Endometrial cancer: How fast should you have surgery?

Posted by cialonel @cialonel, Jan 11, 2022

Hi - I was diagnosed with endometrial adenocarcinoma in early December.. Per biopsy pathology report (Dec 8th) it is FIGO stage 1-2, with more focal solid areas with clear cell feature and cannot rule out higher grade carcinoma. My Oncologist said they would stage and grade the cancer after the hysterectomy. I am concerned that my surgery is not until Feb 10th and if it is a higher grade (more aggressive) that waiting that long puts me at risk for the cancer quickly growing. Should I be concerned? Or is this a reasonable time to wait for surgery?

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Welcome @cialonel. I can imagine you are concerned about the wait time until surgery. Fortunately, endometrial cancer grows slowly and your cancer was detected at an early stage (before spread). I might suggest that you talk to your surgeon about your concerns so that they can confirm the wait time and put your mind at ease.

I'm tagging fellow thrivers like @naturegirl5 @miriam57 @rainna @goldengirl2 @stparker54 @rose53 @ejohn @ejrdevries @andrea69 to join this discussion as they have stood where you are now and can share their experiences.

You might also appreciate this related discussion:
- Just diagnosed with Endometrioid Adenocarcinoma: What to expect? https://connect.mayoclinic.org/discussion/adenocarcinoma-1/

Cialonel, do you have a contact number for your surgeon or a nurse coordinator or a patient portal where you can ask questions to your team?

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Thank you. I had a teledoc appt today with my oncologist. While she didn't seem concerned with the date, she could definitely see that it concerned me (because of the pathology comment re: higher grade clear cell). I'm a little more informed now, and not as concerned. That said, she is also checking schedules to see if she can move the surgery sooner. She wants me to be comfortable. I feel fortunate to have someone I trust with my care. Lucky to have found her. Thank you also for the link above...I will definitely check it out.

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@cialonel

Thank you. I had a teledoc appt today with my oncologist. While she didn't seem concerned with the date, she could definitely see that it concerned me (because of the pathology comment re: higher grade clear cell). I'm a little more informed now, and not as concerned. That said, she is also checking schedules to see if she can move the surgery sooner. She wants me to be comfortable. I feel fortunate to have someone I trust with my care. Lucky to have found her. Thank you also for the link above...I will definitely check it out.

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Hello @cialonel
I'm Rose53 and read your experience right now. I have been where you are now and at the very day I was told I had the same cancer you have Iwas stunned. I couldn't not process it for a couple of days !Then it sunk in and that's when flood of emotions came all out. I didn't want to wait so followed what I needed to do, go see an Oncologist and have surgery. That was first and foremost, so I focused on that. I did not know how bad or whether it spread. I would know that after surgery. However, CAT SCAN was done before surgery but no spread anywhere else, so good news. My spirit was up.
Within a month I was having surgery. I was fortunate I got in quicker than I thought. You know we think worst of our situations than what it really is. Pray, pray, hope, hope. I leaned on that. The day of surgery, robotic, I was told no visible signs of cancer around uterus.When pathology report came after surgery, no spread and cancer was located in one of fallopian tube, small one. So no treatment required and go back in six months . Please, be calm, hope for the best, trust doctors will do their best for your treatment. Mayo is fantastic. Your in a good place. Best wishes for a good outcome and a quick recovery. This connect group was my support and Colleen has given you names I reach out to. They were so helpful 🥰 Let us know please how it turns out.

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@cialonel Hello, I was diagnosed with endometrial adenocarcinoma, FIGO Grade 1 in 2019. I live in the rural Upper Peninsula of Michigan.
Two referrals were offered by my gynecologist - University of Michigan and Mayo Clinic. I chose Mayo Clinic. Within two days of the referral I was in Rochester, MN meeting with the GYN/ONC surgeon. By then, my pathology slides had been sent to Mayo Clinic where their pathologists provided a second opinion. The radical hysterectomy including cervix, fallopian tubes and ovaries was performed just five days after the first appointment at Mayo. Quite honestly, I was in emotional shock when I first heard the diagnosis from my local gynecologist. After the hysterectomy at Mayo Clinic pathology indicated the cancer was Stage1a, FIGO Grade 1. No spread, no more treatment needed at that time. This certainly was a relief at the time.

Did you have an endometrial biopsy with your gynecologist? Or dilation and curettage with hysterescopy which means that all of the endometrial tissue would have been sent to pathology? You were wise to contact your oncologist and see if you could have the hysterectomy sooner for two reasons.

1) Your initial diagnosis in early December with surgery scheduled two months later is a long time for anyone to wait with such a scary diagnosis. Unless there was another treatment such as radiation treatment or something else prior to the surgery that needed to occur, this seems very long to me. I don't believe anyone should have to wait two months for cancer surgery.

