CARCINOMA ENDOMETRIUM PT MN SAGE- PT1aN0- HIGH GRADE- CARCINOMA

• Name of Patient - Smt Kamala Singh
• Age/ Sex - 66 Years/ Female
• Name of Hospital - Max Smart Super Specialty Hospital (East Block) New Delhi
• Name of Doctors - Dr Alok Gupta, Medical Oncologist / Dr Sharan Choudhary, Surgical Oncologist

Brief Complaint and Patient History

Smt Kamala Singh, aged 66 Years female in the month of May- June 2016, started feeling tiredness, weak day by day and suddenly bleeding started and caused great worries. It was Post menopausal DUB for 15 days.

On consultation with classified specialist (Obst & Gynae) I was for biopsy test. The lab reports take about a week to come but during this time I was worried and tensioned. To my fear the lab report confirmed that I was suffering from endometrium carcinoma. It was a case of poorly differential carcinoma.

We had no clue what to do next and I felt as if my life has come to an end. But the friends and doctors supported me morally and doctors advised Max Smart Super Specialty Hospital Saket, New Delhi is Cancer Centre, is having most dedicated team of specialist doctors and leading technologies, medicine and equipment.

Immediately, we reported to Saket Max-Smart super speciality Hospital and met , Dr Sharan Choudhary, a surgical oncologist. We had taken all our reports with us. The doctors asked about complaints, health and past history. In view of high risk disease number of test and examination is carried out like MRI, CT Scan, PET Scan, and numerous blood reports.

Before starting any imperial treatment must get all investigation to decide whether it is at primary stage or spread over the body.

Histo patho slides/ Block reviewed with IHC maker was done which revealed high grade undifferentiated carcinoma thereafter I went for whole body PET CT SCAN which revealed faintly FDG avid subcentimere size left level III & IV supraclavicular LN were noted likely inflammatory, Femoral lymph nodes were noted largest measuring size 1.7X1.7 in left external iliac region mass lesion measuring 4.9X4.6 SO in size was seen involving the uterus.

Consolidated review was carried out after getting blood reports, CT Scan, PET test MRI Brain and Medical Oncology Doctor was also consulted and planned for surgery.

Oncology surgeon explained choice of treatment depends on type of cancer and stage of disease and best treatment of cancer is surgery in which large number of lymph nodes will be removed and without open surgery treatment will be incomplete, open surgery will provide quicker recovery and it is more important result of treatment is best when cancer is detected and treated as soon as possible.

I was admitted for planned surgery and under went exploratory Laparotomy + TAH + Omentectomy + LN dissection, Fenoral lymph nodes were noted and in large size seen involving the uterus. Uterus with bilateral fallopian tubes was removed. During my hospital admission post operative period was uneventful but uncomfortable and painful. I was given conservative IV Anti-biotics, Physiotherapy supportive medicine and regular medical care and motivation assured quality care, support and early recovery after surgery. I was given all due care, medicine and morale support by oncology team including sisters and nurses on duty who are well trained.

CHEMOTHERAPY – (Medical Oncology)

As suffering from high grade carcinoma high risk disease, Chemotherapy was planned. Oncology medical doctor Dr Alok Gupta explained chemotherapy is must and required after surgery procedure to remove cancer chances and increase chances of cure . Six cycle of chemotherapy was planned every after 21 days.

SIDE EFFECTS OF CHEMOTHERAPY

He also explained that adherence of international cancer treatment is given to avoid any discomfort, pain, vomiting, tiredness, of course loss of hair from head which will be temporary and it will again come up once chemotherapy is over.

HOSPITAL COURSE OF CHEMOTHERAPY

1. First Chemotherapy- I received first chemotherapy C1D with injection Paclitaxed- Paclitaxed 200 mg + Inj Carboplatin 400 mg and next day Inj Pagastim 6 mg with proper and pre and post hydration and it was well tolerated by my body.
2. Second Chemotherapy- It was planned after 21 days and I was admitted for C2D, Chemotherapy at 25% chose reduction and it was well tolerated.
3. Third chemotherapy – I was given C3D Chemotherapy with inj. Paclitaxed 150 mg and next day Inj Pegastine 6 mg S/c, and carboplatin 300 mg it was well tolerated and there was no complain.
4. Fourth Chemotherapy- Subsequent Chemotherapy C4D, C5D, C6D chemotherapy treated completed and it was well tolerated and there was no side effect.

I had heard a lot about chemotherapy that it is very painful and with lot of side effect. But the Dr. had explained me everything and told that the side effects are temporary and medicine will be given to reduce the effects. Also the hair fall will be temporary and will grow as the treatment will stop.

In the beginning, PET CT has been done for assessment of disease status and restaging and in follow up case of carcinoma endometrium status post-operative and post Chemotherapy PET CT was again carried out. The findings of final PET CT Scanning – No metabolic active residual recurrent disease in the body.

BACK TO LIFE

Of course cancer is risky disease. Cancer results of treatment are best when cancer is detected and treated early. The Oncology team lead by Dr. Alok is expert and very cooperative. They provided most advance cancer treatment and given best care plan for best results and given quality care, support and reassurance that there will be no side effects of chemotherapy for coming back to life, motivated and encouraged to be bold, strong. It was the team at Saket MAX of super specialist surgical, medical oncology, pathology and staff including sisters and nurses that today I am back to my normal life doing house hold work and happily living with my family. Now, regular follow up checkup after 3 months with almost no medication. One can fight with such disease if patient and doctors join together to overcome and come to life again and yes my hair have grown again and much better than before. Dr. Alok says I look more beautiful than before.