
When doctors catch endometrial cancer at an early stage, it's often curable with surgery to remove the tumor. Once the cancer spreads outside the uterus, it becomes more challenging to treat – but not impossible. New treatments like immunotherapy and targeted therapy have led to a better outlook for people who are diagnosed with this cancer.
"We used to think that for patients who had stage IV disease, the overall survival at five years was less than 10%. That number has improved a great deal," says Leslie Boyd, MD, a gynecologic oncologist and director of the Division of Gynecologic Oncology at NYU Langone Perlmutter Cancer Center in New York City.
Endometrial cancer treatment is personalized based on things like your health, where your cancer has spread, and the results of your molecular and genetic tests. Choosing the right treatment approach involves a collaboration between you, your oncologist, and other members of your medical team.
Many therapies are available now for advanced endometrial cancer, and they can cause short-term and long-term side effects that you should know about. Because this can be an emotional and stressful time, it's important to openly communicate with your doctor and advocate for yourself to get the care you need.
Learn About Endometrial Cancer Treatments
Margie Wilson was totally unfamiliar with endometrial cancer when she got her diagnosis in 2016. "I didn't even know what an oncologist was when I was first diagnosed," she says.
She had to ask her doctor about the chemotherapy she was being prescribed, how it worked, how often she'd need it, and what side effects it could cause. "It was a lot of information," she recalls.
Now program director for the Endometrial Cancer Action Network for African-Americans (ECANA), Wilson stresses the importance of getting familiar with the treatments you're offered. With so many therapies available today, that knowledge will empower you to make the best choices for yourself.
Find the Right Medical Care
Visit a National Cancer Institute (NCI)-designated cancer center if you can, suggests Boyd. These centers offer high-quality care and are staffed by doctors who are familiar with the most up-to-date endometrial cancer treatments.
You may see more than one doctor, including:
- A gynecologic oncologist to oversee your care
- A medical oncologist to manage your chemotherapy and other medications
- A radiation oncologist to treat you with radiation therapy
Finding the right doctor is especially important for women of color, who are not only more likely to be diagnosed with advanced endometrial cancer, but who also face more barriers to treatment than White women. A culturally competent provider will respect your needs and preferences.
If your doctor's advice doesn't feel right, listen to your gut and talk to another oncologist. "Your hunch is enough to warrant a second opinion," says Boyd. Organizations like ECANA and SHARE are good places to get treatment advice and support for endometrial cancer.
Discuss Treatment Side Effects
Your doctor's goal is to slow your cancer's progression and give you more time. But endometrial cancer treatments, while effective, come with some side effects. "The side effects that are most impactful day-to-day while you are on treatment are fatigue, mild nausea, rashes, anemia [a drop in oxygen-carrying red blood cells], and thrombocytopenia [having fewer of the platelets that help blood clot]," says Boyd. These should improve once you finish treatment.
Cancer therapies can also leave you with long-term problems such as weak bones, infertility, early menopause, and painful sex. Before starting treatment, ask your doctor which side effects to expect and how to manage them. For example, there are medicines to reduce nausea and vomiting. Pelvic floor physical therapy helps with vaginal dryness and pain during sex.
Your doctor or palliative care provider might also recommend complementary therapies. Wilson found that peppermint oil and acupuncture relieved the nausea from her chemotherapy. But don't try any remedy, even a natural one, before checking with your doctor that it's safe and it won't affect your cancer treatment.
Communicate With Your Doctor
To make informed decisions, you need to know as much as possible about the treatments available to you. Asking questions and being honest with your doctor about your concerns are essential.
If you're not sure what questions to ask, this list can get you started:
- Why are you recommending these treatments?
- How might they help me?
- What are the possible side effects and risks?
- How will you manage any side effects I have?
- Will my health insurance cover the cost of my treatment?
- If not, are other resources available to help me afford cancer care?
- How will you monitor my treatment response?
- Should I join a clinical trial?
Bring a trusted relative or friend to your doctor visits if you feel overwhelmed. They can ask questions and take notes for you. "Everything was such a blur," Wilson says of her first few months of treatment. "I always had somebody with me at every appointment, and then we debriefed it all later."
Advocate for Yourself
Endometrial cancer can take control away from you. Self-advocacy is a way to regain at least some of that control, and feel more empowered and in charge of your own health.
To be an effective self-advocate, you have to know what you want, stand up for yourself, and clearly communicate your needs. Learning about your cancer and working with your hospital's social worker, counselor, and patient navigator can help you learn these skills.
Manage Your Emotions
Endometrial cancer can cause a lot of stress and anxiety. It's very common to get overwhelmed. First, take a deep breath. "Any cancer diagnosis is a tremendous upheaval to your current routine, to your expectations, and to what you were thinking about your future," Boyd says. "Acknowledging that, making space for it, and coming to terms with your current situation is really important."
To relieve stress, try relaxation methods like meditation and mindfulness. Ask for help when you need it. Allow yourself to have a good cry. Go out for coffee with a friend. Write what you're feeling in a journal. Cross something fun off on your bucket list. And take time to enjoy and appreciate the people and special moments in your life.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Leslie Boyd, MD, gynecologic oncologist; director, Division of Gynecologic Oncology, NYU Langone Perlmutter Cancer Center, New York City.
Margie Wilson, program director, Endometrial Cancer Action Network for African-Americans (ECANA).
American Cancer Society: "Chemotherapy for Endometrial Cancer," "Choosing a Cancer Doctor," "Survival Rates for Endometrial Cancer," "Questions to Ask About Endometrial Cancer."
Cancer Medicine: "Acupuncture for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Cancer Patients: A Systematic Review and Meta-Analysis."
Complementary Therapies in Medicine: "The Effects of Peppermint Oil on Nausea, Vomiting and Retching in Cancer Patients Undergoing Chemotherapy: An Open Label Quasi-Randomized Controlled Pilot Study."
Diagnostics: "Racioethnic Disparities in Endometrial Cancer Outcomes."
Focus: "Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients."
Healthbook TIMES Oncology Hematology: "Evolving Treatment Landscape in Endometrial Cancer."
Mayo Clinic: "A Modern Approach to Endometrial Cancer Care: Molecular Risk Stratification, Targeted Therapy and Team Science."
National Cancer Institute: "Find a Cancer Center."
National Coalition for Cancer Survivorship: "Becoming a Self-Advocate."
Psycho-Oncology: "Anxiety and Stress in Women with Suspected Endometrial Cancer: Survey and Paired Observational Study."
Yale Medicine: "Uterine Cancer."