Just diagnosed with Endometrioid Adenocarcinoma: What to expect?

Hello, again, Andrea, @andrea69

Thank you for responding so quickly to my posting. I am so very relieved to know that you have a referral in place to GYN/ONC and that you will continue to advocate for yourself by calling their office if they didn't get back to you in a timely manner.

How wonderful that you are so mindful about your weight loss. Since you've already done so well it does show that you are very serious about this. As you continue to be followed for the endometrial cancer diagnosis you will be showing the physicians that you do intend to reduce your risk and are getting yourself ready for surgery.

It's good that your husband was present as the doctor explained the findings from the hysteroscopy and he can continue to reassure you. That "extra pair of ears" is so important. I was fortunate like you that my husband was present at all of my appointments and took notes for me.

Yes, will you please come back here and keep me/us informed? Thank goodness for the UW-Madison nurse who informed you of Mayo Clinic Connect. I'm very happy you found us.

I'm wishing you many blessings and healing prayers,

Helen

Good morning Helen,

Thank you so much for your reply. I spoke with a physician yesterday, who is filling in for my doctor who is currently on vacation. She told me that she had already sent a referral to the GYN/ONC department, so hopefully I will be speaking with them soon. I do have a copy of the pathology report, and it is indeed quite confusing in spots - especially the marker terminology, so I will def. have questions about the terminology.

I wish I could have children, but they told me I was walking a fine line between being menopausal and post-menopausal. One of the biggest risk factors I have right now is obesity. I have been told that I am indeed a candidate for robotic/laparoscopic surgery, but it seems whenever I breach the subject, they shy away from it. I am going to strongly press for it now. I am conscientiously dieting and have lost a fair amount of weight, and my goal is to lose at least 10-20% of my overall weight. Hopefully they will see that as an indication I am serious about getting this surgery and that I am doing everything I can on my end to get this excess weight off.

I will give the GYN/ONC today to get back to me. If I don't hear from them, I will give them a call tomorrow. I keep reminding myself that my doctor did tell my husband that "she got it all", and that the muscle underneath the concerning area was clean, pink and without discoloration or erosion. It did sound positive, so I am hoping that is an indication of everything as a whole.

Many, many thanks and blessings to you. I will report back when I have some more info.

Andrea

Thinking of you, Rose. How was your appointment yesterday (Monday)?

Helen

Hello, @andrea69
We aren't medical professionals here at Mayo Clinic Connect so we cannot provide you with medical recommendations. We do provide support and can help you search for the resources you need and formulate questions to ask.

I do understand how frightened and confused you are right now. I've felt the same and it's frightening to navigate your way through the medical jargon and the system.

You stated that you were diagnosed with FIGO Grade 1 carcinoma. Was this information provided to you after the hysteroscopy and D&C? If yes, I'm wondering why you weren't referred to a cancer specialist. Do you receive your care at UW Madison? If yes, then I would insist on a referral to gynecologic oncology at the cancer center at UW. You are in an area where there is comprehensive cancer treatment and research in an academic environment. They will be up-to-date on the latest advances.

FIGO Grade 1 refers to cancer cells that are well-differentiated and very small growth of tumor (less than 5%). Your doctor who performed the hysteroscopy removed tissue that was sent to pathology and the pathologist then provided the diagnosis of FIGO Grade 1. There should also be information about the kind of cancer. Do you have a copy of the pathology report? If not, please ask for your own copy and then ask your doctor to explain what everything means in the pathology report.

FIGO Grade is different than stage. The FIGO grade helps the team of physicians to decide on the best treatment forward after initial diagnosis. FIGO Grade 1 means that the cancer is early stage. Additional biopsy which might include surgery will stage the cancer to determine if it has spread. Here is an explanation from the American Cancer Society that I have found helpful.
https://www.cancer.org/cancer/endometrial-cancer/detection-diagnosis-staging/staging.html
After doing some research I learned that information hormonal IUDs are placed for early endometrial cancer. The IUD you mention (Liletta IUD) is in that category. Your IUD is often placed where there is low grade endometrial cancer such as FIGO Grade 1 and is a nonsurgical approach. Here is an article that is very technical but discusses the research on the type of hormone that is in your IUD and its use in treating low grade endometrial cancer.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5739955/
I would like to encourage you to really advocate for yourself. Your post again makes me wonder why you weren't referred immediately to the cancer center to discuss all the options available. Are you planning to have children? Are there other reasons your doctor is advising against a hysterectomy? You mention that you have some other risks factors If that is something you want to know more about so you can weigh out what you want to do then please ask for that referral and be tenacious and persistent about it. We are the best advocates for ourselves.

Since you are in Wisconsin you are close to Mayo Clinic in Rochester. If you'd like to explore whether Mayo Clinic can provide a second opinion, here is the link:
http://mayocl.in/1mtmR63
Blessings. Please come back here and let me know what you find out. I'll be thinking about you.

Helen

Hello everyone. I live in Central Wisconsin, and was referred to your page by a lovely nurse at UW Madison, where I had a hysteroscopy done last week, along with a polypectomy and a IUD placement. Long story short, I have a FIGO Grade 1 carcinoma. I 50 years old, and have been bleeding on and off since last December. It's taken me this long to get the help I needed, as the prior doctors I went through literally ping-ponged me around.

