July 28, 2022

Dr. Cilliers Mirais

RE: Rita Charbonneau

DOB: September 20, 1964

Dear Cilliers,

Thank you for asking me to see Rita again. Rita is 57 year old G2P2 that was diagnosed with endometrial
cancer and is now coming to me follow-up.

In summary she was seen the first time by me in January of 2020. At that time she had some
menopausal bleeding. Endometrial biopsy confirmed high grade sarcoma with rhabdoid features. In
February of 2020 she was taken to the operating room by gynecologist Dr. Mirette Lee and total
abdominal hysterectomy bilateral salpingo-oophorectomy and bilateral pelvic lymph nodes dissection
was performed. The final pathology was reviewed and the diagnosis of a high grade component rhabdo
sarcoma stage 1B was made, lymph nodes were negative.

Postoperatively, she received adjuvant chemotherapy. She received a total of 14 cycles of

chemotherapy.

In May of 2020 the patient had a confirmed polumnary emboli and was treated with heparin.

It is noted in the progress note from BC cancer agency that Rita should be seen every 3-4 months for the
first two years and then annually thereafter was taking off the history and a physical examination
including pelvic examination. Regular chest exercise recommended while other imaging investigation
should be performed only as clinically indicated.

You have referred today to me for follow-up.

Rita confirmed she has not had any bleeding. She does not have any change in symptoms. She does not
have any abdominal pain. She does not have any chest symptoms. She has using a dilator once of week
to maintain normal cavity of the vagina. Currently she is not sexually active. Currently she is being
followed-up radiation oncologist every six months and today she has follow-up appointment with him in
three months.

On examination today abdomen was soft. On speculum examination no abnormalities was noted in the
pelvic area.

Rita needs to be seen by me in six months. I have no problem proceeding with the follow-up but I will
need referral from you to see on six months according to MSB rules.

I thank for your kind referral.

Dr. Lampen.