Cancer Cells in Peritoneal Wash`

[trish54]

Can you tell me what would/will be the next step.. I had a D&C in Dec showing endometrial cancer (stage 1 well-defined). Hyst. in Jan.. Lymph nodes, tubes and ovaries all clear but Non-Small cell carcinoma showing up in peritoneal Wash.  Upgraded to Stage IIIA Grade 1  Just wondering what would be expected when I see gyn/onc at the end of Feb.
Thanks

[Annekathryn Goodman, M.D.]

Hi there,
As I said, we do not know the significance of this finding. what is important is grade, depth of invasion into the muscle wall of the uterus, and whether there is any spread to lymph nodes. In the absence of other risk factors such as high grade (grade 3) or involvement of lymph nodes or deeply invading tumor into the wall of the uterus, it is not at all clear that having  positive cytology has any additional risk for recurrence.

Ask your oncologist about the option of a laparoscopy in 6 months to get another wash. If that is negative, it is unlikely that this positive cytology is important.

I know it is a hard concept to get one's mind around
best wishes

[trish54]

A related discussion, CT Scan Findings was started.

[trish54]

Thank you so much for your comments... My oncol. first recommend 6 rounds of chemo or abdominal radiation, but when I asked about the NCCN guidelines to just observe he said that "We could do that." He did ask about starting me on Tamoxifen. I said I might consider that but we did not agree as to when. Where we left it was he would see me in 3 months and I would get a ct scan and CA-125 blood work.  I appreciate all of your help

[Annekathryn Goodman, M.D.]

Hi There
we do not know if cells are dead or alive in a wash. It is one of the uncertainties
take care

[trish54]

I appreciate all the comments you have made.. You did say in your orig. post (Feb 12)
that there was a possibility of the malignant cell in the wash were "Dead cells"... How would the pathologist or oncologist know that and can I ask a specific question about it when I see the oncologist on the 29th?
Thanks again...

[trish54]

How would I know from the path report if they are "dead " cells.Path report reads
Cul-de-sac fluid: Pos. for Non-Small Cell Carcinoma, Favor Adenocarcinoma  (Adeno was my dx from my D&C in Dec.) In the comments it says "Rare three dimensional clusters with papillary features are noted, consistent with the above dx." Recommend clinical correlation.  Can you explain this?
Thanks
Trish

[Annekathryn Goodman, M.D.]

Hi There,

here is no clear answer as to what to do . It could be that the cells found in the wash are dead cells. so it is controversial whether the finding of malignant cells in a wash when there are no other risk factors for spread (ie: grade 3, deep invasion, involvement of lymph nodes


With a grade one cell type, many gyn oncologists would suggest using progesterone as a protective treatment.  This is similar concept as giving women with breast cancer tamoxifen fro 5 years after treatment of their breast cancer.

please let us know what your oncologist recommends
take care