Gynaecology Referral on 2 week pathway

[Pinkelephantisreal]

Have had a very bad week - went for a routine scan last Monday (ultrasound) as had some unusual bleeding and my iron levels are really low - think they are 7. Exhausted all the time too. All was fine until Wednesday when I got a text from GP saying results were abnormal and they would call me the next day…

Next day the doc explained that my uterine lining is severely thickened and looks “abnormal” on the scan and they are referring me on the 2 week (apparently now 28 day!) pathway.

Ive been referred for a biopsy and further ultrasound and today got a letter confirming my referral to Gynaecology Oncology department for suspected cancer.

I genuinely feel in shock as I didn’t expect this for a second (and was actually moaning what a waste of time the first scan was!)

I am completely terrified of the biopsy and the GP just told me to take some paracetamol as it can be a little painful. From what I’ve read online (know I shouldn’t have) that’s a bit of an understatement!

I don’t know what to think and didn’t ask the GP anything as was too shocked…not sure if they are just being cautious or if there is a real chance of it actually being cancer.

My iron levels have been low for around 18 months so concerned something could’ve been wrong all this time.

(Sorry if this should’ve been posted on woman’s health I couldn’t make my mind up!)

I had an ivu last week for post menopausal bleeding and the doctor casually mentioned that she’d do a quick biopsy. It was quick, less than 2 minutes, and it was very uncomfortable - sharp cramps - but it was over and done with before I could come to terms with what was happening. To be honest the biopsy was only slightly more painful than the internal ultrasound was unpleasant.
good luck x

I had a hysteroscopy earlier this year for post menopausal bleeding. I took paracetamol and ibuprofen beforehand. I was not painful, just uncomfortable. I had a few cramps for a couple of hours after. If I had to have another it wouldn’t particularly bother me. Better to find any problems before they get potentially more serious.
I hope it goes well and you get good news.

Thank you both, that’s very reassuring. You hear so many horror stories of these tests it’s “nice” to hear some say it wasn’t so bad.

Think the waiting is just making me imagine all sorts. Hope you are both ok now?

Thanks again x

I’ve been through this. Having the sample taken was actually pretty pain free. I think my mind was in overdrive at the time, so I barely noticed.

The good news is, you are now in the system. The NHS are actually pretty good with situations like yours.

I was diagnosed with cancer, eleven years ago. I’m all good following treatments. When I was first told, I thought I was going to die. It's such a horrible shock. I saw my GP, who was lovely with me. She prescribed amitriptyline which helped me sleep, whilst I was waiting for everything to happen. You think you won’t cope but we do. We’re stronger than we think.

There are excellent treatments now for cancer, so even if it is cancer, and nothing is certain yet, you’ll be okay. 💐

Thank you all.

Ive received my appt letter today and it’s for next week - eek. But I am very impressed with the speed this has all been sorted (and a little overwhelmed!) the NHS seems to be pulling out all the stops. It will be 2 weeks exactly from when I was referred and less then 3 weeks since the scan so quite amazed by that.

a hysteroscopy is a barbaric procedure , or can be without proper pain relief. I opted for a GA when I had mine about 15 months ago, I'd do more research about options if you can. Quite a few threads here about this.
I wouldn't call them horror stories, it's just other people's experiences.
i had a full hysterectomy following the hysteroscopy as cancer was present, and this was later followed by a few rounds of radiotherapy as the cancer had spread. I'm still seeing consultants from both gynaecology and oncology every three months and being monitored. I feel fine, was pretty awful at the time

You should have the option of a general anaesthetic- I opted for that for mine and was v grateful.

Sorry OP, but I also had an extremely painful hysteroscopy and uterine biopsies, so much so that I was left with PTSD afterwards. Unfortunately, there is a wide discrepancy in the levels of discomfort/pain that women feel during the procedure, and there is no way of knowing what you will feel until you are actually going through it and therefore other people's experiences will not necessarily be what you experience.
Statistically about a third of patients feel only discomfort or mild pain, about a third feel moderate pain but 35% of patients suffer severe pain during the procedure. You are entitled to have the procedure under general anaesthetic, but medics may try to dissuade you from this as its cheaper for them to do it with patients awake.
Personally there is no way I would have it done again without GA. The Campaign Against Painful Hysteroscopy can give further advice or support if you need it.
Hope all goes well and you get the all clear.

I experienced something similar 18 months ago. I was 3 yrs post menopause & 2 yrs into HRT. Luckily no issues were found & I was reassured there & then. I do have a Dermoid ovarian cyst & still awaiting a surgery date to remove it along with the ovary.

My lining was measuring 8 instead of the expected 2 - max 4 based on post menopause.

The procedure was indeed barbaric & I too was left traumatised for many months after. My understanding is that years ago this procedure was performed under GA but NHS has now tried to convince women it's a minor procedure with minimal pain!

