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What helps prevent recurrence of endometrial cancer?
Gynecologic Cancers | Last Active: 1 day ago | Replies (28)Comment receiving replies
@naturegirl5
Hi, "Yes", I had the full external beam radiation package, the last two weeks of which were gruelling as I was constantly worried about whether I'd manage to have an empty bowel and full bladder at the right time of day. It also left me with a sensitive bowel and constant burping (which I keep under control with organic kefir). The recurrence is not in the usual vaginal spot, the cuff, but 'introitus', right at outer edge where the vagina meets the vulva, right close to the anus. A CT scan, (chest, torso, abdomen) which was not low enough in the abdomen to register the cancer, was NEF for other mets. I don’t have the results of an abdominal MRI yet but a hysteroscopy and excision with Fenton's flap, are booked under a spinal tap, for 19th July with same-day discharge. Because of the proximity to the anus and mild IBS caused by the external beam, both the surgeon and I are trying to avoid brachytherapy which could compromise anal function. But until the histology on the excised material is done, making clear if the cancer has gone through the vaginal wall, no decision can been made.
I would dearly love and feel reassured by, having regular Signatera tests but they're not available on available on the UK NHS and I can't afford £3k a pop. I'm looking round to get adopted by a trial! If I could have the scientific back-up of that test, I'd feel more confident about eschewing brachytherapy this time round.
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@carointheuk Whew! The radiation you had does sound grueling. While it's a good thing that the recurrence was observed it must be so tiring to go through all of this testing while you and your surgeon are trying to decide how to treat this. These next few weeks until July 19 are likely weighing on you. It's like one wants all of the information available through any means possible but it's anxiety-provoking when leading up to each and every test. Approach and avoidance - that's how I look at this and I've certainly felt that way. I never "want" to avoid appointments and more testing but the anxiety that's generated by all of this certainly "tells" me to run away.
My husband is a pathologist (now retired). He says that many of these "blood biopsies" such as the Signatera test are not particularly reliable. Actual observation through surgical biopsies and imaging are more so. I've read scientific articles on this topic of liquid biopsies and while the Signatera is used for gynecological cancers there is more research available for some cancers than others. So, liquid biopsies can be a useful adjunct but the results generated by the Signatera should not be considered diagnosistc without additional information such as a tissue biopsy. If you are interested, I can dig up the article I read however here is what the College of American Pathologists has on this topic:
College of American Pathologists, The 'Liquid' Biopsy:
-- https://www.cap.org/article/the-liquid-biopsy/
From what you've shared, waiting for the read on the slides by pathology will be key in figuring out what is next. The manner you write about your own history and results makes me think you are a scientist or have a medical background.
What does your surgeon/oncologist say about the utility of Signatera testing?