Women who don't have BRCA mutations could have other high-risk genes that affect treatment choices
by Deligirl1 on Fri Aug 15, 2008 12:00 AM
by trehouse60 on Fri Aug 15, 2008 12:00 AM
On 8/15/2008 Deligirl1 wrote:Hello, I just had a endometrial biopsy(DNC) yesterday and am awaiting results. The reason my dr ordered was enlarged uterus plus endometrial fluid found during a vaginal ultrasound. I do not have bloody discharge, but "regular" discharge has increased slightly. What scares me is that the first thing Dr said yesterday was that fluid in the endometrium is not a good thing and is a symptom of uterine cancer. BUT everything I look up says nothing about "endo fluid" can some one give me some input, is the fluid she refers to a discharge of some sort?? I am so scared and for the next 10 days until results I will be a wreck.. Thanks in advance for any insight or if anyone else has my symptoms.
I can try to answer your question, but I cannot be absolutely sure I will be getting at the same thing to which your dr was referring. Therefore, I think the best thing you could do is to call your dr's office, talk to his nurse - tell the nurse you don't really understand what the dr was talking about and you would like some clarification. The nurse might actually be able to answer your question, or if not, ask to have the dr call you when she gets time, hopefully soon. My family practice clinic is linked into an internet system where you can email the docs, get lab results, see graphics on weight and blood pressure etc - I use it to email my doctor when I have questions and concerns, and she gets back to me quite promptly. If your health care system has this type internet program available, try using it to get an email answer to your question. That way you have something written for referral - in case you still don't understand what they say, you've at least got the exact language to use to do some internet research.
Ok, from what you said in your message, your dr probably was referring to a build up of fluid in the endometrium itself; this would be the cause of increased discharge as the endometrium sloughs off cells. (don't be alarmed - every organ sloughs off cells as part of the normal process - the skin is a good example) And because the endometrium does not normally contain fluid, you are very unlikely to find information if endometrial fluid is your search criterion.
I am assuming that the ultrasound showed thickening of the endometrial membrane, indicating that the endometrial cells themselves are retaining fluid, or that the membrane is showing fluid between the cells, much like the swelling you get when you have a sprain. (Or it possibly may be forming cysts - altho I would think if that was the case, your dr would have used that specific language.) So, in order to help you understand why that is bad, I will give you some very basic information on function of the endometrium and the reproduction system. (please forgive If I'm telling you stuff you already know.)
The endometrium is the membrane that functions as the inner-lining of the uterus - the tissue layer that actually prepares the uterus for a pregnancy. When there is no pregnancy (which is most of the woman's life) the endometrium is just a very thin layer of cells, somewhat like the clear layer of filmy tissue that covers pieces of chicken right between the meat and the skin. It contains glandular cells and blood vessels and possibly fat cells , but basically not very much fluid.
When there is no pregnancy, and the body is not in the part of the cycle where it could get pregnant, the uterus is a very small organ, about the size of a small pear. The inner walls actually lie up against each other so that they touch. The endometrium's purpose during this time is to provide a lubricated surface to keep the uterine walls from sticking to each other - to do this it has to be a slippery membrane but a very thin one, without a lot of fluid.
During the estrous cycle (the time of the month when you can get pregnant) the endometrium changes function - it becomes a thick, very blood rich, glandular tissue layer where the fertilized egg can implant and the placenta can start to form directly from the endometrium. If pregnancy doesn't happen, the enhanced endometrium sloughs off to return to normal.
So, the endometrium normally exists in 1 of 4 states: a. very thin with basically not a lot of fluid, serving as a slidey surface lining the uterine muscle. b. preparing for possible pregnancy, building up blood vessels and glands, but not pockets of fluid. c. pregnant - forming and supporting the placenta, basically a thick, rich tissue mass full of blood vessels d. shedding cells to get back to state a after there has not been implantation of a fertilized egg - we know this as menstruation, having our period.