2) Your pathology report indicated "clear cell features" and clear cell cancer is more concerning. I have been told that it's typical for pathology to indicate something that "cannot be ruled out" based on your biopsy. When something looks suspicious the phrase "cannot be ruled out" is used. This is an alert to the medical team reading your pathology report. There may or may not be clear cell cancer and it should be evaluated further.

I realize that all that I wrote above is a lot. I'd like to say that I was very frightened with my diagnosis. Once I knew that I was in the care of my GYN/ONC surgeon and all would be moving quickly I was able to settle down. Personally, I feel better when there is a plan in place.

How are you feeling? You said that you feel trust in your oncologist. Where is your surgery scheduled?

You will receive support here on Mayo Clinic Connect. Would you please come back and let me know other ways I can support you?

REPLY
@rose53

Hello @cialonel
I'm Rose53 and read your experience right now. I have been where you are now and at the very day I was told I had the same cancer you have Iwas stunned. I couldn't not process it for a couple of days !Then it sunk in and that's when flood of emotions came all out. I didn't want to wait so followed what I needed to do, go see an Oncologist and have surgery. That was first and foremost, so I focused on that. I did not know how bad or whether it spread. I would know that after surgery. However, CAT SCAN was done before surgery but no spread anywhere else, so good news. My spirit was up.
Within a month I was having surgery. I was fortunate I got in quicker than I thought. You know we think worst of our situations than what it really is. Pray, pray, hope, hope. I leaned on that. The day of surgery, robotic, I was told no visible signs of cancer around uterus.When pathology report came after surgery, no spread and cancer was located in one of fallopian tube, small one. So no treatment required and go back in six months . Please, be calm, hope for the best, trust doctors will do their best for your treatment. Mayo is fantastic. Your in a good place. Best wishes for a good outcome and a quick recovery. This connect group was my support and Colleen has given you names I reach out to. They were so helpful 🥰 Let us know please how it turns out.

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Hello, @rose53, It's so good to read your post. I'm very relieved to know that your pathology report indicated no spread and that all the cancer was removed.

How are you doing these days? I hope you can put the surgery and results in your rear view mirror (still in your mind but not blocking your view of life in front of you) and keep moving forward.

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@naturegirl5

@cialonel Hello, I was diagnosed with endometrial adenocarcinoma, FIGO Grade 1 in 2019. I live in the rural Upper Peninsula of Michigan.
Two referrals were offered by my gynecologist - University of Michigan and Mayo Clinic. I chose Mayo Clinic. Within two days of the referral I was in Rochester, MN meeting with the GYN/ONC surgeon. By then, my pathology slides had been sent to Mayo Clinic where their pathologists provided a second opinion. The radical hysterectomy including cervix, fallopian tubes and ovaries was performed just five days after the first appointment at Mayo. Quite honestly, I was in emotional shock when I first heard the diagnosis from my local gynecologist. After the hysterectomy at Mayo Clinic pathology indicated the cancer was Stage1a, FIGO Grade 1. No spread, no more treatment needed at that time. This certainly was a relief at the time.

Did you have an endometrial biopsy with your gynecologist? Or dilation and curettage with hysterescopy which means that all of the endometrial tissue would have been sent to pathology? You were wise to contact your oncologist and see if you could have the hysterectomy sooner for two reasons.

1) Your initial diagnosis in early December with surgery scheduled two months later is a long time for anyone to wait with such a scary diagnosis. Unless there was another treatment such as radiation treatment or something else prior to the surgery that needed to occur, this seems very long to me. I don't believe anyone should have to wait two months for cancer surgery.

2) Your pathology report indicated "clear cell features" and clear cell cancer is more concerning. I have been told that it's typical for pathology to indicate something that "cannot be ruled out" based on your biopsy. When something looks suspicious the phrase "cannot be ruled out" is used. This is an alert to the medical team reading your pathology report. There may or may not be clear cell cancer and it should be evaluated further.

I realize that all that I wrote above is a lot. I'd like to say that I was very frightened with my diagnosis. Once I knew that I was in the care of my GYN/ONC surgeon and all would be moving quickly I was able to settle down. Personally, I feel better when there is a plan in place.

How are you feeling? You said that you feel trust in your oncologist. Where is your surgery scheduled?

You will receive support here on Mayo Clinic Connect. Would you please come back and let me know other ways I can support you?

