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Cancer

Occasionally, while seeking out a treatment option for uterine fibroids, diagnostic tests can reveal conditions that include more than just benign fibroids. This issue has been brought to my attention personally during the last several years when women seeking out information on uterine artery embolization as a treatment option for their symptomatic uterine fibroids were directed to go back to their physician and ask about an endometrial biopsy.

The heavy bleeding these women were experiencing simply required a closer look to ensure that hyperplasia or endometrial cancer wasn't present before they ventured down the road to making a treatment decision such as uterine artery embolization.

On several occasions now, women have reported back to me that they were shocked to discover they had endometrial cancer. They knew they had fibroids. They knew they were experiencing heavy bleeding over a very long period of time (many months/years). They knew they did not want a hysterectomy and, therefore, chose not to return to their gynecologist for follow-up care after receiving the standard recommendation for hysterectomy.

What they didn't know was that heavy, prolonged bleeding of this nature could be indicative of other, more serious problems than uterine fibroids. Although these women chose to finally seek out care again so that they could undergo uterine artery embolization, they ultimately ended up with hysterectomy and chemotherapy.

Although uterine fibroids may be present in your body, symptoms that you experience may or may not be the direct result of those uterine fibroids. Appropriate diagnostic tests administered regularly during the "watchful waiting" phase of fibroid growth and development is critical.

If your doctor recommends a hysterectomy and you don't believe that to be an appropriate treatment option, do NOT confuse your disagreement with your physician over this issue with the need to be appropriately tested on a regular basis.

I'm begging you here....

Please don't make the same mistake I did and end up with hyperplasia or worse as a result. Bite your tongue, haul your butt into a doctor and, at a minimum, insist upon annual tests to ensure that your body hasn't chosen to develop additional disease beyond fibroids. If your doctor doesn't want to do the tests because s/he simply believes you should undergo a hysterectomy instead, either look that doctor square in the eyes and lay it on the line about your preferences OR find a doctor who WILL do the necessary tests.

Annual pap smears are an absolute must as are endometrial biopsies when heavy bleeding is present.

If and when a gynecological cancer is diagnosed, most of the treatment options (other than hysterectomy) for uterine fibroids are no longer an option at all. Even so, you might be surprised to learn that there are many women diagnosed with a gynecological cancer who are not interested in hearing about hysterectomy as a treatment option.

RAPIDLY GROWING FIBROIDS

So, did you hear the story about the rapidly growing fibroids? Seems that every woman presenting with fibroids has them but no one really knows what they are or what is meant by "rapid growth." Apparently all that rapid growth spells trouble - potential cancer - immediate need for a hysterectomy.

Realistic statistics on true incidence of cancerous fibroids (leiomyosarcoma) is less than 1% for the entire lifetime of a woman.

So what is, exactly, the definition of a rapidly growing fibroid?

Any uterus increasing in gestational size of 6 weeks or more during the course of an entire year could be considered a rapidly growing fibroid tumor.

This is dependent upon size verification with ultrasound or MRI and then, 1 year later, a second check - again with ultrasound or MRI - to determine the growth during the course of the year.

Recent research, however, has shown that even when a fibroid is diagnosed as rapidly growing, it is cancerous less than 3 in 1,000 cases. Only .25% of rapidly growing fibroids are truly cancerous!

Because cancer can be frightening and deadly, nobody, I mean nobody, wants to mess around with a diagnosis of cancer. However, you might want to think seriously about the low risk factors presented in the preceding paragraph and discuss with your physician in greater depth the probability of whether or not the diagnosis really is cancer before you choose a surgical option that may be entirely unnecessary and change the quality of your life forever.

Reasons for avoiding hysterectomy even when cancer is present, include all of the following:

Anyone who has watched and experienced the death of a loved one from any of the gynecological cancers will tell you one thing: if cancer is diagnosed, please get the appropriately recommended treatment. Even if it is hysterectomy. Learn as much as you can about your condition and work with your doctors to resolve this illness from your body.

A Very Personal Story...

