How much worse can I get

[u/Interesting_You4161]

My mom recently did a colon resection for suspected colon cancer a month ago. She had endometrial cancer previously 2 years ago was Stage 1 localized no spread (what the doctor told us) but looking at a report on a PET CT from a top cancer hospital I moved her to makes me want to throw up. It’s confirmed spread from the endometrial cancer 2 years back, mullerin carcernoma. How did it get to this stage? I can’t help blame myself for not taking her to the doctor for regular scans. Could I get advice from anyone facing similar challenges as well as a realistic outcome? Her report is below:

Impression 1. 3 rim-enhancing hepatic lesions consistent with metastases largest measuring up to 1.9 cm. 2. 1.7 cm cyst segment 6 of the liver. Additional multiple tiny T2 hyperintense nodules within the liver are too small to characterize but presumably representing additional cysts. Consider short-term follow-up to document stability. 3. Areas of enhancement abdominal wall suggestive of recent surgical procedure/trocar insertion. Attention to follow-up is advised to document resolution. 4. CT scan of the chest is recommended to exclude metastases within the chest. 5. 1.4 cm nodule right adrenal gland favoring an adenoma. 6. 1.2 cm probably septated cystic lesion/cyst posterior left kidney. Bosniak 2F.
Narrative MR ABDOMEN AND PELVIS WITH AND WITHOUT CONTRAST: HISTORY: Colon cancer, metastatic, staging COMPARISON: None available TECHNIQUE: MR imaging of the abdomen and pelvis was acquired using a multi-element body array coil. The following sequences were performed: Axial and coronal T2 HASTE through the abdomen and pelvis, in and out of phase abdomen, MRCP, axial T2 with fat saturation through the abdomen, axial and coronal breath-hold VIBE pre-gadolinium through the abdomen and pelvis, sagittal T2 HASTE through the pelvis and axial free breathing diffusion through the abdomen and pelvis at b values of 50 and 800. Following uneventful intravenous administration of 5 mL Gadavist, coronal VIBE as well as axial dynamic VIBE sequences were obtained. FULL RESULT: LUNG BASES: Minimal linear atelectasis right lower lobe. LIVER: 3 T2 intermediate signal hepatic lesions with peripheral enhancement and perilesional hyperemia consistent with metastases. These demonstrate restricted diffusion. Representative examples include a 1.9-1.9 cm lesion segment 7/8 image 16 series 25. 1.4 x 1.2 cm lesion segment 4A superiorly image 11 series 25. 8 x 8 mm rim-enhancing lesion segment 4B image 30 series 25. 1.7 cm T2 hyperintense nonenhancing lesion segment 6 consistent with a cyst. Image 23 series 37. Additional tiny T2 hyperintense nodules are too small to characterize but probably representing additional tiny cysts. GALLBLADDER/BILIARY: The gallbladder is normal. No significant biliary ductal dilatation. SPLEEN: No enlargement or focal lesion. PANCREAS: No lesion, fluid collection, ductal dilatation or atrophy. ADRENAL GLANDS: [No gland is mildly thickened. 1.4 x 1.2 cm nodule right adrenal gland with loss of signal and out of phase sequence favoring an adenoma. Image 26 series 19. KIDNEYS: 1.2 cm cortically-based T2 hyperintense nodule posterior left kidney with possible septations favoring a septated cyst. Image 23 series 37. Unremarkable right kidney. No hydronephrosis bilaterally AORTA AND VASCULATURE: The aorta is normal in size. There is patency of the major mesenteric vessels. The portal vein and SMV are patent. RETROPERITONEUM: No significant adenopathy. BOWEL/MESENTERY: The stomach is unremarkable. Normal caliber small and large bowel. No significant mesenteric adenopathy. Trace pelvic ascites. ABDOMINAL WALL: Areas of nodular enhancement abdominal wall on images 75 and 82 series 25 presumably related to recent postop changes status post trocar insertion. Attention to follow-up is advised to document resolution. PELVIC ORGANS: Status post hysterectomy . URINARY BLADDER: No visible focal wall thickening, lesions or calculi. PELVIC NODES: No significant adenopathy. BONES: No acute or suspicious osseous lesions. OTHER: None

[u/mcmurrml]

Since it has only been two years since the first cancer of endometrial she should have been monitored and getting scans on some kind of basis for at least five years from NED. Even at a low stage of this cancer it can return at anytime and you can have reoccurrence at a different part of the body. I would get another opinion as you need to be confident on if this cancer is a reoccurrence of the first cancer or a completely different cancer. It makes a big difference on the treatment so this is very important.

[u/ResentfulOreo]

First, and most importantly, your mom is an adult and SHE (not you) is responsible for her health care. You need to stop blaming yourself for this. Focus on supporting her in the way she wants to be supported from here on out.

Second, with her history of both colon and endometrial cancer, you should consider being tested for Lynch Syndrome. It's a genetic condition that greatly increases the chance of both of those cancers, as well as others.

Third, you may want to edit this post to remove her medical records, as it is against the sub rules to do that, and posting someone else's personal medical information is particularly inappropriate.

[u/AngelMom1965]

What was her cancer type and grade when she was diagnosed 2 years ago?

[u/Ready-Sherbet-2741]

I’m so sorry about this. I have no idea why she was not getting regular scans. The idea with scans is to catch spread early. But spread is spread - it is serious. Next will be treatment and that’s a big conversation with the oncology team. I know you are freaking out but your main job is to support your mum as she faces this shit. Hugs to you and your mum.

[u/doug123reddit]

I may get the terms slightly wrong, but the malignant mixed Müllerian tumor (carcinosarcoma) you seem to refer to is a rare and high grade (aggressive) flavor of endometrial cancer. In other words, it comes back and the prognosis is a tough one. Options may include chemotherapy and immunotherapy, but you’ll explore this in the follow-up.

[u/Glittering_Hurry236 → u/doug123reddit]

Yes. I'm not a doctor but I don't think this type of EC is ever stage 1.

Again, I'm not a doctor, but I would say this is not a reoccurrence. This is spread from under treatment.

I'm sorry to OP's mom, and -Mom is free to join the sub if she would like to talk about it. I'm not sure why so many adult children are posting for their moms unless their moms are in their 70s or 80s or 90s.

I'm 54 and quite capable of speaking for myself and to my doctors and on this sub.

When the actual patients post for themselves, the-emotion is taken out of it because it's yourself - the patient.