon who was unfortunately not there in his clinic but the other consultant told me that CT Scan report is good and it show that cancer hasn't spread anywhere else. I am here by enclosing reports for your kind perusal. Unfortunately, I can attached only 02 reports here. Just mentioning you below
Calcium (Serum) : 8.4 mg/dl conducted on 06JAN, 16.
Creatinine : 0.9 mg/dl conducted on 05JAN before CT Scan (contrast)
Awaiting your best advise.
From the reports it appears that she has a very good prognosis. However, even though the imaging looks good, you can't evaluate microscopic disease; so it's not impossible that some cancer cells are still in her body. I could make a better estimate if I could see the actual surgical report, to see what was removed. However, I'd still recommend that she see a gynecologic oncologist to see if there is anything further that should be done. She's probably going to do well, but I worry about the lymph nodes which were left behind. Hope this helps.