During the procedure, my doctor found a polyp about the size of a grape that was discolored, and she said that it was a 50/50 chance of it being malignant. She went on to say that if it was the bad part of the "50/50", that the IUD was in place and would help to eliminate the endometrial lining and quite possible reverse the disease. My husband asked her if she got everything out, and she did confirm that she did.

I have been asking for a hysterectomy for some time. I have some very considerable risks, but I don't want to play the "what if" game, and have this possibly come back at a later stage.

I guess I have two questions. The first being - is the FIGO Grade the same as a Stage indicator, and do the IUDs really reverse this disease? I have a Liletta IUD.

I am so incredibly frightened and lost right now with so many questions I don't know which way to turn.

Thank you so much for your help. Blessings to all.

Thinking of you today, Rose.

I was prepared with the following questions.

1. Please explain the plan for surgery based on my diagnosis.

2. I was going to ask my surgeon if she planned to remove lymph nodes because I was worried about the edema that can occur. Before I asked my question my surgeon explained that she planned to sample sentinel nodes, This is a relatively new procedure so ask your surgeon how they plan to sample the lymph nodes.

3. When will I know the results (cancer stage) from my surgery? Your tissue will be sent to pathology where the pathologist will carefully examine and do other tests which can take a few days.

4. How long will I have to stay in the hospital? Can I have visitors (good question to ask during this pandemic)?

These are just few questions that I hope will be helpful to you.

Blessings,
Helen

This is very helpful to me more than you will ever know. We have to travel about 6 hours to the hospital. Would you have any questions to suggest what I should ask?? 😔

Hello again, Rose53,
I realize that you might wish to know how I did emotionally over time following the total hysterectomy. I received a referral for the Menopause and Women's Sexual Health Clinic from the nurse practitioner who I see every 6 months for my follow-up. I saw a psychologist who is trained in sex therapy and plan to return again in January. I learned so much about my own body that I didn't know and the suggestions and advice including reading materials were and continue to be helpful for me and in my relationship with my partner.
https://www.mayoclinic.org/departments-centers/menopause-womens-sexual-health/overview/ovc-20487915

Hello, Rose53,
I’m not sure how much detail you would like to know. If there is something I’ve left out or you’d like more information, please ask. I can tell from your posts that you are nervous and worried. And why wouldn’t you be? Please tell yourself that it’s normal to be worried about this diagnosis and surgery and please don’t try to talk yourself out of what you are feeling.

My hysterectomy was same-day surgery at Mayo Clinic in Rochester. I spent a few hours early in the morning in a hospital room with a very empathic and informative nurse who got me ready for surgery. Then, I was taken to the pre-surgical area where the anesthesiologist checked in with me and the IV was started. The nurse that started the IV asked me to drape my hand over my bed and then she crouched down to start the IV. That’s the first time I’d ever had that experience and she told me that gravity would help this process and it sure did. It was the most painless IV start I’d ever had. When the OR was ready for me the surgical fellow (surgeon doing a fellowship in gynecological oncology) wheeled me to the OR. And then the surgeon came into the room. She stood next to me, held my hand for a moment, and told me she was there. I’m almost in tears as I describe how calming this was and how much everyone I had contact with focused on me, the patient. And then I was asleep. The hysterectomy was robotic non-invasive with 5 very small abdominal incisions. I awakened in the same hospital room where I started the day. I was really uncomfortable when I awoke because the surgeon must introduce gas into the belly in order to visualize the surgery. That gas bloats the belly. The pain medications were somewhat helpful and I was told it was take some time for the gas to dissipate from the abdomen. Within 24 hours I believe the gas was gone because I felt better. We stayed in Rochester for an extra day and then made our way home stopping every hour or so (it’s a 9 hour drive for us) for me to get out of the car and move around as the surgeon recommended.

I had a whole list of things to do and not do including not driving for at least two weeks and not lifting anything heavier than two grocery bags. The first week I was fatigued which is normal after surgery especially when there is general anesthesia which I had. I didn’t have any pain after I returned home two days after surgery. The incisions were covered with small bandages and were self-healing sutures. I returned to Mayo Clinic 4 weeks later to see the surgeon again. By then I was back at work (I work part-time) and my energy was back to normal for me. Since internally I was still healing, the surgeon advised me that I continue to be careful about physical activity.

Initially I didn’t have a strong emotional reaction to the hysterectomy other than gratefulness. That’s when I started the “Noticing my blessings thread” here (https://connect.mayoclinic.org/discussion/noticing-my-blessings-every-day/) on Mayo Clinic Connect. But later I did have some psychological adjustments to make for myself and in my sexual life with my partner. I can share some of that in another post if you like.

Your appointment with your surgeon is tomorrow? I’d like to suggest the following. Be prepared ahead of time with your questions already written down. Take notes during your consult with the surgeon. And bring someone with you so that there are an extra pair of “ears”. Don’t’ go to the appointment by yourself if you can. This is an emotionally difficult time and the person who accompanies you can better recall when the surgeon says.

Please check back in and let me know what happens at your Monday appointment. Ask any questions here that occur to you and please know that I and the other Volunteer Mentors are here for you.

Blessings,
Helen