tamoxifin and endometrial cancer
Comments
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I thought the in office endo bx was a piece of cake and the hosp D&C was not much worse, home a few hours later. I guess it's all relative, after doing the bc. The in office bx hurts like a bad menstrual cramp, but just hurts for less than a minute. It's a good idea to take some ibuprofen prior ro the procedure. My sister went with me to the bx and we went out to lunch right after!
Of course for the D&C you remember nothing.
While not everyone has post menopausal bleeding, please do not ignore it and report any episodes to your gyn for prompt evaluation.
Dreaming,
I also have a small piece of mesh in my abdomen which was a problem for an abdominal hyst. I was being urged for the past 1 1/2 years to have a hyst b/c the uterine lining was already at 17mm and appeared to just keep getting thicker. I wouldn't consent to another abd surgery, so my gyn sent me to a gyn/onc who completed the hyst via davinvi robotic surgery. The recovery is probably a third quicker, and 6 tiny incisions.
Seaside, hope you are feeling better today.
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Jennifer:
I hope all went well and you are feeling better today!
Jan
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Thanks ladies for asking about me!
The D&C went just fine yesterday. They were running right on schedule so didn't have a whole lot of time to get freaked-out which was a good thing!
The procedure was done under a very light anesthesia so you are asleep and remember nothing but, not so deep that you require a breathing tube or anything like that. I had asked in the office if I should stop taking the TAM just prior to the procedure and was told no.
They did put a pair of lovely compression stockings on and gave me a low dose shot of Heparin but, I think he was just being overly cautious because of the slight increased risk of blood clots from the TAM.
Once they got me all set and wheeled me off to the OR my husband said it was only 15 minutes before it was all over and they came out to talk to him. Was in the recovery room for about an hour then moved to another room where my husband could come in. Arrival to departure a little over 2 hours.
They gave me a pain pill before I left (although I was in NO pain what so ever). Was a little loopy and had/still have some spotting but do not hurt at all. Will get my results on Monday but, he did tell my husband they took a look around with a hysteroscope and he is pretty certain it is benign but, only the patholgist can tell for sure so, Monday it is!
While, I'm sure that each place and doctor is different, hopefully this gives anyone having to have this done a picture of what's involved.
To the girls having an endometrial biopsy done,
I've not had that done but they did have to do a saline ultrasound in the office which requires that they pass a small tube through the cervix to fill the uterus with saline. I was told to take 4 Advil (the nurse specifically said Advil and NOT Tylenol) about 1 hour prior to the procedure. Really wasn't too bad. Like someone mentioned before. Felt a bit like a menstrual cramp but, was over quickly.
You might want to check with your doctor prior to see if maybe taking some Advil will be OK.
Hope all goes well for everyone! Will let you all know the results on Monday.
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I'm 2 1/2 years on Tamoxifen, last month I had my 2nd Endometrial biopsy ( due to unusual bleeding), and my first trans vaginal ultrasound. All was fine even w/ the unusual bleeding..I'm blaming it on a mix of tamoxifen and peri menopause ... The Endometrial biopsy is similar to a pap....no big deal...
kle
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Nanay!
I would very much like to find out about DIM as I am very reluctant to begin hormone treatment: i.e. Aromasin. Where can I find information about it?. I have no idea what it is.
Thanks so much!
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srbreastcancersurvivor,
Lots of good discussion over on the Alternative, Complementary & Holistic Treatment forum. Just do a search on DIM and narrow your choices to that forum and you will see several threads that have information about it.
I plan to head over there to read about it when I get a few minutes!
Hope this helps!
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Hi Chocolat !
I second the other posts and would suggest that you take some pain killing meds before. Maybe, I'm an exception or perhaps some gynecos are more gentle than others.
Had so much pain in the pelvic area at my first chemo, presented at the ER thinking I had a bladder or urinary tract infection. Maybe, chemo damaged something down there. Went yesterday for a repeat PAP, as there was blood on the first one. WAITING for results, as always !
