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Discussion:
Thickened uterine lining
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The nurse called and said my ultrasound showed this and I have to come to get either a biopsy or d and c. I'm so scared right now, I put off going to a gyn my entire life and now I feel like I'm suffering consequences. I'm 52 with no kids or or anyone. I'm not afraid of dying, but I'm terrified of doing it alone and in pain. Everything I google talks about cancer. And I was just about to start fresh with a gastric bypass. I'm sorry I can't even stop crying.
Posted on 09/20/12, 01:00 pm
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Reply #1 - 09/20/12  4:48pm
" I'm sorry for this troubling news! You didn't mention if you're still having regular or occasional periods. During perimenopause when ovulations are less frequent, the lining tends to thicken (usually causing heavier bleeding) but then generally thins back out. The lining is thickest right before menstruation and thinnest right after so it's best to have an ultrasound one or two days after your period stops.

How thick did she say your lining is? This link may be helpful -
http://www.hersfoundation.com/docs/... Also, there are quite a few studies in PubMed if you search on "pubmed endometrial thickness hyperplasia."

Hoping the biopsy shows nothing serious and if you have a D&C that any abnormalities are gone forever! "
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Reply #2 - 09/20/12  6:51pm
" Don't put it off too long. If it is something, early treatment is best and if it is nothing, then you can stop worrying. I wish you all the best. "
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Reply #3 - 09/20/12  8:28pm
" Thank you, I will check out the link. My appt is on 10/16. I've calmed down a bit and may call the nurse tmw just to chat about it. She was the one who calmed my nerves before the first appt.

I will ask her how thick it is, too. My periods stopped a couple of years ago. I had one or two "normal" ones during those years. I'm very heavy and that can cause them to stop. I went in b/c I wanted everything checked out before weight loss surgery, and I was having lower back pain and seeing very light pink tinted blood on tissues and seeing wispy bits of pink mucous or tissue when I urinated.

I told the gyn that although I don't bleed once a month per se, I do feel that i'm having a cycle in terms of water gain, irritability and cravings, once a month. She did blood and urine tests, so I will ask the nurse about this tmw.

Thank you so much. I tend to overreact. "
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Reply #4 - 09/22/12  1:23pm
" Hi I know how scary it is when everything seems to pop up as cancer. I had the same situation. Mine was dx as Adenomyosis. It is like endometriosis inside the uterus. I can't imagine them putting off your appointment to October if they thought it was active cancer.

I just wanted you to know there are several things that can cause this, so take a deep breath and I will be praying for your nerves to calm down and for mild results from your biopsy. Hugs-RJ "
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Reply #5 - 10/09/12  10:10am
" Update:

Prior to appt to discuss d/c, I received a call from gyn doctor, telling me that she decided to refer me to a gyn oncologist b/c he was more suited to "difficult cases". She said it doesn't mean I have cancer, but she wanted to defer to someone with more experience. I saw him yesterday, and he wants to do a d/c and biopsy under general at the hospital. The lining is 16mm. Because of my weight/tummy, he said I'd be tilted way back so a breathing tube would be necessary. He was very nice, but he didn't do the "don't worry; these cases are almost always non cancerous" as I hoped. He also wants to put in some IUD that dispenses meds to compensate for high estrogen. This is all going to happen quite quickly; they gave me the lab slip for preop blood test and referred me back to primary for pre op EKG/physical. I'm trying to go on "auto pilot" in order to stay calm. Despite lack of symptoms, he said previous bloodwork showed me to be in/post menopause. "
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Reply #6 - 10/09/12  12:44pm
" It's good your gyn referred you to an oncologist. Interesting about the IUD. I guess he figures it's easier to insert it while he's in there for the D&C and if not needed for treatment, it will serve as a preventive measure. What's your procedure date? Hope all goes and it's nothing serious! Let us know how you're doing afterwards. "
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Reply #7 - 12/02/12  11:08am
" Update, parts are from another forum. After I posted here, I decided on a different doctor:

One doc wanted to do a d/c and biopsy in hospital under general. I sought second opinion from the head cheese at the local university hospital and while examining me, which isn't easy as I'm over 400 lbs, this is what happened:

He took a look and said very calmly, "would you like me to do the biopsy right now?" I was shocked and looked up at the nurse like WTF lol I babbled umm uh will it hurt? I don't know um... he said "you might feel some cramping" I said well ok he said "ok now what is your name? And what are you giving me permission to do? Are you allergic to iodine? I will have you sign the consent afterwards" I answered and laid back and closed my eyes, keep in mind I had taken a tranquilizer and a vicodin earlier due to anxiety and a pain in my side. I heard him instructing the nurse, then I felt a weird but not painful sensation, almost a deep internal "tickle". Then a very, very slight cramping. He said "ok, all done" While the nurse cleaned me up, I saw a fair amount of blood and she showed me the sample container which just had a little string of red tissue in it. I go back on 11/27 for the news. I bled like a medium period for about 8 hours and that was it.

