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Poorly Differentiated Papillary Serous Adeno Carcinoma (adenocarcinoma)...Jul 06 '06 (Updated Mar 05 '08) Write an essay on this topic.
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involving endometrial polyp Grade 3. Day 1 July 6, 2006 You get these results. Now what? We are told the doctor won't know the Stage, until the total hysterectomy is completed. That will be in 6 days. 6 days left with this thing inside growing. I hate this thing. (Sorry to my family for the "hate" word, but I can't help it.) Translated means: Poorly differentiated: More abnormal. Serous: Benign, pale yellow, transparent fluid or discharge. Adeno: Gland. Carcinoma: Malignant cancer from epithelial cells. The facts: Adenocarcinoma of the endometrium is typically a disease of postmenopausal women with approximately 85% of the patients being over 50 years of age. Pap smears are positive in a minority of cases of endometrial carcinoma. This type of tumor os not associated with increased circulating estrogens. These tumors metastasize early and account for a disproportionate number of mortalities from endometrial malignancy. Spreading can include local invasion and lymphatic, vascular embolization (Embolization: is treatment to block the flow of blood to a tumor.) The most common spread (metastatic) sites include the cervix, adnexa, and retroperitoneal lymph nodes. (Retroperitoneal is an anatomical term that refers to the relationship of the contents of the abdominal cavity to the peritoneal space. Organs such as the kidneys, bladder, and portions of the duodenum and the colon lie behind the peritoneum and are thus termed retroperitoneal.) *Source: Wikipedia.com* I wanted to write about my research with this to help me cope with my Mom's new partial diagnosis. If anyone has any questions, please feel free to email me or post comments, as any new ones will be emailed to me. Grade The grade is about the cells themselves, and refers to the amount of difference between the healthy and changed cells. Tumor grade is a used to: 1. Identifying cancer cells under a microscope, how abnormal are they? 2. How fast is the tumor likely to grow and spread? Grade 1 or I: Tumor cells look more like normal endometrial cells. Grade 2 or II: Tumor cells are moderately different than normal endometrial cells. Grade 3 or III: Tumor cells look the least like normal endometrial cells. (Poorly differentiated.) This includes deep muscle invasion. When cells are extremely undifferentiated that a pathologist cannot tell which tissue they came from, it is called anaplastic. Anaplastic cells are cancer cells that divide rapidly and bear little or no resemblance to normal cells. Grading is done, in a lab, using cancerous cells taken during biopsy. A pathologist determines the grade using a microscope and tissue sample. There are many different types of grading systems used around the world. The grading system also changes depending on the type of cancer. Generally, a lower grade speculates a less aggressive behavior. A higher grade warns of a comparatively more aggressive cancer. Grading a tumor is not entirely a "cut and dry" process. Pathologists may disagree on the grade of a single tumor. Differentiation Differentiation focuses on how different the tumor cells look, from the original, healthy cells, under the microscope. How much have the healthy cells changed? Signs & Symptoms Endometrial cancer usually presents with abnormal uterine bleeding. My Mom's did NOT. It should be checked in any postmenopausal women with bleeding symptoms. In pre- or perimenopausal women, bleeding abnormalities such as heavy menstrual bleeding (menorrhagia) or bleeding periodically between menses(metrorrhagia) may exist. Less commonly, asymptomatic women may present with an abnormal Pap smear revealing atypical or malignant endometrial cells. A normal Pap smear in a symptomatic woman, however, must never be relied on to exclude endometrial pathology. Stage Stage relates to how far the tumor has entered into the original tissue or grown beyond it. It is easy to confuse the stage of the cancer and its grade. The grade of the tumor, relates to the behavior of the individual malignant cells. The stage pertains to how big the tumor is and how far it has spread. The decision of which treatment to use depends on the cancer's stage. It is vital for the cancer stage to be accurately determined. Then, the treatment can be individualized to the patient's needs. Gynecologic oncologists are considered the best professional for adenocarcinomas. How? Surgical staging is for cancers of the "upper" female reproductive system, *the body of the uterus (not including the cervix), the ovaries, and the fallopian tubes,* can be