Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Ovarian Cancer (Expert Forum)
Stage IIIA Gr. 3 endometrial cancer questions
Answered by
Annekathryn Goodman, M.D. - Gynecologic Cancers, Complex Gynecologic, Surgeries, Palliative Care, Acupuncture
Massachusetts General Hospital Cancer Center
Boston - MA
This forum is for questions and support regarding ovarian cancer issues, such as: Biopsy, Chemotherapy, Clinical Trials, Genetics, Hysterectomy,Immunotherapy, Ovarian Cancer Types, Radiation Therapy, Risk Factors, Screening, Staging, Surgery.
|
Stage IIIA Gr. 3 endometrial cancer questions
by Apricot100, Jun 29, 2006 12:00AM
I had a radical hysterectomy 6 weeks ago for what was determined to be Stage IIIA grade 2 endometrial cancer. It had moved to my ovaries which had 15cm & 30cm adnexal masses. One of these masses ruptured during surgery & a clear yellow fluid from the mass leaked into my body (per op report & surgeon). My questions:
Exactly how bad is it that one of the masses ruptured during surgery? My abdomen/pelvis is enlarged now, Dr. says ascites and thinks it will clear after 1st chemo trt.
My Dr. was unable to give me statistics on survival rates - I tried internet search, got confused, I think something said 30% for 5 yrs. Is this accurate? Can you provide any info?
A visiting nurse said that generally no matter where I go, all treatments for this cancer would be the same, so it wouldn't matter that much where I go. My Dr. said it would be chemo. & radiation. Is this true? Should I try to seek out another, better hospital or do you think it would all be the same no matter where I go?
I have lost a lot of weight since surgery and may be anorexic. I'm barely 100 lbs at 5'6". Today especially I'm very nauseous but still try to eat. Do you have any suggestions on gaining wt. and how to deal with it, how it will affect trt? Dr. says just to keep doing what I'm doing. Please help. I'm frightened, live alone, and not sure where to turn. My trt. consultation mtg is on Monday w/another Dr. because surgery was done in another state.
Exactly how bad is it that one of the masses ruptured during surgery? My abdomen/pelvis is enlarged now, Dr. says ascites and thinks it will clear after 1st chemo trt.
My Dr. was unable to give me statistics on survival rates - I tried internet search, got confused, I think something said 30% for 5 yrs. Is this accurate? Can you provide any info?
A visiting nurse said that generally no matter where I go, all treatments for this cancer would be the same, so it wouldn't matter that much where I go. My Dr. said it would be chemo. & radiation. Is this true? Should I try to seek out another, better hospital or do you think it would all be the same no matter where I go?
I have lost a lot of weight since surgery and may be anorexic. I'm barely 100 lbs at 5'6". Today especially I'm very nauseous but still try to eat. Do you have any suggestions on gaining wt. and how to deal with it, how it will affect trt? Dr. says just to keep doing what I'm doing. Please help. I'm frightened, live alone, and not sure where to turn. My trt. consultation mtg is on Monday w/another Dr. because surgery was done in another state.
Doctor's Answer
by Annekathryn Goodman, M.D., Jun 30, 2006 12:00AM
, Jun 30, 2006 12:00AM
Hello, it sounds like you have been having a really rough time. I see three main things that we should talk about here:
1.What is your diagnosis and what does that mean?
2.How are you doing physically right now?
3.Who should take care of you?
1.You have been told that you have a Stage IIIa grade 2 endometrial cancer. What that means is that the cancer started in the lining of the uterus (the endometrium) and has traveled to involve the outside surface of the uterus (the serosa) and/or the ovaries/fallopian tubes and/or fluid in your abdomen has cancer cells in it (malignant ascites). It is also possible that you have two different cancers: a cancer inside your uterus (Stage I) and a second cancer that started in your ovaries (Stage I-II). Sometimes it is hard to sort out the difference because under the microscope, the cancers from the uterus and the ovary can look very similar.
Prognosis and survival statistics are traditionally reported as the number of people with the particular cancer and stage whose cancers come back and cause the death of the person in 5 years out of 100 people with that cancer and stage. These statistics are very different for a stage III endometrial cancer compared to a double primary ovarian/ endometrial. Stage III endometrial cancers are quite rare and only 13% of all women with endometrial cancer are diagnosed at stage III. One study looked at women who only had spread to the ovaries and tubes and found an 80% five-year survival (Gynecol Oncol volume 9 pages 12-17; 1980.) Other studies have reported lower 5-year survivals of 40%. For women with double primary cancers, the prognosis will depend on the stages of the cancers and is usually better than for a Stage III endometrial.
Treatment after surgery does involve a combination of chemotherapy and radiation. How exactly that is done should be tailored to the individual person.
