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Re: adenocarcinoma of endometrium and 'natural' treatmentsFrom: Marco A. Pelosi, III, MD (marcop@agoron.com)Tue Mar 20 21:01:35 2001
At Mon, 19 Mar 2001, Carlos Roure MD wrote: > >Recently saw a 42 yo female with longstanding history of prolactin in >the 100 range, prolongued amenorrea (LMP about 1 year ago) who several >years ago had a diagnoses of adenocarcinoma of endometrium treated with >megace and "it went away". >By October of 2000 her gynecologist does an office D&C and >adenocarcinoma of endometrium is again diagnosed. TAH advised but >patient is now a Jehova's witness, serious believer in the healing >powers of God and nature and runs away to a natural healer who >prescribes all sorts of treatments from mud (barro) to ajonjoli tampons, >vitamins, herbs and what have you. >Three months later her natural healer askes her to return to mundane >medicine, her gyn gto see if she's healed. >It is a long story but bottom line is she arrives at mine. Endometrial >thickness is 14 mm, she is not bleeding at all for a year, and several >endometrial aspirfation curettages show basically no endometrial tissue. >She is very happy as this is a sign that she is cured but agrees to an >inhospital histerocopy curettage. En hysteroscopy the endometrium seems >atrophic and lots of sharpe curettages shows basically no endometrial >tissue again. The hospita Pathologist reviews the october sample and >agrees it is adenocarcinoma of endometrium, very well diff. >Sshe does not want any treatment for elev. prolactin but. Aside from >what she will desire and interpret this as meaning what would be your >advise to this patient. Be advised that she is a very nice person. > >Carlos > Kudos to the bush doctor. He probably treated a tumor limited to the endometrium, but no one can prove this. This woman would benefit from chest X-ray and an MRI of the abdomen and pelvis with attention to the pelvic and paraaortic lymph nodes since she refuses surgery. Also, if you have the chance to perform another curettage, send a sample for progesterone receptor status and take peritoneal washings via culdocentesis.
-- M.A. Pelosi, III, MD
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