Download Treating cancer of the endometrium

Treating cancer of the
endometrium
Information for patients
Gynaecology
We have written this leaflet to provide you with information following
your diagnosis of cancer of the endometrium. We understand that this
can be a very difficult and stressful time in your life. To be told that you
have cancer can be a real shock and most women will have many
questions and fears.
This leaflet will provide you with written information about the different
ways of treating cancer of the endometrium.
Your doctor and nurse specialist (key worker) are available for you to
talk to about any aspect of your disease and to explain the treatments
you may be offered.
What is cancer of the endometrium?
The endometrium is the lining of the uterus (womb). A cancer can occur
when the cells of the endometrium grow abnormally. If left untreated
the cancer may grow and spread through the wall of the uterus and to
other parts of the body.
Fallopian
tube
Ovary
Uterus
Vagina
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What treatment can I have?
Cancer of the endometrium can be treated in several ways. Your doctor
will discuss these with you and advise which treatment would be
recommended for you.
Hysterectomy
This is the most common treatment for cancer of the endometrium and
for many women this is the only treatment they will need.
A hysterectomy is the name given to the operation to remove a
woman's uterus (womb) and cervix (neck of the womb). Both ovaries
and tubes are removed as part of your operation (surgery). They are
removed to help reduce the risk of the cancer spreading and help to
stage the disease (tell how much cancer is there). For some people the
operation can be done using laparoscopic (keyhole) surgery. Your
doctor will discuss the exact procedure with you. You will be given a
booklet that contains more information about having a hysterectomy.
Radiotherapy
This is sometimes given in addition to, or instead of having a
hysterectomy.
Radiotherapy is the use of high energy X-rays to destroy abnormal cells.
These cells are more sensitive to radiotherapy than normal cells and will
be destroyed. Normal cells in the area being treated are also affected by
the radiotherapy but recover after treatment.
Radiotherapy can be given externally (similar to having an X-ray) or
internally, where the radioactive source is placed near the cancer using
a vaginal applicator. Your doctor will discuss the exact treatment with
you and explain how it is to be carried out. You will also be given written
information about the type of radiotherapy you are going to have.
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Clinical trials
We are constantly investigating ways of improving the treatment of
endometrial cancer. In order to do this clinical trials are organised to
compare current methods of treatment and to introduce and study the
effectiveness of new treatments. If you are eligible (meet the
requirements) your doctor may ask if you would consider taking part in
a clinical trial and give you information about this.
You do not have to take part in any trials and you do not have to give a
reason if you do not wish to take part, your care will not be affected in
any way. If you would prefer not to take part in a trial you will be offered
the standard treatments that are available.
Drug treatments
These include chemotherapy and hormonal therapy which may also be
used in some cases.
What is chemotherapy?
Chemotherapy is a form of drug treatment used to destroy abnormal
cells. Cancer cells are more sensitive to chemotherapy than normal cells.
Chemotherapy is given as an infusion (drip) through a tube/cannula into
a vein in your arm or neck, or in tablet form. The side effects of
chemotherapy vary depending on the specific treatment you are having.
Your doctor will explain this to you and you will be given information
leaflets about the chemotherapy you are going to have.
What is hormone therapy?
Hormone therapy is another form of drug treatment. This is often used
in patients who choose not to or, for medical reasons, are not able to
have other forms of treatment. Hormone therapy can be given in tablet
form. Alternatively, an inter-uterine device ('coil') containing hormones
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(Mirena coil) can be inserted into your uterus to help control the cancer
cells. Your doctor will discuss hormone therapies with you.
Will I need any further investigations?
Sometimes it is necessary to carry out further investigations before
deciding which treatment is best for you. Your doctor will explain,
discuss and plan your care and treatment with you.
Where will I go to have my treatment?
Surgery is carried out at the Royal Hallamshire Hospital. Radiotherapy
and chemotherapy are given at Weston Park Hospital. Some forms of
chemotherapy be may be given at Doncaster Royal Infirmary.
How will my treatment affect me?
Psychological effects
Having treatment for any kind of cancer can be very stressful and
upsetting. People will react in different ways; there are no right or
wrong ways to feel. Your specialist nurse (key worker) is available if you
would like to discuss how you are feeling about your diagnosis and
treatment.
Physical effects
The physical effects of cancer treatments vary. Your nurse will give you
verbal and written information about what you may expect from the
specific treatment you are going to have.
Loss of fertility
Although not common, cancer of the endometrium can occur in
younger women who have not had any children or who would have
liked to have had more children. It is not possible to become pregnant
following treatment for endometrial cancer. If you would like to speak
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to a specialist doctor about fertility issues before starting any treatment
this can be arranged.
Menopausal symptoms
Many women with endometrial cancer have already gone through the
menopause so removing your ovaries or having radiotherapy is unlikely
to have any effect on your hormone production. If you are still having
periods, removing your ovaries or having radiotherapy will cause early
menopause. This may cause symptoms such as:
•
•
•
•
•
•
Hot flushes
Irritability
Dryness of the vagina
Loss of libido (reduced sexual desire)
Dry skin
Hair loss
You may not experience all of these symptoms, but, if these symptoms
occur they may occur more suddenly than during a natural menopause.
You may be able to have hormone replacement therapy to help with
these symptoms and your doctor will be happy to discuss this with you.
Sexual intercourse
Endometrial cancer cannot be passed to your partner during
intercourse. Occasionally you may notice a change in your libido
following diagnosis and treatment. This may be improved or reduced,
but it is difficult to predict how it may affect you.
Radiotherapy may also cause soreness and inflammation of the vagina.
After radiotherapy the vagina may become shorter and narrower and
less lubrication may be produced. The vaginal changes can be
uncomfortable, especially during intercourse. The use of vaginal dilators
following treatment is recommended. The radiographer or your
specialist nurse will discuss this with you.
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Your specialist nurse is available if you would like to discuss any issues
and will try to answer any questions you have.
What happens when my treatment has finished?
When your treatment is completed we will arrange to see you at a
follow up clinic for 3 years (every 3 months for the first year, then 4
monthly and 6 monthly intervals). This may be at either the Gynaecology
Outpatient Clinic which is held in the Jessop Wing, or at Weston Park
Hospital depending on the treatment you have had. If you were referred
to Sheffield Gynaecological Cancer Centre from one of the district
hospitals, it may be possible for you to have follow-up appointments in
your local hospital. You will need to discuss this with the consultant who
is looking after your care.
Where can I find more information?
You will be given contact details for your specialist nurse key worker.
Your key worker is an experienced specialist nurse in gynaecology
cancer. Her role is to provide support and information for you and for
your family throughout your treatment. Your key worker can also
provide you with information about other agencies that may be able to
offer support, counselling, benefits advice and information.
Please feel free to contact your key worker if have any concerns or
questions about your planned treatment or if you simply wish to talk to
someone about how you are feeling.
You can contact the nurse specialist gynaecology-oncology key workers
on:
• 0114 226 8423
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You can also telephone the main switchboard on:
• 0114 271 1900 and ask for the Clinical Nurse Specialist for
Gynaecology to be contacted.
Or for general information please contact:
Ward G2
• 0114 226 8367
• 0114 226 1094
Produced with support from Sheffield Hospitals Charity
Working hard to fund improvements that make life better
for patients and their families
Please donate to help us do more
www.sheffieldhospitalscharity.org.uk
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Please email: [email protected]
© Sheffield Teaching Hospitals NHS Foundation Trust 2016
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PD5369-PIL141 v4
Issue Date: October 2016. Review Date: October 2018