Growth near cervix

[SD1609]

Im looking for some input from anyone who may be able to help. My partner had a hospital appointment recently following recurring bleeding. She takes a birth control pill daily which meant she would never have periods, so this was unusual. She had an appointment with a gynaecologist in August and everything seemed fine. This time, she had the same gynaecologist who, upon examination, stated that it was like looking at 2 different people. It appears a growth has appeared out of nowhere in the last six months that seems to be the primary cause of the issues. I wasn't in the room at the time but the information I have gathered from my partner is that:

- The growth appears to have smooth edges
- cant confirm yet whether its on the cervix or womb
- The doctor took 2 biopsies and multiple blood draws
- Doctor has requested an emergency MRI but this could still take a few weeks
- Doctor has requested priority on blood work and biopsy
- Growth appeared to have an eggplant type shape on preliminary scans
- Bled profusely on the floor when biopsied

The doctor, who I believe to be a professional of some years, advised she had never seen anything like it grow so fast before and appeared baffled by it. My main concern is that the doctor kept using phrases with my partner such as, 'I don't want to sugarcoat' and 'prepared'.

I don't know if medical history would be helpful here but partners father died of pancreatic cancer and aunt died of breast cancer that spread to the lungs.

Im just worried, given the doctors reaction, that we are waiting on a cancer diagnosis or whether there may be less serious diagnoses.

Any input or information would be greatly appreciated.

[old_before_my_time]

I am sorry for your partner's diagnosis. It seems odd that this has developed so quickly since "a colposcopy was carried out in April 2019 which returned as normal and apparently everything was fine." Cervical cancer is usually very slow to develop from abnormal cells (like 10 years slow). A second opinion from another pathologist may be worthwhile. It will be interesting to hear the oncologist's take also. Hysterectomy is overused in a number of countries so it is always good to do your due diligence before consenting to one. And it is important to hold onto the ovaries if  their removal is not necessary.

Please keep us posted as you find out more.

[AnnieBrooke]

It sounds like all your questions are very valid and should be answered, since obviously if there was a mistake in the diagnosis, there could be a less-than-perfect decision about treatment. You are definitely within your rights to ask for tests to be run again, or for more imaging.

Regarding the speed at which things happened, is your girlfriend a smoker? It apparently affects the cervical mucus and can greatly increase the chances of getting cervical cancer.

The good news is, the doctors are saying it's still stage 1, and that means confined to the cervix. By the size you mentioned, it sounds like stage 1B. If this diagnosis is correct, surgery plus chemo or surgery plus radiation are called for, not necessarily a hysterectomy. BUT the doctors, not someone on the Internet, should be the advisor about that. Sometimes the surgery just removes the tumor and tissue around it, and if the lab finds that the cancer is confined to the tissue they took, they don't go as far as a hysterectomy.

If the doctor does say the uterus needs to be removed, do your damndest to get him or her to understand that this is not to extend to removal of the ovaries. Some docs will tell you that "the ovaries will go if the uterus is removed," as though they naturally will die if the uterus is gone, but that is often just the doctor being ignorant of the possibilities, or out of date about research. Research says keeping the ovaries is important, and that removing them when there is no medical reason to do so causes negative consequences (heart disease and other problems).

I wish your health-care system wasn't so leisurely, and you could get answers right now. Good luck to you both.

[SD1609]

Hi Annie,

Yeah it's not been great, we contacted the oncology nurse yesterday whom offered some advice and said she would chase up the oncologists call. We still haven't heard from the oncologist, so all we know is basically the type of cancer, the proposed treatment and the fact that we are going for a PET CT on Thursday.

The main thing that's frustrating my partner is that she believes that the best course of action for us to take is a full hysterectomy and she is disappointed that this is, as of yet, not on the table as an option. I suggested that it may be because we could face a lengthy wait for a surgery date and that if we did opt for hysterectomy then they wouldn't do the chaemo incase there was overlap with the surgery date, rendering whatever chaemo we had done up to that point ineffective. We plan to call back again on Monday if we still haven't heard from the oncologist.

Thanks for the suggestion regarding her pill. It was, to my knowledge, the daily pill that would stop periods altogether. I asked about missed pills since the diagnosis and she told me that the only day she forgot to take it was Friday, which could make sense given that it was Friday night that we had the excess blood, but she doesn't feel that 1 missed day would lead to this level of bleeding as she has missed days with it in the past. Could it be that with the cancer, now, she would be more susceptible to a heavy period after missing 1 day of the pill.

