My mom has recurrent UTIs.

@angievas1 I feel for you as you know only too well what it's like to be diagnosed and then treated for cancer. While you are being followed for Lynch Syndrome and your own diagnosis you are worried about your mother. It's make me very when I read how so many of us experienced appointments with our local medical providers that either misdiagnosed or delayed diagnosis and treatment. I'm wondering why her gynecologist or gyn/oncologist did not recommend a survival plan that included regular exams that included pelvic exams.

Is your mother still being seen at City of Hope? Is that the location of her hospital oncologist? When is her CT scheduled? While scans are frightening - at least I get very anxious and frightened when I have CT scans even when I have no symptoms - I hope that your mother's scan shows no evidence of disease and that this is a UTI. I've been advised not to use any estrogen products for vaginal dryness because my endometrial cancer was estrogen positive. There is a discussion on Mayo Clinic Connect about vaginal moisturizers that you may find helpful:

Vaginal Dryness Solutions:
https://connect.mayoclinic.org/discussion/vaginal-dryness-solutions/?pg=4#chv4-comment-stream-header
Have the antibiotics helped?

I don't see anything for you to be guilty about. If her cancer has been monitored with scans, there's no real reason for a pelvic exam, especially if she's on immunotherapy. And since the cancer had already spread outside of the vaginal cuff, a pelvic exam is definitely not sufficient.

I also spend more time than I should dreaming myself into an alternate universe where I got better, more timely treatment, and didn't have a recurrence that's incurable. But I also recognize that what I have gotten is about the best modern US medicine has to offer, so I should be appreciative.

Yes, it is sad, but she is truly grateful to have you to help her with it.

Thank you, Helen. My mom's oncologist is at City of Hope, and they treat her very well. She has always felt cared for by him. He was the one who ordered the CT scan right away. I took her for the scan on Friday, and her follow-up appointment with him is scheduled for April 17th. My mom was frightened, but I tried to encourage her and help her remain positive.
She used the vaginal cream for a week, and the last day she used it is when she noticed the bleeding.
Her oncologist also referred her to a local lab for a urine analysis, which showed no bacteria and no infection. However, she continues to experience discomfort and lower pelvic pain. A gynecologist from City of Hope will see her as well, but we haven’t received an appointment for that yet.
Thank you for the recommendations; I truly appreciate your help. Take care.

Thank you, Val, for your kind message. Throughout my mom's cancer journey, as well as my little sister's and mine, I often find myself reflecting on what I could have done differently or better. However, I am learning to accept things as they are and appreciate each moment.
Take care. ❤️

That's very kind of you to say, thank you! I know my mom appreciates it a lot. She often tells me how grateful she is that I drive her around and accompany her to her appointments. We're also creating memories together through these experiences. I'm grateful, too.
I hope you’re doing well.

@angierivas1 It's reassuring your mother continues at City of Hope with her same oncologist and that she feels comfortable with him. Hopefully when she sees her oncologist they can talk together about the vaginal cream and whether or not to continue with that. Also, hoping that the City of Hope gynecologist sees your mother soon.

As I look back at my own cancer journey I also think of what I could have done differently. I wish I had gone to Mayo Clinic at the onset of the vaginal bleeding instead of the local gynecologist. But we cannot change what's already happened in the past. We can try to make our choices now and in the future based on what we've already experienced. Isn't this how you knew to get your mother to be seen right away because of your own cancer journey and that of your younger sister?

Hello Angie,
I am a family physician with ovarian cancer. According to the National Comprehensive Cancer Network (NCCN) guidelines for endometrial and uterine cancers, after treatment, surveillance pelvic exams should be done every 3-6 months for 2-3 years, then every 6-12 months after that. AND whenever new symptoms happen, such as pink discharge or pain.
Imaging should be done on a similar schedule AND when new symptoms occur.
In English: https://www.nccn.org/patients/guidelines/content/PDF/uterine-patient.pdf
In Spanish: https://www.nccn.org/patients/guidelines/content/PDF/uterine-esl-patient.pdf
Hope this helps : )
—Laurie

I assumed this surveillance protocol applied to patients who are NED, not patients with a known tumor who are actively being treated and monitored by CT scans.

I haven't had a pelvic exam in the year and a half since my recurrence was found. (by myself, doing a self-exam two weeks after the NP had done a pelvic exam and declared me all clear.). And I don't see any reason why I should, since I'm having CT scans every three months or so.

And actually, the NCCN guidelines don't recommend imaging at all during surveillance for stage 1 endometrial cancer, unless there are symptoms or other findings. My oncology team (at a top 10 cancer center) was dutifully following the NCCN guidelines, and not doing any imaging, when I had to self-diagnose my own recurrence and then go beg for a CT scan.

CT scans are not 100% accurate. They do not show anything smaller than about half a centimeter (1/5 of an inch). And they don’t show what the vulva, urethral opening, anus, and perineum look like. Speculum and internal manual exams can be helpful, but should not be done if painful for the patient.
I reviewed the guidelines again (page ENDO-9), and, if I am interpreting them correctly, surveillance for endometrial cancer is the same for all stages. And new symptoms necessitate imaging and pelvic exam. I’m appalled you had to beg for a CT when you had new symptoms!