Can Adenocarcinoma Move To Other Body Parts?

Last July I had a partial hysterectomy removing my uteris and cervix.  I was 25 at the time.  We did the surgery due to endometriosis and severe menstrual pains.  I had one child 6-years prior to the surgery that ended in a c-section due to not responding to inducement drugs even though I was 2-weeks overdue. 

 After the surgery was done and sent to pathology, it came back saying that I had both adenocarcinoma and squamous cell carcinoma in-situ of the cervix as well as the endometriosis and HPV (high-risk group).  I got lucky and both cancers were In-situ and the surgery and follow-up is all that was required, no chemo. 

Now though, I was doing a BSE (breast self-exam) and may have discovered a small lump this morning.  I'm not scheduled for my first CT-Scan to check lymph nodes and other areas for spreading until June/July of this year. 

I've also had problems lately of a sharp pain in my lower abdomen right around my right ovary.  Both of my ovaries were left in me although I did have frequent problems of cysts on my right ovary.  I also went through no periods for 3 years due to depo-provera and then developed the first large ovarian cyst within 6 months of stopping depo.  My gall-bladder has already been removed to an unusually small cystic duct. 

How quickly does this cancer spread?  Is it possible to already have cancer in another area after having cancer removed?  Could I have cancer through-out my body and my doctors are being to conservative about checking the rest of me?  What should I do about the lump?  Wait another month and see if it's still there?

I won't be 26-year-old until mid May.  I'm too young for these problems.  My doctor told me I was the youngest person in his 20 year practice to be diagnosed with adenocarcinoma.  The youngest he'd seen was 35.  I live in Alaska also.  I only know of one adenocarinoma specialist in the state and she told my doctor that she didn't need to see me.  Should I push for more tests?  What do I do?  My son is turning 7 next month and I don't want to leave him or my family.  I will do anything to stay with him longer.  But in the past 7 years I've have a c-section, my gallbladder removed, a cyst the size of a softball removed, endometriosis, a hysterectomy, and 2 types of cervical cancer.  Should I just expect more problems with my body? 

Hi there - the mixed cell type you had can be very aggressive, so I would be sure to go to your doctor any time something doesn't seem quite right. The lump in the breast may be unrelated, but even so, it should be checked immediately.

Cervical cancer starts slowly in most women, but once it becomes aggressive, it really takes off. My partner was diagosed with stage 1B in September, 2003. Her recurrence came in September, 2005, with mets to the lungs. In August, 2006 it was in her brain. She passed away this past November. She was 34, and she had the same cell type you did - the mix. Don't wait.

You are very young to have had cervical cancer, but as you can see from the Cancer Compass story this week, a 19 year old girl without HPPV and who was not sexually active still was diagnosed with adenocarcinoma of the cervix.

Get back to the doctor ASAP - that's my advice. God bless you and your family -

First a little reassurance.  It would be extremely unusual for a cervical cancer to spread to the breast. Also, at your age, unless there is a family history of breast cancer, it is not very likely to be a breast malignancy. However, make sure your doctor takes a look at feels it. Sometimes other tests, like breast ultrasound might be reasonable. Mammograms usually don't help because your breasts are too dense at this age. But check with your doctor.

The other possible reassurance is that if you truly had the pathology report say "adenocarcinoma IN SITU" or "squamous cell carcinoma IN SITU", and that was all they found, you actually only had PRE-cancer, not a cancer.  I would get a copy of you pathology report and make sure of that.  The term "carcinoma" is cancer, but in the cervix, when combined with the term "IN SITU" it is NOT cancer yet (it is pre-cancer).  If you had invasive adenocarcinoma (not IN SITU), then you should still consider a second opinion from a gynecologic oncologist. You should still be examined every year ( or more often if it was a cancer) and you should ask your doctor to explain this further.  

Finally, if you had the surgery at a hospital which does not see this very often, you might want them to send the slides to a center that does see a lot of gynecologic cancer for a second opinion by another pathologist.  All of the above is really dependent on an accurate diagnosis of IN SITU only, and nothing more. Or, if it was invasive adenocarcinoma, that diagnosis can be tricky and there are details to that diagnosis that are very important to consider.  Too much to write about here.

Please talk to your physician.  Posts like this are not meant to replace your physician's advice. As noted, a second opinion is also an option. But asking for varying tests (other than the pathology confirmation) is not something that will help you without a physician's input.  That physician should be one you have confidence in.   

Hope this helps.

Dr Steve (Gyn Onc)