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Thread: Possible Pelvic Recurrence

  1. #1
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    Question Possible Pelvic Recurrence

    Hi everyone, my first post.

    Just started on my fourth year cancer free when I had to get a MRI to find out why my right thigh was going numb. My Neurologist thankfully ordered so many test that the doctor reading my pelvic MRI found the possible 3 cm lobulated neoplasm behind my bladder in the hysterectomy bed, two weeks ago. According to a CT of my pelvic area I had exactly one year ago there was nothing visible then.

    My question is how are they going to confirm it is a recurrence? Do they biopsy or just cut right into me again to get it out? Does a recurrence have stages just like before or is it something totally different?

    I have an appointment with my PCP to get referred to a different Gyno Oncologist but I know it probably won't be a few weeks before I get any answers about general procedure. And Doc Google doesn't have much info on recurrence. Any help with these questions would be appreciated.
    Diagnosed at age 39 on March 17, 2014
    Stage 1A
    Grade 3
    Endometrial Adenocarcinoma
    Hysterectomy with salpingo-oophorectomy
    Plus omentum removed along w/27 lymph nodes
    No RADS (was a quality of life decision)
    June 2018 possible pelvic recurrence

  2. #2
    Super Moderator Top User po18guy's Avatar
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    Feb 2012
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    Sorry to hear of this as I welcome you. Guessing here, but I would imagine that, since they know what they are looking for, an ultrasound guided needle biopsy might be in order. In the case of a solid tumor, a needle biopsy will provide sufficient tissue for a decent pathological examination.