appropriately assessed through surgery. The removed tissue is examined, and often sent away for testing and assessment. Local lymph nodes may be removed. Peritoneal washing is used to discover malignant cells in peritoneal cavity fluids. The abdominal area is also examined for signs of cancer. What are the cancer stages? There is more than one classification system for staging cancer. For gynecologic cancers, the FIGO system is the most common system used. It is accepted world-wide and is supported by an international standard. Professionals speak with one another and can compare each other's research. These are the main stages of the FIGO system, as it applies to endometrial cancer. Stage 0: Endometrial hyperplasia (abnormal cell growth). Stage 1/I: The tumor is limited to the body of the uterus. Stage 2/II: Uterine body and cervix are involved, but no cancer outside of the uterus. Stage 3/III: Cancer is beyond the uterus, but not outside the pelvis. At stage 3/III, cancer is found in the uterus and in any of the following: peritoneal fluid, ovaries, fallopian tubes or lymph nodes. Stage 4/IV: Cancer is beyond the pelvis; in bladder, bowel or other areas of the body. My Mom had a full staging done. This meant all the organs below were removed to check for cancer to determine the stage. My Mom's staging went this way: Stage 1 - Uterus was removed and will be checked for cancer. (We know she has it here.) Stage 2 - Cervix was removed and will be checked for cancer. (The Doc thinks it is fine, but it will be tested.) Stage 3 - Lymph Nodes were removed from her pelvis and aorta and will be checked for cancer. The Doc found 1 that was "funny" looking. He checked it under the microscope and it looked fine, but he sent it for further testing. Stage 4 - Omentum (A fold of the peritoneum (the thin tissue that lines the abdomen) that surrounds the stomach and other organs in the abdomen) was removed and will be tested. It will take about 1 week for the staging to come back. The stage will be determined by where the cancer cells are found. The uterus would be Stage 1 and the Lymph Nodes are Stage 3. The doctor believes my Mom has an 80% chance of being Stage 1. Even though she might be Stage 1, she will still need to undergo chemotherapy and radiation because of the type of cancer it is. She will have Pap test every 3-4 months now. Don't let your doctors choose a 3-5 year pap plan for you. Go every year. The Pap Test costs about $50 and if it isn't covered by your insurance, Planned Parenthood has a sliding scale for Pap Tests. TREATMENT: Combined therapy with (Adjuvant) platinum-based chemotherapy improves overall and disease-free survival in women with stage I/1 uterine papillary serous carcinoma, researchers at Yale University School of Medicine report. Please read this study to be informed of ONE of your choices: http://www.cancerpage.com/news/article.asp?id=8895 My Mom has been negative about chemo, but based on this and other studies for Stage 1, she should choose this or start looking for her casket. This is a very serious form of cancer. Another doctor told her that microscopically inside her, she may still have cancer cells. First Dose Thursday, September 21, 2006 My Mom started her platinum based chemo today. It went from 9 AM to 2 PM. She is on medication to help with her headaches that were caused by the chemo. She is scheduled to recieve 1 dose of chemo every 3 weeks. Eventually, the doctor will decide when to try her with the paclitaxel/platinum-based chemotherapy or Taxol. Friday, September 22, 2006 Mom is a little tired. We went to look at wigs today. Found a nice wig made by Amy's Presence. You can actually swim, shower, sleep in her wigs. They have Cyberhair, Luxhair, and Synhair wigs. Nice article: http://abclocal.go.com/wls/story?section=websites&id=4250393 More info: http://www.amyspresence.com/ Many insurance companies will pay for a wig, so be sure you have it written as a prescription from your doctor (usually written as "cranial prosthesis"). Unfortunately, Medicare will not pay for wigs. If you must pay for your own wig, remember that it is a medical deduction, for tax purposes. I will let you know how helpful insurance is or isn't soon. Thursday, October 12, 2006 My Mom had her first dose of the Platinum based chemo with Taxol. They didn't add the Platinum until about 1.5 hours after they started the chemo and my Mom did better with the headache part of the chemo. Her haedache didn't start until late that night. They had started chemo at 9 AM. Saturday, October 14, 2006 My Mom is feeling horrible. She feels like someone is ripping her muscles out. She had blood coming out from one of her toes from her blood being too thin? No cut, hole or anything. She has tried 1 pain medicine, will