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Post-op visit #1: Path results are back! Spoiler alert - good news

Thanks to Tram for having me write a guest post! I have been able to accompany Tram to some of her appointments, and hope that with my medical background I have been able to help in a small way. The information can get very complicated and overwhelming, so it helps to have a medical “interpreter” to navigate through all the technical jargon. For me, it is analogous to taking my car to the mechanic - it makes sense when they are explaining it to me at the shop. Once I leave, there are all sorts of questions I wish I had asked, and I forget all the details they talked about. Tram had her first post-op visit today with Dr. Tenney and her team, and we (and Erwin, via speakerphone) were anxiously awaiting the pathology report. Verdict: Stage 1A. In terms of cancer staging, that is just about the best news we could have hoped for. The uterus has 3 layers: the endometrium (inner layer, the lining of the uterus), myometrium (middle, thick muscular layer), and serosa (thin outer layer). What Stage 1A means is that the cancer cells have grown in the endometrium but have not spread more than halfway through the myometrium. At the largest, the extent of the tumor was 4 cm. All of the tissue samples outside of the uterus that were taken during Tram's surgery were negative for cancer. So that's great news! What's next? Because of the aggressive nature of uterine carcinosarcoma, and the fact that it is impossible to say whether there aren't a few cancer cells left here or there that were too small to detect, chemotherapy is the standard of care even if we think the cancer was all taken out during surgery. Without chemotherapy, there is a high recurrence rate of this type of cancer. Dr. Tenney explained it as an insurance policy, which provides extra protection against the cancer coming back. Tram is set to begin chemo on November 9. This will be done through an IV every 3 weeks, for 6 cycles. There will be hair loss, which will start to occur 12 days after her first chemo session. Other side effects vary among individuals, but common ones include nausea, fatigue, and a weakened immune system. She is also going to see a radiation oncologist to talk about possible radiation therapy. So thankful for Dr. Tenney, who besides being a skilled surgeon, is a compassionate physician. Whew! That's a lot of information. On another note, Tram's recovery from surgery is going well. If anyone is able to stop by, she does need occasional help with small chores that are more difficult for her because of the bending over and lifting - washing dishes, taking out the trash, picking up the mail, doing laundry. And maybe she will let you help with her puzzles :) -Christina

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