WOMENS-HEALTH Messages for March, 2002: Re: [Birth Control] ADENOCARCINOMA & CHRONIC ENDOCERVICITIS

Re: [Birth Control] ADENOCARCINOMA & CHRONIC ENDOCERVICITIS

From: Leena (anonymous@obgyn.net)
Mon, 4 Mar 2002 04:31:15 -0600 (CST)

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In reply to: William F. von Almen, II, MD, FACOG: "Re: [Birth Control] ADENOCARCINOMA & CHRONIC ENDOCERVICITIS"

Hello Doctor,

My friend was recently diagnosed with adenocarcinoma endometrium. She is a newly wed who is only 31 years old and has no kids yet. For many years she was suffering with heavy bleeding and severe pain during her period. Recently her gynacologist did a D&C on her and when the results came she was diagnosed with adenocarcinoma endometrium cancer. The final pathologist's report says "The Specimen sent as 'EA' shows features of well differentiated adenocarcinoma with squamous metaplasia and foci of atypical hyperplasia. 'ECC' shows Chronic endocervicitis." Her cancer is in Stage I.

A group of Gynacologists that is currently treating her suggested that since she is young they are going to take a chance for a month by treating her with reverse hormonal therapy with Provera (Medroxyprogesterone acetate) 10mg to be taken 3 times a day. After a month they are going to do another biopsy on her to see whether the cancer cells have shrunk. If not, they will be doing a total abdominal hysterectomy (uterus, ovaries, and fallopian tubes to be removed).

My questions are as follows:

1. Even if this particular treatment appears to respond by shrinking the cancer cells and thus they decide not to do the hysterectomy right away, won't she have to keep taking the Provera? She and her husband would like to try for a baby before they do the hysterectomy but I recently read in an article that Provera is a contraceptive and if that is true won't there be a problem for her to conceive? Will that be too much of a risk for her to wait at least a year to have a baby or is it safer for her to immediately remove the uterus due to the adenocarcinoma endometrium?

2.The biopsy report (not the hysterectomy specimen) also shows that she has chronic endocervicitis, was this caused by the adenocarcinoma or was there another cause such as STD? Does she need to be treated specifically for this? Does her husband need treatment for this too since I read somewhere that this is contagious and if left untreated it might cause other complications? If endocervicitis was not caused by STD, and is caused by adenocarcinoma then does that mean that this was still caused by the same bacteria (chlamydia trachomatis)? If so then does she and her husband still need treatment for this?

Kindly provide me with your valuable opinion and suggestions with regards to this matter.

Thanks and I greatly appreciate your advise and help.

--
Leena

At Sat,  2 Mar 2002, William F. von Almen, II, MD, FACOG wrote:
>
>At Sat,  2 Mar 2002, Leena wrote:
>>
>>Hello Doctor,
>>
>>My friend was recently diagnosed with adenocarcinoma endometrium.  Her
>>cancer is in Stage I and she is currently being treated for that.  My
>>questions is that the report also shows that she has chronic
>>endocervicitis, was this caused by the adenocarcinoma or was there
>>another cause such as STD? Does she need to be treated specifically for
>>this? Does her husband need treatment for this too since I read
>>somewhere that this is contagious and harmful? If endocervicitis was not
>>caused by STD, and is caused by adenocarcinoma then does that mean that
>>this was still caused by the same bacteria (chlamydia trachomatis)? If
>>so then does she and her husband still need treatment for this?
>>
>>Kindly advise about this matter.
>>
>>Thank you very much
>>
>>--
>>Leena
>>
>Leena
>
>I would not worry about that diagnosis.  I would venture to bet that a
>pathologist will read that into almost every hysterectomy specimen he
>sees.  It is very nonspecific and not to cause any worry
>
>--
>William F. von Almen, II, MD, FACOG
>Chairman, Editorial Advisory Board
>Pregnancy and Birth Section
>Private Practice
>New Orleans, La.
>
>*Please understand I can not respond to private emails.
>
>*These comments are for educational purposes only.  They are
>not meant to take the place of an examination by a qualified
>health care provider.  They are not intended to be the start
>of a physician-patient relationship.
>

Next message: Leena: "[Birth Control] PROVERA & ADENOCARCINOMA"
Previous message: William F. von Almen, II, MD, FACOG: "Re: Ovulation Pains"
In reply to: William F. von Almen, II, MD, FACOG: "Re: [Birth Control] ADENOCARCINOMA & CHRONIC ENDOCERVICITIS"

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