    Now as before, you do not have cancer until a pathology report says you have cancer.
    05/08-07/08 Tumor appears behind left ear. Followed by serial medical incompetence on the parts of PCP, veteran oncologist and pathologist (misdiagnosis via non-diagnosis). Providential guidance to proper care at an NCI designated comprehensive cancer center.
    07/08 Age 56 DX 1) Peripheral T-Cell Lymphoma-Not Otherwise Specified. Stage IV-B, >50 ("innumerable") tumors, bone marrow involvement.
    08/08-12/08 Four cycles CHOEP14 + four cycles GND (Cyclofosfamide, Doxorubicin, Vincristine, Etoposide, Prednisone & Gemcitabine, Navelbine, Doxil)
    02/09 2) Relapse.
    03/09-06/13 Clinical trial of Romidepsin > long-term study. NED for 64 twenty-eight day cycles, dose tapered.
    07/13 3) Relapse, 4) Suspected Mutation.
    08/13-02/14 Romidepsin increased, stopped for lack of response. Watch & Wait.
    09/14 Relapse/Progression. Visible cervical nodes appear within 4 days of being checked clear.
    10/06/14 One cycle Belinostat. Discontinued to enter second clinical trial.
    10/25/14 Clinical trial of Alisertib/Failed - Progression.
    01/12/15 Belinostat resumed/Failed - Progression. 02/23/15
    02/24/15 Pralatrexate/Failed - Progression. 04/17/15
    04/15 Genomic profiling reveals mutation into PTCL-NOS + AngioImmunoblastic T-Cell Lymphoma. Stage IV-B a second time. Two dozen tumors + small intestine (Ileum) involvement.
    04/22/15 TEC (Bendamustine, Etoposide, Carboplatin). Full response in two cycles. PET/CT both clear. Third cycle followed.
    06/15-07/15 Transplant preparation (X-rays, spinal taps, BMB, blood test, MUGA scan, lung function, CMV screening, C-Diff testing etc. etc. etc.) Intrathecal Methotrexate during spinal tap.
    BMB reveals 5) 26% blast cells of 20q Deletion Myelodysplastic Syndrome MDS), a bone marrow cancer and precursor to Acute Myeloid Leukemia.
    07/11-12/15 Cyclofosfamide + Fludarabine conditioning regimen.
    07/16/15 Total Body Irradiation.
    07/17/15 Moderate intensity Haploidentical Allogeneic Stem Cell Transplant receiving my son's peripheral blood stem cells.
    07/21-22/15 Triple dose Cyclofosfamide + Mesna, followed by immunosuppressants Tacrolimus and Mycophenolate Mofetil.
    07/23-08/03/15 Marrow producing zero blood cells. Fever. Hospitalized two weeks.
    08/04/15 Engraftment occurs, and blood cells are measurable - released from hospital.
    08/13/15 Day 26 - Marrow is 100% donor cells. Platelets climbing steadily, red cells follow.
    09/21/15 Acute skin Graft versus Host Disease arrives.
    DEXA scan reveals Osteoporosis.
    09/26/-11/03/15 Prednisone to control skin GvHD.
    11/2015 Acute GvHD re-classified to Chronic Graft versus Host Disease.
    05/2016 Tacrolimus stopped. Prednisone from 30-90mg daily tried. Sirolimus begun. Narrow-band UV-B therapy started, but discontinued for lack of response. One treatment of P-UVAreceived, but halted due to medication reaction.
    09/16/16 Three skin punch biopsies.
    11/04/16 GvHD clinical trial of Ofatumumab (Arzerra) + Prednisone + Methylprednisolone begun.
    12/16 Type II Diabetes, Hypertension - both treatment-related.
    05/17 Extracorporeal Photopheresis (ECP) begun in attempt to control chronic Graft-versus-Host-Disease (cGvHD. 8 year old Power Port removed and replaced with Vortex (Smart) Port for ECP.
    05/2017 Chronic anemia (low hematocrit). Chronic kidney disease. Cataracts from radiation and steroids.
    06/17 Trying various antibiotics in a search for tolerable prophylaxis.
    08/17 Bone marrow biopsy reveals the presence of 2% cells with 20q Deletion Myelodysplastic Syndrome, considered to be Minimum Residual Disease.
    12/17 Bone marrow biopsy reveals no abnormalities in the marrow - MDS eradicated. The steroid taper continues.
    01/18 Consented for Kadmon clinical trial.
    03/18 Began 400mg daily of KD025, a rho-Associated Coiled-coil Kinase 2 Inhibitor (ROCK2).
    09/18 Due to refractory GvHD, Extracorporeal Photopheresis halted after 15 months ue to lack of additional benefit.
    10/18 I was withdrawn from the Kadmon KD025 clinical trial due to increasing fatigue/lack of benefit.
    11/18 Began therapy with Ruxolitinib (Jakafi), a JAK 1&2 inhibitor class drug. Started at half-dose due to concerns with drug interactions.

    To date: 1 cancer, relapse, second relapse/mutation into 2 cancers, then 3 cancers simultaneously, 20 chemotherapy/GVHD drugs in 11 regimens (4 of them at least twice), 5 salvage regimens, 4 clinical trials, 5 post-transplant immuno-suppressant/modulatory drugs, the equivalent of 1,000 years of background radiation from 40+ CT series scans and about 24 PET scans.
    Both lymphoid and myeloid malignancies lend a certain symmetry to the hematological journey.

    Believing in the redemptive value of suffering makes all the difference.

  3. #3
    Hi, I wish I had answers for your questions, but I don't know what actual steps are taken to deal with recurrence. My oncologist explained to me addressing recurrence is very different and more difficult to treat. But on the positive side, the lobulated neoplasm just recently appeared on your CTs and has been caught relatively early. Typically recurrences of uterine cancer occur within the first two years (and less so in three years), then the odds significantly decrease each passing year. I am speculating here, but I would imagine a biopsy and I think surgical removal is likely. Please post back as to what happens in your case. I pray and wish all the best for you,

    Rhonda
    rmaureen
    Diagnosed Sept. 2005
    Stage III-C Endometrial Adenocarcinoma
    Grade 2
    My Story:
    http://fierytrial.wordpress.com/2009/12/09/my-diagnosis

  4. #4
    Super Moderator Top User po18guy's Avatar
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    Feb 2012
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    10,303
    A considerable number of abdominal neoplasms end up being benign. I think it best to hope that is what it may be.

 

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