Endometrial Cancer Recurrence
When Uterus Cancer Returns

Uterus Cancer Recurs


Endometrial Cancer Recurrence


When Does It Come Back?
What Follow Up Care Should I Expect?
What Are The Symptoms?
How Is It Treated?
Who Is More Likely To Have A Recurrence?
Can It Be Prevented?

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Endometrial Cancer Guide

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?

What Follow Up Care Should I Expect?

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?

There may be no symptoms. It may be that the results of a Pap test are abnormal and this alerts the doctor. Alternatively you may experience some vaginal bleeding or spotting in between periods or at any time in postmenopausal women. If a tumor has occurred then this can cause pain if it blocks the cervix.

How Is It Treated?

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.

Sometimes tests show that cancer has spread further than doctors suspected. Even though other organs seem to be untouched by cancer cells, during surgery a sample of fluid from inside the stomach (peritoneal fluid) is taken and examined. If cancer cells are detected this indicates that cancer has spread beyond the uterus and the treatment plan will need to reflect this. The chemo drug doxorubicin, combined with other drugs seems to be effective in fighting recurrent and advanced stages of endometrial cancer. However clinical trials into finding the best form of treatment of endometrial cancer (radiation, chemo drugs, surgery or hormones) are ongoing. See also: cancer treatment options.

Who Is More Likely To Have A Recurrence?

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.

Can It Be Prevented?

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.

Compare To Other Common Female Cancers
Recurring Breast cancer
Cervical cancer recurrence

  Related Articles on Uterus Cancer

For more information, see the following:

Endometrial Cancer Survival Rates
Endometrial Hyperplasia
Symptoms of Endometrial Cancer
Causes of Endometrial Cancer

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