Oleta Mae Dossett
My mother's youngest sister and an incredible aunt, that's for certain. I loved her so much that words can't even begin to express the loss to my soul when this woman died. Gynecological cancer.

I was around 20 or so years old when cancer finally took Oleta from us -- after a valiant struggle for survival her body could simply not withstand the invasion of cancer any longer. Her oldest daughter was less than a year older than me and her youngest was around age 9 or so when she passed on. A lot of children came in-between the oldest and youngest because this woman LOVED children. In fact, I don't believe she was anything more than a child at heart herself her entire life. Maybe that's why I loved her so much. I'm not sure I ever knew or saw my mother's baby sister as anything but a positive spirit filled with love, fun, and mischief forever twinkling in her eyes.

I miss her.

Please, this means a lot to me -- get the appropriate tests you need to stay on top of your symptomatic uterine fibroids and ensure that you do not or have not developed any additional disease that requires treatment. If you do find you have a gynecological cancer, please get the appropriately recommended treatment as quickly as possible.

My aunt postponed getting the diagnosis as well as the recommended treatment she needed.

My aunt died.

I miss her.

So do her children.

P.S. Annie Bell...if you're out there and you ever read this, please call me. I love you and miss you as much as I miss your mother. Carla Bell

Link
Site Name/Author
What You'll Find
www.eyesontheprize.org/ Eyes on the Prize The mission of this nonprofit organization is to provide information and emotional support from the survivors' perspective to women with gynecologic cancers, their families and friends, and healthcare providers. Founded by cancer survivors, this website represents an incredibly comprehensive resource for women with gynecologic cancers.
www.cancerguide.org/ Steve Dunn CancerGuide is dedicated to helping you find the answers to your questions about cancer, and especially to helping you find the questions you need to ask. Steve Dunn, a cancer survivor himself, has provided one of the most comprehensive cancer sites on the 'net today. From "soup to nuts," this guide will lead you through the process of learning everything you possibly can about your specific cancer type.
www.ncsdf.org/index.html National Cancer Survivors Day Foundation, Inc. A Celebration of Life. Mark your calendars for June 3, 2001 and check with the organizers on this site for a location of celebration in your community. (In northern California, check out this site: http://www.survivorsday.com/)
www.royalmarsden.org/
home.asp
The Royal Marsden The Royal Marsden is the UK's leading comprehensive cancer center. Many patient information booklets on cancer and cancer therapies simply written. Home of Captain Chemo -- an interactive computer game that teaches children about chemotherapy. (Adults can play too! Even so, when I played this game it evoked tremendous emotions over just how difficult it was to kill the cancer cells. Be forewarned that your heart and soul will be touched by this game.)
www.obgyn.net/women/
articles/rich/stats.htm
William M. Rich, M.D.
Clinical Professor of Obstetrics and Gynecology University of California, San Francisco Director of Gynecologic Oncology University Medical Center
Fresno, California
Cancer Statistics. Discussion of cancer statistics, what they mean, and how to interpret/apply them to your own risk factors.

oncology.medscape.com/
moffitt/CancerControl/
1999/v06.n04/cc0604.
05.cava/cc0604.05.
cava-01.html

You must be registered at Medscape before this link will work.

Medscape
Cancer Control: Journal of the Moffitt Cancer Center®
Denis Cavanagh, MD, James V. Fiorica, MD, Mitchel S. Hoffman, MD, John Durfee, MD, and Santo V. Nicosia, MD, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology at the University of South Florida College of Medicine, Tampa, Fla.

Adenocarcinoma of the Endometrium: An Institutional Review

Cancer Control; JMCC 6(4):354-360, 1999

www.pslgroup.com/dg/be3a6.htm Doctor's Guide to Medical and Other News Ultrasound Procedure Detects Uterine Cancer And Disease 11/4/98

womenshealth.medscape.com/
Medscape/features/newsbeat/
1999/CerCan.html

You must be registered at Medscape before this link will work.

