Have some questions prior to 1st consultation

Hi catsandtrees, as you’ve gone private it may not be so easy for us to say what to expect. On my NHS 2 week pathway I had an trans vaginal ultrasound at my first appointment only one week after seeing my GP and then a hysteroscopy a week after that. I had no symptoms other than a slight pink tinge on the paper when I wiped - no pain, no cramping at all. I’d imagine he might talk with you about your symptoms and then refer you for an ultrasound- or maybe do that at the same appointment?

Hi, it is a shame it took 2 weeks for me to get a GP appointment in the first place. Had I gotten in quicker I may have just gone with the 2 weeks NHS pathway. 

Thanks Marmite Fan. Just hope some some of exam takes place. It would make sense. Read your journey, you have been through a lot and really pleased to read your excellent results. 

Hi catsandtrees

I am sorry to hear that you are having some cramping and some pain.

I originally went to hospital as I had a heavy bleed. From that I was referred to have ultrasound. The ultrasound showed an issue so the next step was to be called in for a biopsy. I was also referred for a CT scan. 

It was not until all of these happened that I actually saw a consultant. By then I knew it was endometrial cancer. 

I was not examined during the consultation as they already had the info they needed but he did take a thorough medical history and asked about cancer history in my family. After that I had my pre op checks- blood pressure, BMI, ECG etc. This was on a Friday pm and on the following Monday I had a hysterectomy. 

I would imagine that if you have not yet been examined, then this is likely. You could perhaps give them a call and ask what you can expect to happen at the appointment. I spoke to the nurse who was going to be doing my biopsy and it helped that she talked through what would be happening. 

A visual examination will not confirm cancer. If there is an ultrasound or physical examination it can pick up whether something is amiss, however to confirm whether it is cancer or something else, then a biopsy is usually done. Mine was done as an outpatient and after the scans. 

Initially I only had a heavy bleed but it was a couple of weeks later I had some cramping. The nurse said to me it can happen when the uterus recognises something is amiss and is irritated by it. This however does not always mean cancer and some non cancerous conditions such as fibroids can cause it. 

I hope that your appointment goes well on Thursday and if there is anything you want to ask about, there are lots of lovely ladies on here who will want to offer support. 

The Macmillan Support Line is also there if you feel talking things through would be helpful.

Jane

Hi Jane2511, thank you for  that info I will ring up tomorrow and see what I can find out. My GP wrote on the referral letter that it is not fibroids but how he can say that I don’t know. 

This forum is so warm and friendly and it is very encouraging and should the worse happen then I will be on here lots. 

They might want to give you a brief examination - they can sometimes tell if your uterus is enlarged by feeling your abdomen, and when I first saw a doctor about heavy bleeding one of the things they did was a brief examination to see if there was any visible vulval/cervical cause of bleeding. Neither of those things will necessarily tell them a huge deal but it will help them start to understand what might be going on.

In my experience initial consultation was mainly a discussion around symptoms and history, with that small physical examination. 

Next step was transabdominal and transvaginal ultrasound - that will tell them if your endometrium is thicker than it should be (this is a risk factor for cancer but doesn't necessarily mean you have it).

For me, I then had both a CT and MRI scan - I don't think this is the usual next step (I was in intensive care for another reason and then started bleeding very heavily which caused complications with my other condition) - from my understanding these scans tend to occur after a cancer diagnosis, which can only really be done with a biopsy (to answer your question - no, they won't be able to tell if you have cancer just by examination). 

So if your symptoms and ultrasound results suggest something - cancer or otherwise - is wrong, your next step will be a hysteroscopy and biopsy.

For me, I wasn't put on the cancer pathway. I had heavy bleeding to the point of needing multiple blood transfusions but just got sent for the ultrasound and a standard gynae referral for which I had to wait about 3 months, and they didn't seem too alarmed, just booked me in for the hysteroscopy and the wait for that was a about another 4 months. It was only when the MRI was done and the radiologist's report came back that there was a suspicious mass that things started to speed up and people seemed to be worried (I still don't know if I have cancer, but fingers crossed I don't). 

Hi Lauz9888, thank you

I think I am nervous about a cancer diagnosis as the GP wrote on the referral that I will need a hysteroscopy so of course that makes me think that he thinks it is cancer. Hate this second guessing all the time.  Just need to wait and go with the flow.

Gosh what a journey you have been on. Wishes you good news going forward.

catsandtrees, needing a hysteroscopy can just mean a need to have a good look round inside as they really can only tell so much (and not much) from the outside. Btw fibroids usually shrink post menopause so that may be why your GP said that. 

I know it's much easier said than done but try as much as you can not to let your brain get carried away with all the worst possibilities. Of course you don't want to assume everything's fine and then get blindsided if it's not, but all your current circumstances mean is that your symptoms meet a threshold that warrants further investigation. A hysteroscopy just means they want to get a real view of what's going on in there - a view through a camera is a lot more immediately understandable than the various scans etc. that give different sorts of information. 

My friend recently had a colonoscopy for suspected colon cancer. She had the investigation, of course it wasn't pleasant, but the results came back that she doesn't have cancer, she has a much less serious and easier to treat condition.

So do your research, understand the possibilities, but try not to get stuck on the assumption it's cancer, even if doctors are throwing the word around. Worrying means you suffer twice, and trying to keep on an even keel now will help make the investigations a little easier to bear. 

Best of luck with your appointment. 

Thanks Marmite. 

You are totally right. will do my best, thanks