Are There Any Survivors in the Room? A Story for Gynecological Cancer Awareness Month

female-dr-comforting-patient“Are there any survivors in the room?”

I don’t remember why I was there, but it was a discussion of cancer. I looked around at the people who had raised their hands. It wasn’t until the speaker moved on that I realized I was a cancer survivor, too.

Does that seem strange? But my first cancer in 2004 was so ambiguous. I had had a routine Pap test, and was referred to a gynecologist. I had had problematic Pap tests before, and it had usually meant I had a uterine polyp or a vaginal infection. This time it was not simple dysplasia. It seems I had precancerous cells, and the recommended treatment was a hysterectomy. I thought about it, and my sister discussed it with a friend who was also a gynecologist, and reported back that surgery was indeed the treatment of choice.

How was I supposed to relate to a cancer diagnosis that was made only after the cancer was out of my body?

I was over 50, and had pretty much gone through menopause, though once or twice a year I would have some bleeding. Everything about my reproductive system was ambiguous. I had started menstruating at age 9, along with the body changes of puberty, but seldom had my periods. When I was 18 and starting to move beyond my circumscribed Jewish Bronx upbringing, I was diagnosed with Stein-Leventhal syndrome. Great, I thought, I finally get a diagnosis, and it’s Jewish! Since that time, the condition has been renamed polycystic ovary syndrome, or PCOS. PCOS is a risk factor for many other diseases, including endometrial cancer.

But let’s get back to the hysterectomy. I had already decided that I would have the surgery when my sister got back to me. What had my uterus done for me lately, anyway? I had the doctors make the arrangements, met with the surgeon, and went through all the pre-surgery rigmarole. I made plans to stay with a friend for about a week after surgery, and checked into the hospital. When I woke up afterward, I was told that the biopsy that was done during surgery had been negative. Continue reading

Let’s Talk Contraception: Do Birth Control Pills Cause Blood Clots?

Alarming ads urge you to call a lawyer if you’ve been “injured” taking certain birth control products, such as Yaz, Yasmin, or NuvaRing. These injuries include venous thromboembolisms (VTEs), heart attacks, and strokes. It’s frightening to wonder if you are endangering your health by taking a pill to prevent pregnancy or treat dysmenorrhea (painful cramps).

Should you stop taking your pills? What is a VTE and why should you worry? VTE is a blood clot that usually starts in your leg, but may break loose and travel to your heart or brain and cause a heart attack or stroke. It can be life-threatening, so it is a serious side effect to be concerned about. All birth control pills may increase your risk for a VTE, but it has always been considered so small that most women can safely take the pill. About 3 to 9 women in 10,000 who use birth control pills for more than one year may have a VTE compared to 1 in 5 women out of 10,000 who are not pregnant and not on the pill.

Birth control pills are considered very safe for the majority of women, but all medications carry some risk of adverse effects.

When oral birth control pills were first developed, they contained much higher doses of estrogens and progestins — types of hormones — especially estrogen. It was also noticed that there was a higher risk for developing a blood clot while using birth control pills than in nonpregnant women who didn’t take the pill. It was thought that the high dose of estrogen was responsible for this risk. So, with continuing research and development, eventually the dose of estrogen was decreased to the lower level used today to minimize the chance of a clot. The type of estrogen in pills today is almost exclusively ethinyl estradiol. Continue reading