Is this wait too long? US Healthcare Filter
August 18, 2023 6:04 AM Subscribe
My doctor recommended I have a hysteroscopy with d&c to biopsy a mass in my endometrium. This is scheduled for Nov 22, 2023. This seems like a long time away. Am I being unreasonable?
Following abnormal menstrual bleeding, mass was found in my endometrium on ultrasound. The gyn told me she preferred to do a hysteroscopy for biopsy rather than an in-office endometrial biopsy as it would be more specific and reliable. This has to be done under anesthesia at a surgery center.
I have a history of breast cancer and took a long-term breast cancer recurrence-preventing drug that also increases the risk of endometrial cancer. I have had multiple breast biopsies, and they were always scheduled in a matter of days after ultrasound confirmed the need for biopsy. Despite my cancer history, I'm not particularly anxious about my health in general or cancer in particular. I don't get "scanxiety" or worry about every possible symptom. But 3-4 months seems like a long delay for this procedure.
They did offer me a date in mid-October, but it was 2 days before my wedding (recovering from surgery is not on the wedding timeline!) and still > 3 months from the original ultrasound. I asked the surgery scheduler to double check with the doc that four months after the ultrasound was a reasonable delay for this procedure, but I'm curious if my history and risk factors are making me unreasonably anxious about the timing here. I'm in the US. The surgery scheduler mentioned that the gyn only has access to the surgery center on certain days/times.
Have you had a similar procedure? What was the delay between ultrasound and the procedure?
Following abnormal menstrual bleeding, mass was found in my endometrium on ultrasound. The gyn told me she preferred to do a hysteroscopy for biopsy rather than an in-office endometrial biopsy as it would be more specific and reliable. This has to be done under anesthesia at a surgery center.
I have a history of breast cancer and took a long-term breast cancer recurrence-preventing drug that also increases the risk of endometrial cancer. I have had multiple breast biopsies, and they were always scheduled in a matter of days after ultrasound confirmed the need for biopsy. Despite my cancer history, I'm not particularly anxious about my health in general or cancer in particular. I don't get "scanxiety" or worry about every possible symptom. But 3-4 months seems like a long delay for this procedure.
They did offer me a date in mid-October, but it was 2 days before my wedding (recovering from surgery is not on the wedding timeline!) and still > 3 months from the original ultrasound. I asked the surgery scheduler to double check with the doc that four months after the ultrasound was a reasonable delay for this procedure, but I'm curious if my history and risk factors are making me unreasonably anxious about the timing here. I'm in the US. The surgery scheduler mentioned that the gyn only has access to the surgery center on certain days/times.
Have you had a similar procedure? What was the delay between ultrasound and the procedure?
Yes, it's long but it's not unusually long. There should be discussion with your medical team, though, about what hypothetical concerns are and specifically how the timeline might influence equally hypothetical outcomes. There are situations in which I would advise against waiting any longer than necessary, and situations in which flexibility makes more sense. You and your doctor(s) can (and should!) talk about that.
posted by late afternoon dreaming hotel at 6:47 AM on August 18, 2023
posted by late afternoon dreaming hotel at 6:47 AM on August 18, 2023
That seems unreasonable, and you’re right to be concerned. Do you live near an NCI Designated Cancer Center? They will likely be a better resource for your biopsy.
posted by bluloo at 7:18 AM on August 18, 2023 [2 favorites]
posted by bluloo at 7:18 AM on August 18, 2023 [2 favorites]
In Australia, three months would be considered too long. We have a mandated 3 week maximum wait between diagnosis of potential gynecological cancer, and the surgery to assess/remove. But that's under a one-payer system and the US private system might have other barriers. With your previous diagnosis, I would be pushing hard for surgery sooner.
posted by Thella at 4:47 PM on August 18, 2023 [1 favorite]
posted by Thella at 4:47 PM on August 18, 2023 [1 favorite]
Comparable situation in the UK, on the NHS: two weeks from initial phone call to GP appointment; one month from GP appointment to ultrasound; three and a half weeks from ultrasound to hysteroscopy under general anaesthesia.
My understanding is that because the ultrasound raised concerns about cancer, the follow-on test(s) should have been performed within two weeks, but for reasons that are specific to me, that hasn't been possible.
Please feel free to MeMail me if you want more detail.
posted by ManyLeggedCreature at 5:26 AM on October 2, 2023
My understanding is that because the ultrasound raised concerns about cancer, the follow-on test(s) should have been performed within two weeks, but for reasons that are specific to me, that hasn't been possible.
Please feel free to MeMail me if you want more detail.
posted by ManyLeggedCreature at 5:26 AM on October 2, 2023
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Maybe it would help to ask to be put on a standby wait list to get a call if any appointment open up last minute (if your life is flexible enough for that).
Other than that, I don't have any advice. Hopefully someone else will know some magic secret we can both use!
posted by CleverClover at 6:30 AM on August 18, 2023