Wednesday, May 6, 2009

the pap and the house concert video

Hello everyone
Ken and I are in chemo right now. It seems funny to say " WE are doing chemo" ,"We are doing radiation", however in many ways that is just the way it is. Ken is doing this all with me, like everything else in our life, we are joined at the hip.  I feel so lucky to have someone going through this with me, trying at all times to "smooth" things over to make everything go as easily as possible. I believe what Ken would want the most to do for me (and everyone else who cares for me) is to take away this cancer and make sure it never comes back. This is not something Ken, (or any of my friends or family) can do for me.  However presence is the next best thing, and we spend very little time apart, in fact when he works nights at the hospital, me and the dogs spend the night with him in the van. Cosy!
I think one of the things we go over and over in our minds is "is there anything we could have done differently to prevent this". The trouble with most cancers the "causes" are elusive and all we have( in the medical literature), are "high risk groups", that seem to develop this cancer more readily than others.  Then there are random occurrences, which in some ways, I guess I am. I have outlined in the blog a few days ago how the environment is much more likely to be the cause. We are doing the best we can at this point to "overcome" what we have been left with, the mess that is "the environment we all live in."
Of course the OTHER thing we perhaps think about too much if this could have been caught earlier.  I know in this blog I have explained parts of this in the past, but perhaps a new aspect has surfaced today. As I have explained in the past, my problems with bleeding had been going on for some time, but mostly problematically in the fall 2008. I had bleeding following intercourse, which I as a physician, I have always associated with cervical cancer, and since the PAP test is a screening test for cervical cancer, when mine was "reported" as normal, I was somewhat relieved. The bleeding continued and 4 months later I was diagnosed via an endometrial biopsy with advanced endometrial cancer. I never actually SAW the pap report, I just got a card in the mail to say it was normal.
In my reading about endometrial cancer, it can be sometimes picked up on PAPs, however PAPs are not reliable.  It is more often  "picked up" on a PAP when the cancer is advanced.
To explain a bit.... in a menstruating woman, every month the endometrium (the innermost lining of the uterus) is sloughed off, and that is essentially "the bleeding" a woman experiences when she has her period.  The blood vessels in the muscle of the muscle of the uterus vasoconstrict and essentially cut off the blood supply to the endometrium.  A new endometrium forms over the next few weeks.
So when PAPS are done, they report if any endometrial cells are there on the PAP. Since with a PAP they are really just sampling the cervix, no endometrial cells should be seen unless a woman is just finishing their period.  The pathologists who read PAP tests report it when they see endometrial cells and if a women appears to be menopausal, they report that they see them and also report that it is abnormal to see endometrial cells in menopausal women. OR in fact, in women who are not near their period. ( they do not report that last part, but I researched it abit, since so many YOUNGER women also seem to be diagnosed with endometrial cancer)

I have been unable to obtain a copy of my last PAP, so today asked if I could read it ( we are at the same medical center I was when I had the PAP) It showed that endometrial cells were present, and should be viewed as abnormal in a post menopausal woman.
 So now I am thinking this really could/should have been diagnosed earlier. I guess that is all all water under the bridge now.  I guess the reason I am bringing it up here is because I know at least half of those reading this blog are  female and likely more, and most likely a lot of people reading this are in the age group that might be still getting PAPS.  So if you are in a situation where endometrial cells should NOT be on your PAP be sure and make sure there aren't any.  Perhaps the next time you visit your doctor, he/she could likely just check back. 

I have learned over the past few months that women as young as 25 have been diagnosed with this and more in their 30s and 40s. I am currently emailing with a woman in her 30s who found about me reading this blog. She is 38 with endometrial cancer. I do not in any way want to create panic, and for people who have completely normal periods, this is extremely unlikely.  My only goal in publishing this is for people to become......  better consumers of health care. To know the questions to ask, and to know what the results should be.  A transvaginal ultrasound is a pretty good test for endometrial cancer, it is not quite as good as an endometrial biopsy, but it often can give more evidence to direct an endometrial biopsy.
My transvaginal ultrasound done a year and a half before this was diagnosed was normal, the one done a week after this was diagnosed showed the cancer.

For those who might have missed our latest concert, or for those who attended our latest concert, I thought you might like to see a video of a song Ken and I did....complete with my own hair wig it is posted here

love and peace
jankenb (@) 

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