Keep strong
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For those of you wondering about the leg compression devices, these are routinely used for any OR procedure just because having surgery and being immobilized for the time of the procedure can all cause a higher risk of blood clots. I work in Labor and Delivery and we put them on everybody going for a C/Section, tubal ligation, or any other OR procedure.
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Seaside: I just wanted to thank you for all the info about your procedure. It sounds like everything went smoothly and now you wait for results. I will see the GYN on Tuesday and find out more about my u/s results and what tests await me. I wish you the best outcome for your biopsy results on Monday! I'm glad the weekend is here and wish everyone a great weekend.
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I am getting an endometrial biopsy on Wed... Also was suggested I take ibuprofen. I was reading this board since I was told tomaxifin would be suggested after I am done with other tx--- chemo dads. Then they found a mass within the wall of my vagina___ the front wall. I have a small amount of endometrial thickening. This board is helpful!!!
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I am getting an endometrial biopsy done today at 2. I had a pelvic ultrasound last week and they said everything looks "good". My ob/gyn office calls me and says my Dr. wanted this biopsy done as the lining was thicker.... sounds like many of your stories. I have been freaking out and crying all weekkend. I know the risk of this being cancer is low, but there is still a risk. Have only been on Tamox since August Just passing my one year anniversary of dx, and everything that followed. Still doing Herceptin and in the reconstruction process til this fall. I really need some good news today. My guess is I won't really know for sure until after the pathologist reports his findings. ?? Or does your OB Dr. tell you more at the bx appt.? Thank you all for listening. Praying for all going through this.
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Hi gals,
Laurie: Don't know if u've gone or back. In any case, I hope everything went well.
I believe it's standard practice - thickened endo = biopsy. I know exactly how it feels to have that hatchet over one's head
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A few months before BC diagnosis, I had a pelvic US that showed a "lesion" on my ovary. They told me to come back in a month because this was typically due to menstruation. I got busy, then got BC, haven't been back since.
Also, the US tech couldn't get an image of my left ovary at all because it is way too far left..
Does anyone else have a bicornuate uterus? I have one and for some reason had to have c-sections because of it (my 2nd was almost 2 months early because he grew in the small side).
Add to all that the fact my periods have never been regular (hormone issues my whole life), and when they come I become anemic..
That is why Tamox concerns me.
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Today I saw the GYN and found out that it is not routine here in Vancouver to follow up with pelvic u/s when you're on Tamoxifen. She read the radiologist report and found everything described is not unusual when taking Tamoxifen. There was no measurement given for my uterine lining so don't know that info. After taking my history (no spotting since menopause, normal PAP tests) we decided that the Dr will get more info and I'll see her in two weeks. After reading this board I'm inclining to get the biopsy in two weeks. I will be switching to Aromisin in May so if I get the "all clear" I might not need to get a hysterectomy. I'll have more info in two weeks and can think about it until then. I'm OK with that and had a good raport with this doctor.
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I hope all of those that have bx scheduled are well -- I just want to relay that I had two children delivered by C-section as I could never dilate and attempting the bx in the office was pretty much torture. I had to go have a D and C anyway (and a cone biopsy as it turned out there were some cervical issues) but I will never allow a biopsy in the office again, yikes!!! that was after 4 iboprofen and a zanax. i knew when the np couldn't do it and they called in the doc, i was in trouble.......anyway, all over now and I am a year later, just had a pap yesterday and i forgot all about asking about the trans vaginal test, which is easy as anything, but I am nervous about having another as I know if uterine is thickening again, where I will be. Actually the drugs are so good when you have a d and c - and the nurse actually looked like a deer with glasses on. I was having a bite to eat at a restaurant a few hours later and work the next day. Maybe I am a baby, but rather have surgery than a biopsy - my breast biopsy was also awful but the surgeries were a breeze, go figure.....
