Fast track cancer investigation

[HelpIcantfindaname]

I saw my gp yesterday. I have been on HRT for 18 months & have had 2 bleeds recently. GP is fast tracking me to Cancer thing.
I have a mirena coil & evorel 25 patches.
Has anyone been through this and can tell me...

• how long did you wait for appointment? When gp looked on computer yesterday there were no available appointments, she said I should hear from the hospital within 2 weeks. But I dont know if that means appointment in 2 weeks, or just hearing from them within 2 weeks.

• when you went to hospital, did you have a scan/investigation & were you told what they could see straight away....or did you go back for a further appointment for results?

I have to go to gp for blood tests on Tuesday.

I have been googling - daft I know, I'm a bit worried. And just wondering what to expect from appointments?

I was seen within 3 days, had transvaginal ultrasound, examination and ( after careful discussion with options ) endometrial biopsy - all on the same day in the same unit. Consultant said he considered it would all be ok but would be confirmed later . Heard about a week later - all to the good, thankfully.

To give you some context - less than 5 % of 2 week wait referrals actually pick up a cancer, so being referred on a 2 We is just your GPS lazy way of bypassing the usual referral process and getting your investigations done

I know it's easy to say this, but it's unlikely you have cancer. The Mirena usually controls bleeding when on HRT but not always. You are also on a very low dose of estrogen.

Not knowing your age, OR how long you have not had a natural period, it's hard to say, but the more likely explanation is your bleeding is a period caused by your own hormonal ups and downs.

Even if it were hyperplasia (which can be cancerous or not) the Mirena is actually the treatment for it.

How old are you and were you post meno when you had the Mirena fitted?

OP if you can, try to avoid thinking of this as a 'cancer' referral. Your GP is working by the book and avoiding you having a long wait, but it's not necessarily cancer at all.

There can be all sorts of reasons for a bleed, anything from a polyp to your own periods. I had 2 or 3 bleeds ( just spotting) in the first 2 years on HRT. My consultant who I see for gynae things (private) organised a scan, then did a biopsy after the 2nd bleed and a hysteroscopy and biopsy after the 3rd one. Each time I waited around a week or two for the investigations (again, privately) and was given the results of the hysteroscopy on the day and the biopsy results a week later. In my case it seemed it was just an HRT 'blip' or my own periods (I was about 54) kicking in.

I had horrific bleeding that resulted in being admitted.
Tests included ultrasound scan, hysteroscopy and biopsy. None of them horrific, but obviously not pleasant either! A fibroid was found and resected at a later date and then had a hysterectomy as bleeding continued, but could have tried mirena /ablation.
They will check for worst case scenario, but unlikely that it is. Staff are usually lovely, so try not to worry and look at it as getting your issues sorted.

The target is that you are supposed to be seen face to face within 2 weeks. Probably 95% of referrals to be seen within 2 weeks and most trusts achieve that or very close to it. I have heard you can ring the hospital and just ask what the typical wait is right now to be seen; they usually know.

I dunno what exact tests they'll do but they will try to blitz and get as many tests done as possible in an appointment until they can be sure there's nothing to worry about. Don't fret if there are a lot of tests; it's because each test can only rule a few things out and they are hyper cautious about not discharging you before they check everything.

Sometimes you'll get called back another day for extra tests. This is usually because the tests are limited rather than because they found something sinister. Even when they find nothing to be concerned about they like to tell you in person what they did or didn't find (so you can ask questions).

Let us know what happens?

Thank you everyone.
I'm 51.
Had mirena since last child who is nearly 11.
Perimenopausal since Dec 2017ish...well, that's when it dawned on me what all the crap things I was going through were.
End of Feb 2018 got HRT. Was on Eleste duo at first, began to bleed a lot 4 months later & after googling found doc had put me on wrong meds...as I already had the mirena I didnt need the extra progesterone from the tablets. I'd put some weight on too, so decided to try patches.
Been on patches since June 2018.
Bled March 2019 for a week, like a normal period. Same happened in June.
At doc last Thurs & when told her that, she decided to take swabs, she found brown discharge & said looked like I'm bleeding now, (but nothing to see apart from on her swabs since)
I don't have other symptoms, & gp did say this is to just make sure it's nothing sinister, & it doesnt mean she thinks it is.
Back to school on Mon after 6 weeks off so wont have time to worry from next week anyway!
Really appreciate your replies - thank you.

PS will update to let you know how it all goes.

@HelpIcantfindaname How old is your Mirena? it's licensed for 4 years as part of HRT so if it's older than that it won't be working. If it's coming up to 4 years there won't be much progestogen left in it = bleeding.

Is this the same Mirena you had had in place for 11 years or has it been changed a couple of times at least?

Mirena has been replaced twice since got it. Last time just few months ago.

I have a mirena and evorel 50, I'm nearly 50 and have been peri for 4 years. For the most part the mirena has left me period free but occasionally I do get a bleed which is my own hormones taking over again (which is totally normal in peri), I know it's a hormonal surge as I get all the symptoms I used to get when having regular periods... sore boobs, spots and headache so although you're getting checked out which is great to rule other things out it's more than likely as Jingly said your own hormones.