The main thing we just can't get our heads around is how this has came about. My partner was completely up to date with her smear tests and the latest one was the one that showed abnormal cells. Off the back of this smear test, a colposcopy was carried out in April 2019 which returned as normal and apparently everything was fine. We just can't understand how this can be the case and then 8 months later there is a cancerous tumour that measures in at 3.5 x 3.5 x 5.2. We can't understand how a cancer that is supposedly very slow growing, has went from non existent to 1b in 8 months. Could it be that these tests have not been carried out properly?

We really appreciate the help and advice from you Annie and all the rest on the forum.

Thanks again

[AnnieBrooke]

I'd suggest that it's the location, not the stress of worrying. Lesions (including other kinds, not just cancer) that are on the cervix are often found by the fact that they bleed a lot.

But where is her doctor in all of this? I would expect with her diagnosis, it would a little more urgent and she would be getting some decent medical attention by now.

[AnnieBrooke]

I mean, seriously, call the doctor. If you get nowhere, do you have access to an ER? Go in when she is bleeding and just say she is bleeding a LOT, and that she has just been diagnosed, and that you are concerned.

[AnnieBrooke]

I thought of one other thing. You said at the top of the thread, "She takes a birth control pill daily which meant she would never have periods". Did you mean she just takes the active pills straight through and doesn't ever take the placebo pills to allow for a period once a month? If that is what she has been doing up until now, and if she stopped taking her pills once she got the diagnosis, it would be to be expected that she would be bleeding. Her  body would get the signal from the lack of hormones that it is time to dump the endometrial lining.

[SD1609]

If I could bother this group with yet another question/s. My partner is having occasional bouts of excessive bleeding. This has been over the last couple of days. Obviously I have done what most would do and frantically googled possible reasons for this. What I would like to know is:

Can this excessive bleeding simply be from stress of worrying?
How is my partners period affected by her cancer?
Is this excessive bleeding most likely a sign that the cancer is advanced or invasive?
Is there a difference between advanced and invasive?
Can the cancer be both stage 1b but also advanced/invasive?

Sorry for the bombardment of questions. I just want to try and have some answers for my partner when things like this are happening.

Thank you all, again.

[AnnieBrooke]

Again, it sounds like with the cancer being only at stage 1, it's not worth worrying about fertility except when talking with the doctor about courses of action and the consequences of each choice. If two options have equal success, in her shoes I would choose the one least likely to leave scarring on the uterus that would impede or put a pregnancy at risk. But even in a worst-case scenario that required a hysterectomy (and again, it does NOT sound like she is in that spot), that doesn't rule out children. Her ovaries probably are fine. Before any surgery, you could go to an IVF clinic and make embryos using your sperm and her eggs, and freeze them. Then when the time comes for children, hire a gestational carrier. Even if carrying a pregnancy is medically unwise or not possible, you two can still have children together.

Regarding cervical squamous-cell cancer: it's most often caused by the human papilloma virus, HPV. It's a very common virus and huge numbers of people have it. But if you and she have not always been exclusive (if you had a time period when you were sleeping with other women and her), be sure to disclose the possibility of HPV to those women. Cervical cancer isn't contagious, of course, but HPV is. When you get the chance, ask both your own doctor and her doctor about all the ramifications of this. Here's a link with some info:
https://www.webmd.com/sexual-conditions/hpv-genital-warts/hpv-virus-men#2

Good luck and I'm thinking about you both and hoping that this turns out to be as small of a problem as cervical cancer ever can be, given of course that the whole thing totally s ucks.

[SD1609]

Thanks for all the info Annie, was a bit of a struggle to retain all the information the doctor gave us. From what I remember, my partner is being sent for a PET CT to check it has not spread. Kids have been something we had talked about and I really wanted to have one but I wouldn't care at all if it means a course of treatment that will prevent us doing so. I can only hope it's not spread and the fact it has been caught early will lead to successful treatment.

Thanks again

[AnnieBrooke]

The Mayo Clinic's information on cervical squamous cell cancer is useful, especially where it talks about the various treatment options and how to prepare to talk with the doctor. I am so sorry to learn this is what it is, but at least you caught it early.

https://www.mayoclinic.org/diseases-conditions/cervical-cancer/diagnosis-treatment/drc-20352506

[AnnieBrooke]

From other articles I was reading, it looks like they might want to try a surgical option too; removing the tumor, or the tumor and some surrounding tissue. So be ready to discuss the options and don't be taken by surprise if the doctor mentions surgery. I assume part of the issue here (because of her age) is preserving her ability to have children? If so, if the doctor proposes surgery, be sure the doctor explains very clearly what the impact would be on future ability to carry a pregnancy.

One thing I assume they will go to some trouble to check is, if squamous cell cervical cancer is not caught early it can spread to the endometrium (uterine lining). Even though hers was caught early, they should be planning to do an endometrial biopsy, to be sure that hasn't happened.

