Uterine cancer: what happens after treatment?
Recovery and follow-up care
Recovery and follow-up are different for everyone and depend on the treatment you have. It takes time to recover from the various types of treatment: there are physical and emotional changes to cope with. You may need to talk with your employer about how the treatment may affect your work, and with your family about the support that you need.
You will need regular health checks that will include tests and examinations after treatment is over. As well as checking to make sure your cancer hasn't come back, follow-up visits may be necessary because of the possible physical changes that will occur as a result of the cancer and the cancer treatment.
Check-ups will continue to be necessary even if you haven't had any sign of cancer for some years. This can make it difficult to put the experience of a cancer diagnosis and treatment behind you. For family and friends, your cancer may be a thing of the past, but check-ups may well bring it into the present for you again-you may feel quite anxious at check-up time. Finding ways of supporting yourself and taking care of yourself when a check-up is scheduled is a part of living with cancer.
Side effects of treatment for uterine cancer
It may take some time to recover from your treatment. You will find that there are physical changes as well as many emotional changes to cope with. It is important that you and the people around you (this could include your partner, employer and family members) are prepared.
Many women find that tiredness is a major problem. This tends to be particularly a problem if you need to have radiotherapy and other treatments. Travelling backwards and forwards to hospitals and clinics for treatment and appointments is also very tiring. If you start work again during the treatment or if you have a home and a family to care for, you will almost certainly be very tired.
Your tiredness may continue for quite a while even after treatment has finished. Some women find that it takes them up to one or two years to feel really well again. It may help to talk with your family and friends about how you feel and discuss ways in which they can help you. You may need to plan your activities during the day so that you get regular periods of rest.
Women who go through menopause as a result of the cancer treatment will have to adjust to the symptoms and body changes caused by no longer producing large amounts of the female hormones. Hormone replacement therapy (HRT) can help reduce menopausal symptoms. Using HRT for more than five years increases the risk of some diseases including some cancers. However it also decreases the risk of some other diseases and cancers. You will need to discuss with your gynaecological oncologist what the benefits and risks are for you of having HRT. If you were already on HRT when your cancer was diagnosed, you will need to weigh up the risks of continuing it with your specialist.
Bladder sensations or control may change after cancer treatment or surgery. Some women find they need to go to the toilet more often. Others find they need to go in a hurry and sometimes don't get there in time. Others find that they pass urine when they cough or sneeze. While these problems may improve, even a small loss of bladder control can be distressing.
If bladder control is a problem, you should seek help straight away. Your specialist will be able to suggest ways to help with bladder control. These may include exercises to strengthen the muscles of your pelvic floor. Ask to see a physiotherapist who can teach you about these exercises, or you can contact your community health centre for help, or call the Continence Helpline on 1800 330 066.
Some hospitals have continence nurses who can help you with bladder problems.
After surgery or cancer treatments some women have problems with their bowels. Some women find that they become constipated or suffer from diarrhoea or wind pain. Talk to your doctor, nurse or dietitian about your symptoms. There may be some simple treatments they can advise. Some women may need to change their diet or take medication.
Lymphoedema is swelling of part of the body, usually the legs or the arms. It may occur after treatment for cancer of the uterus if you have had the lymph nodes in your abdomen removed (lymphadenectomy). Removal of the nodes may prevent normal draining of the lymph fluid from the legs. As a result, fluid can build up in one or both legs causing swelling. This usually does not occur until some time after the original treatment.
It isn't possible to predict whether you will have problems with lymphoedema. If you have problems seek immediate help as symptoms are better managed if treated early. Seek advice from your specialist or nurse. You may be given special stockings to wear after your operation that can help prevent this problem.
Some hospitals have specialist physiotherapists who can advise you on how you may be able to reduce your risk of developing lymphoedema. They also help you manage if lymphoedema does occur in the future. The Cancer Council Helpline has more information and may be contacted on 13 11 20.
When you are first told you have cancer, you may feel a range of emotions, such as fear, sadness, depression, anger or frustration. The feelings may continue during your treatment and afterwards. It may be helpful to talk about your feelings with your partner, family members or friends, or with a hospital counsellor, social worker, psychologist or your religious or spiritual adviser.
Sometimes your friends and family do not know what to say to you. They may have difficulty with their feelings too. Some people may feel so uncomfortable that they avoid you. This can make you feel very lonely. You may feel able to approach your friends directly and tell them what you need. You may prefer to ask a close family member or a friend to talk with other people for you.
Practical and financial help
A serious illness may cause practical and financial problems. You do not need to face these alone. Apart from offering emotional support, a social worker is able to assess what practical and social help you and your family or carers may need. They can also organise help from a variety of sources. Ask at your hospital, your community health centre, or ring the Cancer Council Helpline.
Many services are available, including:
- financial assistance, which may be available for transport costs to medical appointments, prescription medicines, or through benefits or pensions. Contact the social worker at your hospital.
- home nursing care, which is available through district nursing, or through the local palliative care service—your doctor or hospital can arrange this.
- meals on wheels, home care services, and aids and appliances, which can make life easier—contact the hospital social worker, occupational therapist or physiotherapist, or your local council.
A healthy diet may help you to keep as well as possible and cope with the cancer and any side effects of treatment as best you can. Depending on the kind of treatment you have had, you may have special dietary needs. A dietitian can help you plan the best foods for your situation—ones that you find tempting, easy to eat and good for you.
You will probably find it helpful to stay active and to exercise regularly if you can. Exercise can help with fatigue. The amount and type of exercise you do will depend upon what you are used to and how well you feel. Talk with your doctor about what is likely to be best for you.
Some people find relaxing or meditating helps them to feel better. The hospital social worker, nurse or doctor will know if the hospital runs any programs, or may be able to advise you on programs in your area. Your local community health centre may also be able to help.
Sexuality and cancer
Cancer treatment and the emotional effects of cancer may affect people with cancer and their partners in different ways. Some people may withdraw through feelings of being unable to cope with the effects of treatment on themselves or their partner. Others may feel an increased need for sexual and intimate contact for reassurance.
It is important to talk about your feelings with your partner. If you are having trouble continuing with your usual sexual activities, discuss this with your doctor or with a trained counsellor. Your partner may also like to seek support.
If you are without a partner, you may be worried about forming new relationships. Talking about this with a close friend, a family member, a social worker or phoning the Cancer Council Helpline on 13 11 20 may be useful.
After you have had your check-up following surgery you will be able to resume sexual intercourse if you wish. You don’t have to wait for the doctor’s okay to be affectionate but you might find that it takes time before you feel physically and emotionally well enough for sexual intercourse.
If you have had internal radiotherapy, you may find that your vagina has changed and shortened and it may be dry as well. Talk with your doctor and the clinic nurses about this. Lubricant, which can be bought at chemists or supermarkets, can be helpful when dryness is a problem, or you might try different positions. If you are having external radiotherapy, you are usually able to continue having intercourse as long as you are comfortable and you feel like it. Everyone is different: be guided by your own feelings. You may find that, particularly near the end of treatment, you don’t feel like intercourse.
It may be some time until you feel ready for vaginal intercourse and you may need to build up your confidence first. Sharing affection with your partner through kissing, caressing and touching can give you both much pleasure. When you do feel ready again for vaginal intercourse, you may wish to proceed slowly. Talking about your needs together is important to help you feel more confident and to reduce any fears.
Sometimes you might be ready for sexual intercourse and your partner may be anxious about hurting you. If you find that you are having difficulty regaining your sexual relationship, you may need specialist help and advice. You and/or your partner may want to talk with your doctor or nurse about this or to seek advice from them on where you might get help.