Endometrial Cancer Recurrence
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|When Does It Come Back?
When a woman has completed her treatment for endometrial (uterine) cancer it can be both an exciting and stressful time. She will no doubt be relieved that therapy has finished but may still worry about a recurrence. Worrying about cancer coming back is a very common issue for survivors. In fact 70 percent worry about the chances of it coming back. They worry - if it does will I know? What will I do if it does? If it does, when is it likely to recur? These fears are perfectly normal. It is worth noting too that fears are not necessarily always a bad thing.
Cancer can come back, and staying alert to symptoms may lead to early detection and treatment. About 75 percent of endometrial cancer recurrences are diagnosed within the first 3 years after treatment. Your healthcare team may not warn you about this because they want to protect you from the fear and uncertainty. This is only natural, but as the individual concerned you should do your own research and stay alert. The good news is, the longer you go without a recurrence (after 3 years) the less likely it is to come back. See, also: what does cancer remission mean?
Once a woman has completed treatment for her initial cancer, doctors will monitor her very carefully for a few years, watching for signs of recurrence. It is very important she attends all these appointments and uses it as an opportunity to discuss any concerns she may have. For the first 3 years she can expect to visit the doctor every 3 to 6 months. During the consultation the doctor will perform an extensive pelvic examination, keeping an eye out for enlarged lymph nodes around the groin area. A Pap smear test will be carried out to look for cancer cells in the upper part of the vagina. Sometimes a CA 125 blood test is carried out. This is a screening test generally used for detecting cancer of the ovaries. If any of the tests highlight abnormalities or indicate that cancer may have come back, further tests will be ordered. This includes a CT scan, ultrasound scan and a biopsy. The same process for the original endometrial cancer diagnosis, will apply again.
Important: Read about preventing endometrial cancer.
What Are The Symptoms Of A Recurrence?
Treatment for recurrent uterine cancer depends on how far it has spread and which organs are affected. Recurrent sarcoma and carcinoma are not generally considered curable. Instead treatment primarily focuses on managing pain, abdominal pressure and bleeding. Women with recurrent sarcoma (which is very rare) are usually offered chemo (see chemotherapy guide). Physicians also sometimes adopt treatment plans from cancer clinical studies, even though the patient may not be enrolled. For example recent trials show that some women with sarcoma experience some benefits with a certain combination of chemo drugs. Some women have also responded to radiation treatment combined with progesterone hormone therapy.
Women with recurrent endometrial carcinoma limited to the vagina are sometimes cured by radiation. Those who test positive for estrogen and progesterone receptors usually respond better to hormone therapy. Occasionally it also predicts they would respond better to chemo. Some women are given the drug tamoxifen which is more commonly given to postmenopausal women with breast cancer. It can help some women with recurrent endometrial carcinoma, especially those who did not respond to progesterone therapy.
One important study reported that progesterone receptor levels are the single most important fact in determining the 3 year survival rate for women with stage 1 and 2 endometrial cancer. 93 percent of women with progesterone levels higher than 100 were disease free 3 years later compared to only 36 percent with levels lower than 100. These levels can be tested by biopsy and indicates that it should be part of every diagnosis as a predictor of indicating those women at most risk of recurrence.
Some reports indicate that nearly 90 percent of all cancers are in some way caused by lifestyle choices and occupational exposures. For this reason, it is particularly important for survivors of the disease to read about cancer prevention. Losing weight if you are obese may reduce the risk of uterine cancer recurrence, although this is still speculative. It has never been established whether obesity itself predisposes a woman to endometrial cancer or whether there is some underlying condition which predisposes a woman to both obesity and endometrial cancer. Staying active, eating a balanced diet and cancer diet foods will certainly help improve your overall health and well-being.
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