Again, this is not a diagnosis you wanted, but (as I am sure you are both saying to each other), at least it was caught early, and it can be fixed when caught early.

[SD1609]

Thanks for everyone's input. We found out today its stage 1b squamous cell carcinoma. Would like to ask for your help again in giving an idea on what we may expect now. The consultant has told us we will be contacted by the oncologist who will discuss the treatment which I believe to be chaemo and radiotherapy.

Thanks again for everyone's input.

[SD1609]

Thanks for your input, all. My partner received a call today from the receptionist at the consultants to ask that she goes for an appointment this Wednesday to discuss the results. We had the MRI done about 5 days ago. The appointment we were given was a 20 minute slot at the end of the day so don't know if that's good or bad. The receptionist advised that she couldn't give us any information so no idea what to expect on Wednesday.

[AnnieBrooke]

Frustrating. But at least you'll know soon enough now what's going on. I would really insist on talking to a doctor (not just a consultant) from now on out.

[CHIN_C]

Regarding your question about the reason for the MRI, I think the answer is yes to all. It can characterize the abnormality in terms of size, shape, borders, composition (i.e., solid vs. cystic), and enhancement/vascularity. It can show if the abnormality is within the cervical canal or cervical stroma. It can show if the abnormality is confined to the uterus or not.

[SD1609]

CHIN_C so is it likely that we wouldn't be referred for the MRI if the doctor didn't think it was cancer, or do you think the MRI was more of a precaution in case of a cancer diagnoses?

UPDATE: Still awaiting the results from biopsy and blood tests. My partner had an appointment scheduled in for an ultrasound that we hadn't intended on going to, as the consultant (who I mistakenly noted as the Doctor above) said it wouldn't provide any further clarity than the exam that was originally carried out. She decided to go for the ultrasounds anyway and the doctor doing the scan said that it actually seemed like an ordinary fibroid. We think the consultant may have sought the MRI as she couldn't be sure from where the growth was growing from so hoping things are sounding a bit more positive.

[AnnieBrooke]

That's helpful news. I had thought of fibroid originally when reading your post (that's why I mentioned it above) because of the bleeding -- when a fibroid is near the cervix, that is notorious for unusual bleeding. Here's hoping that is all it is! Glad you decided to go to the ultrasound, and shame on the consultant for discouraging you from getting all the information possible.

[CHIN_C]

I was just basing everything based on your description of the doctor's preliminary reaction. For now, just take things one step at time, wait for the biopsy result to come back, then get the MRI. Thinking about this too much will only cause unnecessary anxiety.

[CHIN_C]

Diagnostic considerations include cervical cancer, polyp, or intracavitary uterine fibroid prolapsed into endocervical canal. Based on your description of the doctor's preliminary reaction, it sounds suspicious. The biopsy will be the definitive assessment. The MRI is more for staging the cancer to help guide treatment approach (surgery, chemotherapy, etc).

[AnnieBrooke]

I assume they did a pregnancy test and ruled out an ectopic pregnancy?

[SD1609]

I couldn't say for sure, my partner never mentioned it so I would assume not. I don't want to keep asking her questions about it to try and keep her mind off of things so trying to go off the info I took in at the appointment.

[SD1609]

Thanks for your input. My partner is 32, the wait time for the MRI is a few weeks on NHS, although the Dr put her on a priority call list so that if an appointment cancels, she will be contacted about the vacancy. I agree we need more information, the doctor has just made it difficult no to think about constantly. She also stressed the fact that she didn't believe it was a fibroid, though Im not sure if that was based on size, growth rate or location.

[SD1609]

Meant to add, the biopsy information will be back within 1-2 weeks from the appointment which was Saturday 18th.

[specialmom]

Argh, waiting is hard but it seems you have not been given much choice.  Be really sweet to her and take her to do some fun things while you wait to distract you both.  Let us know.  Until you have more information, it is just all speculation but there are enough benign things that it also could be that I still think you should try not to worry until you have to.

[AnnieBrooke]

I'm also thinking of a fibroid that is just placed in an unfortunate spot. As specialmom said, if it becomes something other than a routine need for an MRI, they will make it happen fast. She won't have to wait weeks.

[specialmom]

Goodness.  This is scary for you both.  I do have a motto though which is to try not to worry until you  have to and you do not have to yet!  How old is your partner? And this has grown within the last 6 months it sounds like?  Is there any guess on the size?  And when do the biopsy results come back? I would not think an emergency mri would take a few weeks but will happen quickly. Remember, this could also be a cyst!  https://www.medicalnewstoday.com/articles/316796.php#Treatment  Polyps and tumors on a cervix are usually small. Could she also be having a prolapse?  And if it is a tumor, remember, they are sometimes benign.

I know you are worried.  But you need more information.  When will that biopsy information be available?