2. I am worried about your weight loss and anorexia. It is very important for the medical staff who are caring for you to address this. Everyone looses weight after big surgery (about 20 pounds) and it does take a while to get back on track with eating (about a month). However, it is important for you to have a full nutritional assessment. If your protein levels are low, you need a consultation with a nutritionist and you need to start on supplements. It is also important for your doctor to make sure you do not have a problem from your surgery such as an intestinal blockage or an infection.
3.) It is true that chemotherapy is chemotherapy and can be given anywhere. Radiation therapy is usually given at certain radiation centers. Many radiation centers are part of big cancer centers. When a person has a rarer cancer such as a stage III endometrial cancer, it may be worth looking for an oncologist at the large cancer center in your region. These places have more resources and may have more experience taking care of people with your cancer. Having said that, nothing replaces a good patient – doctor relationship that is built on trust and communication. There are many oncologists in a private practice community setting who are experienced, thorough, and willing to take complete care of your needs which include treatment of the cancer, management of symptoms (pain, side effects of therapy), nutrition, and spiritual well being. When you go for your appointment on Monday, see if you feel that these issues will be addressed. If you feel that they will be, perfect, stay there. If you do not, then please look at the bigger cancer centers. Finally bring a friend with you who can be your support person and take notes for you.
1.What is your diagnosis and what does that mean?
2.How are you doing physically right now?
3.Who should take care of you?
1.You have been told that you have a Stage IIIa grade 2 endometrial cancer. What that means is that the cancer started in the lining of the uterus (the endometrium) and has traveled to involve the outside surface of the uterus (the serosa) and/or the ovaries/fallopian tubes and/or fluid in your abdomen has cancer cells in it (malignant ascites). It is also possible that you have two different cancers: a cancer inside your uterus (Stage I) and a second cancer that started in your ovaries (Stage I-II). Sometimes it is hard to sort out the difference because under the microscope, the cancers from the uterus and the ovary can look very similar.
Prognosis and survival statistics are traditionally reported as the number of people with the particular cancer and stage whose cancers come back and cause the death of the person in 5 years out of 100 people with that cancer and stage. These statistics are very different for a stage III endometrial cancer compared to a double primary ovarian/ endometrial. Stage III endometrial cancers are quite rare and only 13% of all women with endometrial cancer are diagnosed at stage III. One study looked at women who only had spread to the ovaries and tubes and found an 80% five-year survival (Gynecol Oncol volume 9 pages 12-17; 1980.) Other studies have reported lower 5-year survivals of 40%. For women with double primary cancers, the prognosis will depend on the stages of the cancers and is usually better than for a Stage III endometrial.
Treatment after surgery does involve a combination of chemotherapy and radiation. How exactly that is done should be tailored to the individual person.
2. I am worried about your weight loss and anorexia. It is very important for the medical staff who are caring for you to address this. Everyone looses weight after big surgery (about 20 pounds) and it does take a while to get back on track with eating (about a month). However, it is important for you to have a full nutritional assessment. If your protein levels are low, you need a consultation with a nutritionist and you need to start on supplements. It is also important for your doctor to make sure you do not have a problem from your surgery such as an intestinal blockage or an infection.
3.) It is true that chemotherapy is chemotherapy and can be given anywhere. Radiation therapy is usually given at certain radiation centers. Many radiation centers are part of big cancer centers. When a person has a rarer cancer such as a stage III endometrial cancer, it may be worth looking for an oncologist at the large cancer center in your region. These places have more resources and may have more experience taking care of people with your cancer. Having said that, nothing replaces a good patient – doctor relationship that is built on trust and communication. There are many oncologists in a private practice community setting who are experienced, thorough, and willing to take complete care of your needs which include treatment of the cancer, management of symptoms (pain, side effects of therapy), nutrition, and spiritual well being. When you go for your appointment on Monday, see if you feel that these issues will be addressed. If you feel that they will be, perfect, stay there. If you do not, then please look at the bigger cancer centers. Finally bring a friend with you who can be your support person and take notes for you.
Also, the rupture of one of the masses inside of me while operating and ascites - how bad of a situation is that?
By big cancer center, I'm not sure what that is. Would a University Hospital qualify?
Unfortunately I have no friends here who could go w/me.
Thank you.
A "double primary" means that two different cancers are present at the same time. "Primary" refers to where a cancer started. Sometimes a person will have multiple primaries such as a cancer starting in the ovary, second one starting in the fallopian tube, a third one starting in the uterus - all at the same time. Another term you may hear is "synchronous primaries". That is different that say having a breast cancer and then ten years later, experiencing an ovarian cancer. In that situation, one would say that the person had a second primary cancer (as opposed to a recurrence of their breast cancer.) Terminology can be so confusing!
There has been debate back and forth about whether a ruptured cyst that has cancer cells increases the risk that the cancer could come back. My personal opinion is that it probably does not but we try not to rupture tumors when we can. Sometimes it is unavoidable because the cyst is stuck and opens when it is moved.
Major cancer