Jump to this post

Nature Girl,
You said it well. You highlighted very well what went on with me step by step. I insisted to have my surgery much sooner so requested to squeeze me in . Thank God Ii got it in November instead of waiting another month. It will always be behind my rear view mirror but more focused now on how life before us as we know it, can changed over night. It is very precious. Thankful each day.😌😔

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@rose53

Nature Girl,
You said it well. You highlighted very well what went on with me step by step. I insisted to have my surgery much sooner so requested to squeeze me in . Thank God Ii got it in November instead of waiting another month. It will always be behind my rear view mirror but more focused now on how life before us as we know it, can changed over night. It is very precious. Thankful each day.😌😔

Jump to this post

@rose53 Rose, our stories are so similar. I'm very happy to know you are doing well and that we, here at Mayo Clinic Connect, could support you through your journey. I know your posts have been helpful and supportive of others who come here. Doesn't it feel good to be in place to do that for others?

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I commented on here some weeks ago. I was diagnosed with endometrial cancer in September 2007 at age 67.. Within two weeks I had radical surgery, uterus, tubes, ovaries, omentum, and 29 lymph nodes. The report came back that 11 of those lymph nodes had cancer. I was Stage 3 C2 and Grade 3 tumor. Within 3 weeks of surgery I had my first high dose of to chemotherapy medications. I had two more at three week intervals. Then three weeks after that I began daily radiation for 5 weeks. This was followed by three brachytherapy treatments. Three weeks later I started continued with the chemotherapy for another series of three every three weeks. I was given several medications by infusion before each chemo treatment and four more to take at 6 hour intervals for three days. I had no nausea, or upset stomach, no colds, sniffles or cough throughout the eight months of treatment. The first 7 days after chemo i had no strength. Brushing teeth was taxing and required a rest period. Mu husband did all the cooking, laundry, etc that week As energy returned I did those tasks and resumed my three times a week deep water aerobics class. Friends there were very supportive as were many other family and friends. I have kept my regular checkups faithfully and have been told there is no evidence of cancer.
So I am 14 years out now and still no cancer. I do have some long term effects from the radiation and chemo: neuropathy in my legs and feet, one dropped foot, some bladder issues, a partially paralyzed diaphragm. These are not nice, but I am here, alive and relatively active. I have enjoyed all those years with family and 9 grandchildren. Soon there will be the first great grandchild. I have been truly blessed.
P.S. My doctor used the same treatment protocol that Mayo was using at that time. I am a firm believer in treating diligently right at the outset to avoid a return of the cancer.

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@ejrdevries

I commented on here some weeks ago. I was diagnosed with endometrial cancer in September 2007 at age 67.. Within two weeks I had radical surgery, uterus, tubes, ovaries, omentum, and 29 lymph nodes. The report came back that 11 of those lymph nodes had cancer. I was Stage 3 C2 and Grade 3 tumor. Within 3 weeks of surgery I had my first high dose of to chemotherapy medications. I had two more at three week intervals. Then three weeks after that I began daily radiation for 5 weeks. This was followed by three brachytherapy treatments. Three weeks later I started continued with the chemotherapy for another series of three every three weeks. I was given several medications by infusion before each chemo treatment and four more to take at 6 hour intervals for three days. I had no nausea, or upset stomach, no colds, sniffles or cough throughout the eight months of treatment. The first 7 days after chemo i had no strength. Brushing teeth was taxing and required a rest period. Mu husband did all the cooking, laundry, etc that week As energy returned I did those tasks and resumed my three times a week deep water aerobics class. Friends there were very supportive as were many other family and friends. I have kept my regular checkups faithfully and have been told there is no evidence of cancer.
So I am 14 years out now and still no cancer. I do have some long term effects from the radiation and chemo: neuropathy in my legs and feet, one dropped foot, some bladder issues, a partially paralyzed diaphragm. These are not nice, but I am here, alive and relatively active. I have enjoyed all those years with family and 9 grandchildren. Soon there will be the first great grandchild. I have been truly blessed.
P.S. My doctor used the same treatment protocol that Mayo was using at that time. I am a firm believer in treating diligently right at the outset to avoid a return of the cancer.

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Thank you, @ejrdevries I recall your posts on another discussion. Your post provides hope for every cancer survivor. How wonderful that you are enjoying life with your family and grandchildren and soon-to-be first great grandchild.

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@naturegirl5

@rose53 Rose, our stories are so similar. I'm very happy to know you are doing well and that we, here at Mayo Clinic Connect, could support you through your journey. I know your posts have been helpful and supportive of others who come here. Doesn't it feel good to be in place to do that for others?

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@tNature girl5
Yes, it's so humbling to have a place here to listen or offer imotional support to anyone who are going through the same experience we have been through. It's almost as if we are offering our hands. They are not alone just as I was not alone.

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