I respect everyone has different pain threshold's, I would say mine is pretty high, I had 3 natural deliveries with gas & air for the final hour of labour, yet this procedure the pain was off the scale. I'm unsure if it was due to being post menopause & my cervix needed to be dilated in order to insert the camera & biopsy but it was horrific my blood pressure dropped, I almost threw up & passed out with the pain it took 25-30 mins & an hour in recovery before discharge.

I also signed the campaign to stop the procedure without GA or sedation at the very least.

The 2 week pathway is standard for these findings to rule anything untoward out but I would research the procedure from patient's experiences & not the NHS website.

Hysteroscopy without GA is a quick and minimally invasive way to get the answers the OP needs. I’ve had it and it was absolutely fine, about 20 seconds where it was a bit ouchy. Excellent recovery. GA should be available for those who need it but saying it’s essential and shouldn’t be available without it is quite frankly a bit daft.
Good you’ve got an appointment OP. Are you pre or post menopause? Endometrial cancer is now very effectively treated. Obvs not what anybody wants but it’s generally a very positive outlook.

I had gas and air for a hysteroscopy and it was brilliant. Had a polyp removed without any pain.

I had a hysteroscopy and biopsies last Thursday and they warned me it would likely be "an intense pain" but over quickly.

It felt very, very similar to a coil insertion ie uncomfortable briefly but over quickly and only slightly worse than a smear. I didn't even take painkillers beforehand. Some people find them awful but a significant number do not.

I'm wishing you every luck in the world.

Another one who had a hysteroscopy and polyp removal with no pain relief and felt absolutely nothing. It’s tricky because some women find it genuinely traumatic and others find it no big deal, and there doesn’t seem to be an easy way to work out which is going to apply to you. (Although anecdotally, there does seem to be some correlation with women who find smear tests painful?) If you’re worried, ask for sedation or GA. There are no medals for having it without!

The 2-week-wait process is genuinely impressive and all the staff I met when I was on it were so kind. I had good news at the end of it and I hope you do too.

I had one plus biopsies 14 years ago, I was really nervous .. speculum in, lovely older male gynae, he said I might feel some cramping when he did the biopsies, I got nothing, not even post procedural bleeding..I used to have dreadful heavy painful periods, so bad sometimes I passed out..
.

I'm having a Gastroscopy in 2 weeks and terrified!

I had a scan 11 days ago and was referred on the 2 week wait, then had a biopsy 7 days later. It was uncomfortable but manageable, but everyone is different.
It is stressful when referred on 2 week wait but can't fault the Nhs with the speed of referrals.

I had a hysteroscopy in June and didn’t get on with it. I will take the middle ground however and say that the nurses kept asking if I wanted to proceed and stopped quickly when I’d reached my limit. You may well be fine, it’s also fine to advise them to stop (it’s your consent) and I had a GA within two weeks so not a significant delay.
Best wishes, as other posters have said, the NHS really seem to be in it when it comes to the two week pathway which is great.

May I ask your age and are your postmenopausal?

Thanks everyone the letter I received said the initial appointment is for a repeat ultrasound (transvaginal) and biopsy and if I need a hysteroscopy it will be done/ arranged at a later appointment and mentions I can have a general anaesthetic if I choose (so fingers crossed they will provide this if absolutely needed.)

Im 46 and in perimenopause. Still having periods but they have become closer together and far heavier. I’ve also had PCOS for many many years.

Still terrified - at this stage more of the tests then anything else! But I really appreciate all of your replies.

Thank you my gynae is also male too. Glad you had an “ok” experience hopefully I’ll be similar.

I had a hysteroscopy 3 weeks ago, including a biopsy. I was very worried before hand but found it manageable. I did have a local anaesthetic, which I feel helped. Gas and air was available too, but I didn’t need it.

I did feel several bouts of cramping, much like period pain or early labour pain. Only a couple of short periods of ‘sharp pain’ which was bearable. For context, I can’t stand needles, injections and have frequently fainted when in pain! So it can be manageable for some people, but I know others have such a rough experience.

I did take my husband in with me for moral support and the nurses were absolutely brilliant, with one eho focussed on holding my hand and talking me through everything.

Thank you all for writing. I have my hysteroscopy tomorrow and I’ve really appreciated the time you have taken to write and share. It has helped me.

… for anyone else waiting, I’d echo other posters - it’s impressive how quick the NHS can move. I was referred Monday and appointment is 4 days later for a hysteroscopy incl. biopsy.

I’ve had several hysteroscopy procedures, all performed by skilled medics, so no pain at all. The worst part is the undignified position you find yourself in!

Unfortunately for me. I had a large aggressive tumour hiding in my womb wall. The unusual bleeding prompted me to push and push for an mri, where a different cancer was also present! If I hadn’t pushed for the mri, the medics would still be telling me it was a harmless fibroid!

I digress. The NHS can move fast if they want to. Pain relief is on hand and it’s over and done within half an hour.

Good luck @sunnydayswim It will soon be over. Sorry to hear your story @Enigma54 - hope you’re doing ok.