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Spring Survey Results 2012

Caller Questions

Program: In what way does being female increase your cancer risk? A look at gynecologic cancers
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Andrew Schorr:

We're back live on KVI, Andrew Schorr on Patient Power. So somebody out there is listening saying, whoa, Sally is still in bed. She should have heard this. Well, you can. Tomorrow afternoon the replay will be on patientpower.info. And about 10,000 people a month, this month, which is a 50 percent increase over last month, which is a 50 percent increase over the month before, are going to our website and listening. You can download it on your iPod, or if you work for Microsoft your new Zune, and listen to it as an MP3 file. Okay.

We have a question from Sheila in Maple Valley. Sheila, welcome to Patient Power. Thanks for listening.

Caller:

Hi, good morning. Thank you. I was wondering if you could address uterine fibroid tumors that appear to be benign and have been tested and everything, if there's any relation in any way to uterine cancers at all.

Andrew Schorr:

Okay. I'm going to let you listen on the air, and we're going to talk to the professor, Dr. Greer. Go ahead, Dr. Greer.

Dr. Greer:

That's an excellent question. The uterine fibroids are extremely common. Probably 60 percent of women over the age of 65 have uterine myomas, leiomyomatas that are--can be very small or they can be very large. There is a subset of uterine leiomyomas that actually turn out to be sarcomas of the muscle and can be very complicated.

Andrew Schorr:

And that is a malignancy, sarcoma.

Dr. Greer:

Yeah. Sarcoma is a cancer. And there is really no noninvasive way to determine whether leiomyomas are benign or malignant without removing them. There is new technology like computerized--excuse me, like PET scans which is a way of determining the metabolic activity within a tumor that may be helpful. I don't know the answer, if that has been investigated, but it is one possibility that we could possibly use.

Andrew Schorr:

Okay. So if a woman has fibroids--and I know a number who have had it--should they just worry that there's--just generally, should they worry that there's another shoe that's going to drop?

Dr. Greer:

I think that's somewhat age dependent. The younger individuals that have myomas and they are still menstruating, they are responsive to estrogen, and we are most, as clinicians, like Heidi and myself, if someone who has a myoma that happens to begin to grow rapidly, that's something that is a sign that something may be awry. Or if you have someone that is post menopausal they should shrink because they don't have the estrogen support, and if there's any change or increase in those myomas then that should be further investigated.

Andrew Schorr:

Okay. You heard it from the professor who trained a lot of the other gynecologic oncologists around here too.

Now, is this right? We have a second caller whose name is also Sheila, is that right, from Lynnwood? You're on the air. Am I right?

Caller:

Yes. Good morning.

Andrew Schorr:

Wow. It's a combination--this is the Sheila show. Okay. Go right ahead, Sheila.

Caller:

Yes. I recently received my test results back, and I have numerous cysts in my uterus. I also have some fibroid tumors. And I have cysts in each of my tubes and in my kidney. So I was advised that it looked like I could go to a gynecologist and they may suggest a hysterectomy and that I may just deal with the pain or discomfort for as long as I can deal with it and decide what to do. I've been advised to come back in another month or two to do an ultrasound.

Andrew Schorr:

So you're worried sick right now.

Caller:

Well, what worries me is that my breast exam didn't come back very well either, that there's a shadow. So I'm kind of trying to set my priorities here.

Andrew Schorr:

Okay. We're going to go to Dr. Gray for this. We're not practicing medicine over the air, a lot of disclaimers, and you obviously need to see the providers who are right for you.

I did a breast cancer program actually at the Seattle Cancer Care Alliance with Julie Gralow, some people know, and Michael Hunter, who has been on our show as well, from Evergreen. And certainly I know with mammograms and various, there's a lot of stuff that comes back that isn't breast cancer, so all of this may be unrelated. But I know you've got all these cysts and things and you listen to this program, and you say, Oh, my goodness.

So, Dr. Gray, put it in perspective because Sheila and other women listening are worried, get these test results, say come back in a month, and they're losing sleep in the meantime.

Dr. Gray:

Right. Good morning, Sheila.

Caller:

Good morning.

Dr. Gray:

It sounds like there's several things that could be going on, and I agree you do have to kind of prioritize to a certain extent, but certainly all of these need to be followed up on is what I would like to emphasize. Certainly an abnormal mammogram absolutely needs to be followed up on, either to referral to the appropriate either breast cancer surgeon or a breast cancer clinic or something if you need further imaging, ultrasound, possibly a biopsy. And I would, since this is Breast Cancer Awareness Month and as we've spoken about breast cancer is the most common cancer amongst women that should--I would definitely make sure you're getting follow up for that.

The other issues, it's a little unclear what is going on. You've got some issues going on with the uterus, possibly some cysts, and then potentially something going on with the kidneys, although many times we find benign cysts when we do CT scans--I presume that's what you had--that are inconsequential of the kidney. But I think if you haven't seen a gynecologist yet I would definitely go in to see a gynecologist to at least have them look over your records and determine if you need some additional testing, such as an ultrasound.

Caller:

Okay.

Andrew Schorr:

Okay. Sheila, we wish you well. Hopefully that gives you a bit of a plan. But I know for me, I'm one, and my dad, he lived to be 92, and I'll tell you, when he had a concern he tried to figure out who was the right doctor to go to with experience and with a specialty related to what he thought his concern was. Obviously your primary care doctor can guide you, and you can say to your primary care doctor, you know, I really would feel most comfortable if I saw a gynecologist to just look at this further. And I think it's going to be the rare doctor that will say, Well, no, you know, throw cold water on that. You do what makes you feel comfortable. Thank you for listening, Sheila.

Caller:

Thank you for the program today. Appreciate it.

Andrew Schorr:

Thank you, ma'am.

Caller:

Okay. Bye-bye.

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