Medscape Concurrent Cisplatin and Radiation Extend Survival in Cervical Carcinoma
cancer.med.upenn.edu/
psychosocial/
University of Pennsylvania Cancer Center Psychosocial Support and Personal Experiences (for cancer patients and family members)
www.cdc.gov/od/owh/whbc.htm Center for Disease Control Breast and Cervical Cancer info
www.noah-health.org/english/
illness/cancer/nci/
cancernet/201176.html
National Cancer Institute Endometrial Cancer explanation/details
pages.ivillage.com/grammac2/ "Carolyn" Endometrial/Uterine Cancer -- Woman to Woman From a Patient's Perspective. Journal of Carolyn and her discovery of uterine cancer.
www.noah-health.org/english/
illness/cancer/nci/cancernet/
200950.html
National Cancer Institute Ovarian epithelial cancer
www.noah-health.org/english/
illness/cancer/nci/
cancernet/203371.html
National Cancer Institute Uterine sarcoma
www.noah-health.org/english/
illness/cancer/nci/
cancernet/200103.html
National Cancer Institute Cervical cancer
www.noah-health.org/english/
illness/cancer/nci/
cancernet/201055.html
National Cancer Institute Vaginal cancer
imsdd.meb.uni-bonn.de/
cancernet/
National Cancer Institute
University of Bonn, Medical Center; MedNews
Main index entry point for searching cancer database.
www.meb.uni-bonn.de
/cancernet
/103371.html
National Cancer Institute
University of Bonn, Medical Center; MedNews
Uterine sarcoma.
www.meb.uni-bonn.de/
cancernet/
701190.html
National Cancer Institute
University of Bonn, Medical Center; MedNews
Abstract review/listing for January 1999.
www.meb.uni-bonn.de/
cancernet/
101176.html
National Cancer Institute
University of Bonn, Medical Center; MedNews
Endometrial cancer. For healthcare professionals. Literature review.
www.meb.uni-bonn.de/
cancernet/
306754.html
National Cancer Institute
University of Bonn, Medical Center; MedNews
Prevention of Endometrial Cancer
www.sma.org.sg/smj/3801/
articles/3801a1.htm
Singapore Medical Journal
S P Ho, K T Tan, M W Y Pang, T H Ho
Endometrial Hyperplasia And The Risk Of Endometrial Carcinoma
www.mef.hr/
~mkopljar/ec/ec.htm
unknown; sponsored by XOOM education ring Endometrial Cancer for laymen and students
www.cancerlinks.org/ Cancerlinks.org CANCERLINKS SEARCH WEBSITE
www.cancerlinks.com/ Cancerlinks LLC Additional portal for more cancer links.
www.cancerlynx.com Cancerlinks LLC An online e-zine for cancer patients and professionals.
www.sgo.org/ Society for Gynecologic Oncologists Non-profit international organization made up of obstetricians and gynecologists specializing in gynecologic oncology.
www.cancer.org/ American Cancer Society Incredibly comprehensive site on cancer, treatments, and research providing a tremendous amount of information and containing links to every State division of their organization.
medweb.bham.ac.uk/
cancerhelp/
Cancerhelp UK A free information service about cancer and cancer care for the general public and health care professionals.
www.wcn.org/ Women's Cancer Network Physicians dedicated to preventing, detecting, and conquering cancer in women.
www.ocac.ca/ Ovarian Cancer Alliance Canada Federally incorporated in 1998 as a grassroots non-profit organization by women with Ovarian Cancer, those at increased risk of Ovarian Cancer, families, friends and medical professionals.
www.ovarian.org National Ovarian Cancer Coalition Grassroots ovarian cancer awareness organization.
www.cancersupportivecare.com Ernest H. Rosenbaum, MD
Isadora R. Rosenbaum, MA
The Cancer Supportive Care Program based on the book by Ernest H. Rosenbaum, MD & Isadora R. Rosenbaum, MA, Somerville House Publishing, Toronto, 1998.
www.gillettecancerconnect.org/
forwomen/forwomen.html
Gillette Women’s Cancer Connection, The Gillette Company Provides women, their families and friends with access to vital connections needed to address the profound emotional and social issues brought on by breast or gynecological cancer.

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