Endometrial cancer (a form of uterine cancer) is the most common gynecological cancer in the United States. Thankfully, it is often curable. Because this cancer is often caught early, most of the side effects stem from its four main treatments. While treatments are improving, most of them still cause unwanted side effects.
HealthCentral spoke with Jamie Bakkum-Gamez, M.D., a professor of obstetrics and gynecology and gynecologic oncology at the Mayo Clinic in Rochester, Minn., to get her thoughts on optimizingyour endometrial cancer treatment and reducing your side effects, whether it be chemotherapy, hysterectomy, radiation, immunotherapy, or a combination of treatments.
Hysterectomy side effects: What you should know
First, it’s important to seek out minimally invasive, or robotic, surgery to reduce unwanted effects of hysterectomy, Dr. Bakkum-Gamez says. For example, if your cancer is in an early stage, doctors may not need to remove lymph nodes — or, they may be able to do a sentinel lymph node biopsy to find out which lymph nodes need to be removed. Removing fewer lymph nodes decreases the risk of lymphedema, which is the swelling that occurs when lymph nodes aren’t there to do their job.
If your ovaries are removed along with your uterus, you’ll go through surgical menopause. You may be able to use estrogen replacement to help with the side effects.
And, if you want to preserve your fertility after cancer treatment, there are several options.
“We approach this from an individualized standpoint for each patient,” Dr. Bakkum-Gamez says. Sometimes you can postpone a hysterectomy by using progesterone therapies to reverse the cancer and allow for a pregnancy to occur. Removing the uterus but leaving the ovaries, which allows for a pregnancy with a gestational carrier, can be another option.
Chemotherapy side effects: What you should know
Many of the side effects of chemotherapy resolve after your chemo is completed. And chemo has become much more tolerable as research continues to help doctors home in on the best protocol for each patient. Still, you’ll likely experience unpleasant side effects.
Keeping track of them in a journal will help your cancer team figure out how to help you get relief. CancerCare suggests keeping track of when the side effects occur, how long they last, how painful they are on a scale of 1-10, and how your daily activities are affected.
Some side effects may persist. These include neuropathy of the fingers and toes. You can prevent the worst of the numbness by wearing thick socks and shoes, dressing extra warmly in cold weather, using potholders when cooking and gloves when washing dishes. If you do experience pain, you can try massage, creams or lotions, or relaxation techniques such as deep breathing or guided imagery.
Radiation side effects: What you should know
If your cancer team recommends radiation treatment, seek out a radiation oncologist with expertise in gynecologic cancer care, advises Dr. Bakkum-Gamez. Advances in intensity-modulated radiation therapy — super-precise radiation that uses multiple small photon or proton beams to pinpoint tumors — mean that doctors can tailor the amount of radiation used to spare your healthy tissues as much as possible.
Endometrial cancer patients who undergo radiation may experience bladder or rectal irritation from loss of normal tissue around the bladder and bowel, so it’s important to customize the radiation as much as possible.
Immunotherapy side effects: What you should know
New immunotherapy treatments tend to be well tolerated. Still, since they work by ramping up the immune system, patients who have conditions such as inflammatory bowel disease can be exacerbated. Share the symptoms with your care team; they may be able to pause your treatment or treat the side effects with medication.