( for reference: http://en.wikipedia.org/wiki/Endometrium )
If the uterus gets enlarged and there is no pregnancy, that's a sign that something is wrong, as you've already found out. There are many reasons a uterus could enlarge - benign fibroid tumors, infection, and unfortunately, cancer. (possibly other causes, but I don't want to get off track) Our bodies are pretty amazing - our organs have an unbelievable ability to adapt. For most of these conditions, even with the enlarging of the uterus, the endometrium will cope and possibly stretch while still maintaining its basic function - it may be stressed, but should be able to remain a thin, fairly fluid-free membrane.
However, with cancer, the actual functioning of the endometrium can be altered, especially if the cancer is in the endometrium itself. In that case, the endometrium may actually start to collect fluid in an attempt to fight off invaders, or the cells are not able to maintain their normal blood exchange and the cells start to retain fluid and get bigger - if they aren't able to retain the extra fluid it can leak out between the cells and be retained there.
So, your doctor says that fluid in the endometrium is not a good thing - because it means that something has happened to alter the function of the cells - and yes, that something usually is cancer.
Although uterine cancer is widely referred to as endometrial cancer, and vice versa, this is misleading. Endometrial cancer in its early stages can indeed be confined to the endometrium only, without having spread to the uterine muscle and other structures. If a woman has reproductive cancer, this is the best type to have, the easiest to treat and cure.
[I was diagnosed with endometrial cancer in 2002. We caught it extremely early, took out the uterus and tubes and ovaries, and my doc said at the very most only a 2 - 3 % chance of recurrence, so don't worry about it. Hysterectomy is not fun, but life is what you make it, so I decided to count it as no big deal. Rather have my life than my reproductive organs. (Unfortunately I found a lump 5 weeks later - breast cancer, stage II, etc, etc, etc - different story.)]
Please, don't get me wrong: I don't mean to belittle your concerns, For you right now, this is scary. Waiting for biopsy results is difficult, but take it one day at a time, and if you need to, one hour at a time. I am, however, trying to help you put this in perspective. Get educated on uterine cancer, but don't psych yourself into thinking that you have it and that life is never going to be the same. Your doc said 10 days for the biopsy results - I got mine in 4 - NOT GOOD when they call you a lot sooner than they said. So, every day that goes by, take a big sigh of relief, and get on with what you need to do for that day. Wise saying, "Don't borry trouble from tomorrow, for today has worries enough of its own."
Even if the biopsy comes back malignant, uterine cancer is very treatable, and if caught early, curable. Even if it's not caught early, there is a whole wealth of things women can do to kick this nasty critter in the butt, repeatedly!!!
And basically that's what we all keep doing - kicking the nastier parts of life in the butt!!
Take a look at this site for some statistics on uterine cancer, treatment, etc. Look at each of the tabs, and if you have questions, please feel free to send me a private message - I will try to help.
If your biopsy comes back positive, please feel free to let us know. There are lots of people posting on the board who can give you some good ideas how to prepare yourself both mentally, physically, and spiritually.
And if it comes back negative, please let us know that good news, so that we can all rejoice and be very happy for you!
Please take care.
by Deligirl1 on Sat Aug 30, 2008 12:00 AM
by Tough1 on Fri Dec 26, 2008 12:00 AM
Thanks for your response to Deligirl. That was very helpful. I have been diagnosed with uterine fibroids and have had them for about two years. I attempted to get a hysterectomy three times, but for three different reasons the surgery was halted (one due to my ignorance about what I could drink before surgery). I found your reply very informative and was looking for information on endometrial fluid because I have been leaking fluid nearly everyday on a monthly basis for about three months. I became self-employed this year and can not afford health insurance so dr. visits have been no existent for about a year. Based on your response, I think the fluid itself is from the enlarged uterus, due to the fibroids. I saw the fluid on my sonogram when I was diagnosed (for the second time with fibriods one year after two had been removed) Do you have any insight on why the fluid is leaking out each month? Since I don't have medical insurance, I am taking advantage of a local hospital that is doind fibroid studies, so I have an upcoming dr.'s appt that I hope will allow me to get the fibroids removed, provided my hemoglobin levels will permit the surgery. Thanks again for your reply.
by dreaming1 on Thu Dec 09, 2010 11:51 PM
Is one at a higher risk for this cancer if one had breast cancer? I had no bleeding only fluid, they repeated the vaginal ultrasound after 2 months and still shows fluid, what next? I had the C I 125 it was negative. I am worried.
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