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I had a thickened endometrial lining just prior to my BC dx. My Ob/gyn told me it was caused by "post-menopausal weight gain which increased the "bad" estrogen". She had me go for a transvaginal ultrasound - the lining was 8mm thick, with a large fibroid - and I had a small cyst on each ovary which she said they would monitor with yearly US. Then came my BC dx, and the first thing I researched was how tamoxifen could cause endometrial cancer - so I immediately told my BS that I'd NEVER take tamoxifen unless he agreed to a hysterectomy - but he reassured me saying that since I was already post-menopausal, I would be given Arimidex (which doesn't cause endometrial cancer.)
After my mx and year of Herceptin I went for my yearly ultrasound, and the lining and fibroid grew, so I got very nervous and saw a gynecological oncologist. I wrote to him prior to my visit, gave him my full history, and said that I'd like a hysterectomy (including removal of ovaries) because I was so fearful of getting endometrial and ovarian cancer (even though I was BRCA negative). This doctor (a big-wig at a major hospital) fought and wrestled with me over this idea - and finally I won - he agreed to do it, even though he said it was "unethical" because there was no "evidence-based medicine" showing that I really needed that surgery . Once the wrestling match was over - I started to "think outside the box" and came to the understanding that HE WAS RIGHT - and that I should be more fearful of getting MRSA again rather than endometrial cancer. (Please visit http://www.hospitalinfection.org/ for life-saving info on MRSA and C-Diff.) So I never had the operation done.
My mind was put at rest somewhat when he agreed to do an endometrial biopsy (because the thickness of the lining was at the "cusp" of abnormal measurements - and this was only 8 mm!) The biopsy was done in his office - and it was VERY uncomfortable and painful (having had 3 c-sections and never going through labor at all, it was MUCH worse than just menstrual cramps) - but it WAS over quickly. And the good news was that everything was benign.
Fast forward two years later on Arimidex - I got my yearly "dildo scan" (sorry for the disgusting term, but that's what a vaginal ultrasound is really like) - and low and behold, my endometrial lining has SHRUKEN to practically nothing - and the fibroid is nearly gone too. The cysts on the ovaries are so tiny, then can't see it - and THIS is all due to the power of Arimidex! (I never lost any weight - and didn't use any alternative medicine or change my diet, unfortunately.) THIS is "evidence based medicine" that I can live with..........even though I have all sorts of arthiritis-like aches and pains - knowing that the Arimidex has removed the effects of the "bad post-menopausal" estrogen in my body is so wonderful - that I called my girl-friend who had Stage 3 Endometrial cancer (with a full hysterectomy, internal radiation and strong chemo) and asked her if the oncologist put her on any kind of anti-estrogen medication (we have the same oncnologist) - and she replied NO. I was SHOCKED! The doctors KNOW that in most post-menopausal women, endometrial cancers are caused by excess estrogen (at least that's what my ob/gyn told me) so WHY wouldn't they use an anti-hormonal for a Stage 3 cancer victim? My girl-friend asked our oncologist if she could go on Arimidex - he said he'd check with the big-shots endometrial specialists down at Sloan-Kettering - and the big-shots all said YES! That a new study is out showing that Arimidex reduces the recurrence of endometrial cancer! So my girl-friend is now on Arimidex too (but only for one year - that's what the study said she only needed.) And our oncologist told me - "you should have been an oncologist!" which made me laugh because so MANY of us here at bc.org have learned SO much about anti-cancer meds we could ALL become our own oncologists, lol!
Sorry to be so long-winded but I just wanted to share this story with you all about my experience with my own fears of endometrial cancer and how I didn't give in to my fears - even after verbally arguing (much like a lawyer) with a very important oncological gynecologist who would have given in to my request for more surgery. And I hope the knowledge that Arimidex can help fight endometrial cancer is useful to any patients who, like me, are post-menopausal.
Dianeinil - thanks for starting this thred - it's VERY important information!
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Bravo Dianeinil for having won your case!! The more educate we are
The more power to us
Aggiecat - after 2 yyears of tamox i would definetely insist on biopsy
if only to have your mind at peace.