get the name later, and no luck. We are getting pain med #2 soon. Thursday, October 19, 2006 Mom was admitted to the hospital early today. She had shortness of breath, dehydration from excessive diarrhea (running to bathroom about 25 times per day, 3 Urinary Tract Infections ,and low blood sugar. One of her UTI's was Ecoli. She has burns inside both areas from the radiation, but she has sensitive skin anyway, and she skipped her last radiation that was due on Tuesday, October 17. They did tests on: urine, feces, blood, VQ scan to look for possible clot(s) from the chemo (shortness of breath). Mom was released Sunday, October 22, still tired and running to the bathroom. Monday, October 30, 2006 Mom was admitted to the hospital. She had shortness of breath as her main symptom. The tests: Pulmonary, 2 ECG's, and 1 cat scan no contrast. The tests showed no problems. She is looking to be released later today. She has not made up her October 17 radiation yet and the Docs are reducing the amount of chemo and/or radiation because of her being so sick with the chemo (She has Diabetes, Diverticulitis, and Irritable Bowel Syndrome normally). November 2006 The Docs lengthened the amount of time for the chemo and reduced the amount of vaginal cuff radiation. (Also called: brachytherapy: pronounced (BRAY-key-THER-uh-pee) A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called internal radiation, implant radiation, or interstitial radiation therapy. Mom shaved her head and has purchased 2 wigs. We like the wigs, but Mom finds them to be hot and uncomfortable at times. December 2006 Mom had her last treatments!! Yeah! This was absolutely her BEST month. No extra trips to the ER. She is still very tired. She made it through Christmas, but she got upset when she went to take something out of the oven and a small part of her wig melted. (Good thing she has a back-up!) Beware: Wigs will melt from a hot oven door being opened. January 2007 Mom is still very tired. She went to Florida and has had a little trouble being in the direct sun. Since my Mom's diagnosis, 2 of her female friends have also been diagnosed with cancers from having their Pap smears done. One friend is stage 1, the other friend had hers spread and is private about what is going on with her. *** I really can NOT emphasize more, how imporatant Pap Smears are. I have never liked them and also neglected getting them as I should have.*** Not anymore. Gynecologic Tumor Types The basic types of gynecologic tumors: Benign Tumors are not cancerous (not malignant). They can still be problematic, but are considered more survivable. An example is a uterine fibroid . Benign tumors can occur in any of the female reproductive organs. Tumors of Low Malignant Potential are a category of ovarian tumors that are not likely to spread. Malignant (Cancerous) Tumors Main types: Carcinomas start in epithelial cells. Epithelial tissue covers the entire surface of the body. It is made up of cells closely packed and arranged in one or more layers. This tissue is special because it forms the covering or lining of all of our internal and external body surfaces. Common types of gynecologic carcinomas are: Squamous Cell Carcinomas: Squamous cells are flat cells. They are found mostly on surfaces that are in contact with the outside environment. The cancer spark for squamous cell tumors is often environmental. The sun and HPV are two of the most common factors in encouraging squamous cell carcinoma growth. This type of cancer is the most common in the vulva, vagina, and cervix (gynecologically speaking). Adenocarcinomas The prefix "adeno" means gland and refers to glandular cells. Adenocarcinomas occur in tissues that discharge a liquid. Ovarian and endometrial glandular tissues release hormones. Most endometrial and ovarian cancers are adenocarcinomas. The Tests *Pap Smear* If anyone would like to do me a favor and pray for my Mom, Elaine, it would be greatly appreciated. After all, doctors haven't proven why prayer works, just that it does. ; ) Facts and some great pictures of this disease can be found here: https://www.moffitt.usf.edu/pubs/ccj/v6n4/article4.htm *This is NOT medical advice. This is intended to provide further informational and educational knowledge. This should not be used as a substitute for medical advice. Too frequently, patients are left to worry, until their next visit, or searching for any information they can find on their own. Humans are different. This is one human's account of what they faced and how/where to find out more information. Anyone having questions about applying information appearing here to a specific person or situation should obtain medical advice from a qualified physician.  |
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