I asked the doc why the other doc was going to put me through all that when it could be done in office and he said "They don't have the right equipment" I want to go punch the other doc in the balls, I swear. In the hall, this one said "You did great. Anytime I don't get kicked, it means you did great" lol

I hope you go ahead with it, ask questions have the best doc you can find. Make sure he/she is board certified, preferable in both ob/gyn and gyn oncology. Try to get something for anxiety from your primary or the doc who does it. Don't put this off.

The doc called today about the endometrial biopsy and said something about precancerous cells. I was in public so I couldn't have a long discussion. I go back Tues anyway. He said something about early stage, though. Does that mean I could still have cancer? What exactly does precancerous mean?

Saw doctor, he said b/c of my weight he will hold off on hysterectomy until I have gastric bypass and get to a safer weight; got the impression he will only consider lap surgery. In the meantime, 40 mg Megace 2x day, pelvic/abd CAT scan next week and another biopsy in 3 months. This is what the pathology report said, any translations welcome:

"At least endometrial intraepithelial neoplasia (atypical complex hyperplasia); Fragments of benign endocervix.
There are small foci of cribriform architecture which are worrisome for grade 1 endometriod adenocarcinoma"

I don't post this to bum any of you out, but I do want to scare those of you who don't know about uterine cancer and/or are ignoring symptoms. The bottom line is that if you are past menopause and bleeding, even a tiny pink spot or drip in toilet/on paper, demand a biopsy. "
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Reply #8 - 12/02/12  12:45pm
" I'm sorry for your diagnosis. I thought an endometrial biopsy (without D&C) was always an in-office procedure. I assumed the other doctor was doing it in the hospital under general anesthesia because he was doing a D&C (to thin your lining) and the biopsy was going to come from that tissue. A biopsy from D&C can check tissue in various spots of the endometrium versus in-office biopsy that only checks one spot. And since it also removes the endometrium, it's considered both a diagnostic and treatment procedure. I think this is explained in the link I previously provided.

This study http://www.ncbi.nlm.nih.gov/pubmed/... shows the increase in accuracy of D&C for grade 1 although your pathology sounds like it's unclear if you have grade 1 or "just" hyperplasia (by no means am I downplaying hyperplasia). This study says "The final post-hysterectomy FIGO grade was higher in 16/187 (8.7%) cases diagnosed by D&C compared to 52/298 (17.4%) diagnosed by office endometrial sampling (P=0.007)."

According to this link http://www.jfponline.com/Pages.asp?... 57% of complex atypical hyperplasia cases regress with progestin therapy (Megace is a high dose progestin). This link has some stats for progestin therapy for complex atypical hyperplasia as well as well-differentiated endometrial carcinoma - http://www.ncbi.nlm.nih.gov/pubmed/... It also mentions architectural abnormalities. There are a number of other studies in PubMed that may be helpful.

Of course, being obese increases your risk for endometrial hyperplasia. So the gastric bypass surgery (along with progestin therapy) may resolve it (as well as reduce your risk going forward) so you don't even need to undergo another major surgery (hysterectomy). "
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Reply #9 - 12/13/12  1:53am
" Fighting, thank you for all the info. I had a CAT scan and it showed a growth on adrenal gland and a bigger one inside (i think) uterus. "I think" is b/c a routine visit to another type of doc in same system resulted in him printing it out. It showed that the gyn/onc had reviewed it, but he hasn't called me. I saw my primary and showed it to her and she poo pooed the whole thing, saying before all this imaging, people had all sorts of things growing inside them and not to worry. Finally left a msg with the gyn/onc today to call me back to discuss.

I'm pretty sharp, but the lingo the radiologist used is lost on me. Taking the Megace religiously and hoping for the best. It is making me hungry, not conducive to pre gastric bypass loss but I'm stuffing with lots of salad and protein. "
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Reply #10 - 12/13/12  10:17am
" Your primary care doc made a good point. The use of imaging causes a lot of overtreatment, much of which can do more harm than good.

I had my sex organs unnecessarily removed when all my doctor should have done was remove a large, benign ovarian cyst (or worst case, the one ovary). I lament falling for his scare tactics and allowing him to rush me into surgery versus monitoring the cyst (even though he told me that wasn't "possible"). I also mistakenly saw an oncologist he recommended for consultation and he "sold me down the river." My CT scan also showed cysts on my liver and kidneys but no one was concerned about those. I was told these will likely never cause a problem as most cysts don't.

You can contact the non-profit HERS Foundation for help in understanding your pathology report and other medical records related to this diagnosis. "

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