Traveller - thanks - u explained my
Excrutiating pain - dilation !! -
Soorry i meant bravo swimangel
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Thank you again, ladies. Yes, I think I will get the biopsy even though I'm a wimp about the pain! Better toughen up!
Seaside: Did you get your biopsy results yet? Hope all is well. -
Unfortunately, I was not told to take any pain killers prior to my endometrial biopsy. I just feel the need to counterbalance those who have said it is like getting a pap or similar to that. I found it extremely painful, and will never have another one without anesthesia if I can help it. After the procedure I became light headed and nauseous from my body's reaction to the pain, my dh had to come get me and bring me home and I spent the rest of the afternoon in bed resting. Guess I'm a wimp...
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One other thing I wondered is there much bleeding after the biopsy? I have not had a period for so many years I don't have any supplies around. Do you need a pad for after the biopsy? Thanks.
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No Aggiecat, just pain, but hey u might be one of the lucky ones
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Vivre, can you point to some studies showing DIM does the exact same thing? My general understanding is, there are no long term studies to prove its efficacy, and like many of the naturopathic alternatives, it is more an educated hunch based on small studies.
I would love to switch over to DIM. I would love to ditch the Tamox, but I'm afraid. As a young survivor, I feel like I have a lot going against me.
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I had bleeding for quite awhile yes a light day pad will work
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you are lucky
I had bleeding for quite awhile -
Aggiecat52,
I had a D&C done not a biopsy so can't talk specifically about that. With the D&C it was done in the hospital as an outpatient procedure, I was given anesthesia similar to what you would get for a colonoscopy. Did not remember a thing about the procedure and the pain afterward was minimal. Small amount of spotting for around 5 days... By small I mean, you had to wear something along the lines of a "light days" pad!
That being said... The Gyn spoke to my husband while I was in recovery and said everything looked fine (they took a peek around with a scope (hysteroscopy) before the D&C) but that what they removed would be sent to pathology and, of course, they have the final say! Got benign results last Monday.
Since I have not spoken with the actual doctor (he was on vacation this week), I set up an appointment to talk about where do we go from here? That appointment is May 5.
As an aside, I will also meet with my medical oncologist in May (the tamoxifen prescriber). I know he has told me in the past that he is NOT a fan of the monitoring via ultrasound as that can and does lead to, in his words, many false alarms and un-necessary procedures. He prefers to go by any unusual bleeding...
But yet, you see cases such as the original post here where there was really no indication that anything was wrong.....
Hoping to sort out some kind of balance of monitoring techniques that I feel comfortable with. Will post more when I know more!
Hope this helps...
Best of luck to all going through this added stress!!
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Glad your D & C was benign, Seaside. Looks like there could be some bleeding from the biopsy. Thanks for the info, ladies. Now I know what to expect.>
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It is a relief to know that there are others out there going through the same thing! I am on my 2nd biopsy, 2nd transvaginal ultrasound, one D&C and am going crazy. My periods were EXTREMELY regular before DX at age 48. I knew my body was nowhere near to being ready for menopause. But now months will go by, I will think I am on the way, and then out of the blue: a period. My lining is extremely thick this time (I will get the actual numbers this afternoon), but I just wonder: if tamoxifen and chemo haven't put me fully into menopause, maybe I should just ask for a hysterectomy? Does anyone have any opinion on this? I am 50 now.
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Comingtoterms: how long have you been on tamox? Why 2 biopsies + the TVU ? My gyneco told me that TVUs are not useful once your endometrium has thickened. That from there, it is a guessing game.....I would definitely feel better though to have TVUs at 6 months to tell you the truth. I mean, what about my ovaries ???
Initially, my onco had told me tamox for 2 years then AIs, last time I saw him, he told me 5 years of tamox. Asked my gyneco for hormone levels which I will give to my onco...(btw, don't have full confidence in the onco)
We have to be our own advocates in this BC nightmare, I tell you ! -
I am ER+ and Onc wants to start me on Tamox soon (not sure if before rads or after).
I am going to see a OBGYN Onc....what should I ask for as far as hormonal testing??
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