Health Background:
I am a 41 year old female. overweight, but quite healthy (blood pressure, sugar, cholesterol, exercise etc)
I have 1 daughter (12 1/2), uneventful pregnancy, 22 hrs of labor with c-section due to position of baby and inability to "push" the baby out (tried for 2 hours). Good recovery, but then had 3 miscarriages and 1 ectopic pregnancy in the last 10 years. Not sure if all that is relevant.
Decided to not have biological children - husband had vasectomy.
I just got off the phone with my Dr. She indicated that while my pap was "normal" the lab reported atypical endometrial cells present. She wanted to do a checklist to see how to proceed:
1. still having periods? Yes. (good)
Regularly? Yes (good).
Heavy? Yes (Qualify) - lasts 7 days total, 4 of which I use an ultra tampon (larger than super-plus) and must change every HOUR and use pad to account for leakage. 1st day and last 2 days I use a "super" size tampon and change every 2-3 hours. (not good)
2. Any abdominal pain? Yes.
Constant pain or bloating? No (good)
Qualify pain - was seen in urgent care 2x in the past 6 months (post ectopic pregnancy) for what I thought was ovarian cyst. Ultrasound showed NOTHING. (not good)
3. Any breakthrough bleeding mid-cycle? No (good)
4. Any history of cervical or endometrial cancer in your family? Yes
who? mom - endometrial cancer; age 70. (not good, but old enough that does not directly increase risk).
Options:
A. Do nothing. Revisit in a year (or even two). Endometrial cancer is SLOW growing, most likely will take YEARS to progress. Might not even be detected on biopsy, even if cancer is large and developed (biopsy would have to **coincidentally** be from the sample of cells that was cancerous. MOST endometrial biopsy samples are negative, even if cancer is present.
B. Endometrial biopsy (see #1) and then, if negative, "wait and see" repeat pap in year. The problem is that apparently MOST endometrial biopsies are false negative.
C. *Preventive* uterine hysterectomy. She indicated that just based on my heavy periods and age I would be a candidate for this.
Additional info: My mom's initial biopsy was negative, but due to the other symptoms (pain, breakthrough bleeding at 70) opted for hysterectomy. Pathology report AFTER hysterectomy showed uterus was at stage 2 - (over 1/2 the uterus, but contained / not spread to pelvis).
Fun fact: my husband had a stupid vasectomy in February!!!!!!! Talk about irony. :-(
You sound a lot like I was, I ended up having a huge fibroid tumor, and cysts on both ovaries, AFTER a clear ultrasound (they never explained how this happened.) The atypical cells threw them off, they were surprised.
They tried with hormones to shrink my tumor for a few weeks as I bled nonstop for 11 weeks. I finally collapsed one day from weakness (I was found to be extremely anemic from the constant loss of blood) and they performed an emergency hysterectomy. I required 4 units of blood and was on iron an entire year after the surgery.
I personally would go with C. Best wishes!
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E.S.
answers from
Chicago
on
Based on your very heavy periods and your mother's history of endometrial cancer, I would probably opt for C. At this point, which bothers you more, the heavy periods or the fact that the atypical cells showed? If you can't stand the heavy periods (I've only had a few awful ones like that, so I can certainly understand if you'd want to be done with those!) then I would for sure do the hysterectomy now and then you'd solve both issues. If the cells are the biggest worry & they truly do take years to progress, then you could probably spend the year thinking about it and wait to see what next year's test results show. But if it were me, I'd probably just get the hysterectomy & take care of both issues, especially since you are definitely done having children. I would just feel uncomfortable having possibly cancerous cells lingering in my body. Best of luck to you as you make this decision! Please keep us posted.
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M.M.
answers from
Sioux Falls
on
I INSISTED on a retest and then secretly got a second opinion from my hometown obgyn. It was a mistake. I would get a retest and second opinion.
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J.E.
answers from
Minneapolis
on
Due to your heavy abnormal periods (that much bleeding isn't normal) and the increased cancer risk, I would do the hysterectomy. I had one 2+ years ago for that reason. I also had fibroids and endomitriosis. You've already made the decision not to have more children so monthly periods aren't necessary. What they told me is that if the excessive bleeding affects your normal routine, then look at having something done.
I did the Novasure first and due to the fibroids, it was not effective for me.
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P.K.
answers from
New York
on
You are not having any ore kids, heavy periods, I would opt for a hysterectomy. A vaginal hysterectomy is a walk in the park really. I just lost my best friend from Stage 1 endometrial cancer. She also had radiation just to be on the safe side. I guess one cell for out. If you still wanted children my advice would be different, but I live by better to be safe than sorry. Only you can make that decision. You might want to get a second opinion. Good luck with whatever route you take.
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M.C.
answers from
Washington DC
on
You sound like me, but with normal paps, not the stray cells.
I had a procedure called Novasure done 3 years ago. The one requirement is that you have tubal as you should not get pregnant after the procedure. It saved my life.
If Novasure is not an option, I would choose C.
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J.C.
answers from
Philadelphia
on
I would get another pap. The lab once messed up my results.
