Tuesday 28 January 2020

Uterine (endometrial) cancer

The week before Christmas I learned I had cancer in my uterus.

I'd had a couple funky ultrasounds (there was "debris" found).  In November, I had a procedure with a gyno at St. Michael's Hospital where a camera was inserted inside me to see what what going on and a sample was taken.  That's how they found out I had cancer.  Needless to say, it was not the news I was expecting.

Signs and symptoms may include:
  • Vaginal bleeding after menopause - this happened to me once a year, hence the ultrasounds
  • Bleeding between periods
  • Pelvic pain 

Doctors don't know what causes endometrial cancer.  What's known is that something occurs to create changes (mutations) in the DNA of cells in the endometrium (the lining of the uterus).  The mutation turns normal, healthy cells into abnormal cells.  Healthy cells grow and multiply at a set rate, eventually dying at a set time.  Abnormal cells grow and multiply out of control and they don't die at a set time.  The accumulating abnormal cells form a mass (tumor).  Cancer cells invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).

Factors that increase the risk of endometrial cancer include:
  • Changes in the balance of female hormones in the body ~ The ovaries make two main female hormones - estrogen and progesterone. Fluctuations in the balance of these hormones cause changes in the endometrium.
  • More years of menstruation ~ Starting menstruation at an early age - before age 12 - or beginning menopause later increases the risk of endometrial cancer. The more periods you've had, the more exposure your endometrium has had to estrogen. 
  • Never having been pregnant ~ If you've never been pregnant, you have a higher risk of endometrial cancer than someone who has had at least one pregnancy.   I've never been pregnant.
  • Older age ~ As you get older, your risk of endometrial cancer increases. Endometrial cancer occurs most often after menopause.  I'm on the other side of menopause.
  • Obesity ~ Being obese increases your risk of endometrial cancer. This may occur because excess body fat alters your body's balance of hormones.  Weight loss is a constant battle for me.
  • Hormone therapy for breast cancer ~ Taking the hormone therapy drug tamoxifen for breast cancer can increase the risk of developing endometrial cancer.
  • An inherited colon cancer syndrome ~ Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC), is a syndrome that increases the risk of colon cancer and other cancers, including endometrial cancer. Lynch syndrome is caused by a gene mutation passed from parents to children. 

To reduce your risk of endometrial cancer, you may wish to:
  • Talk to your doctor about the risks of hormone therapy after menopause ~ If you're considering hormone replacement therapy to help control menopause symptoms, talk to your doctor about the risks and benefits. Unless you've undergone a hysterectomy, replacing estrogen alone after menopause may increase your risk of endometrial cancer. Taking a combination of estrogen and progestin can reduce this risk.  I was on HRT for about eight years but went off it when I turned 50 because my doctor told me that there is a risk of getting breast cancer if you stay on it after 50.
  • Consider taking birth control pills ~ Using oral contraceptives for at least one year may reduce endometrial cancer risk. The risk reduction is thought to last for several years after you stop taking oral contraceptives.
  • Maintain a healthy weight ~ Obesity increases the risk of endometrial cancer so work to achieve and maintain a healthy weight.

Source:  Mayo Clinic

My gyno scheduled me for a total hysterectomy (the removal of the uterus, cervix, fallopian tubes and ovaries).

That happened yesterday.  I had to be at St. Michael's Hospital at 6am to get prepped.  The surgery started at 8am and lasted three hours.  There are four small incisions (maybe an inch long) in my belly ... one on the right side, one in my belly button and two on the left side.  I spent about two hours in recovery before being moved to my room, where I spent the night.

During the night, I was woken up every two hours by nurses to check my blood pressure, my temperature and take blood (to see if I would need a blood transfusion ... I didn't).

I was released this morning.  I had to fill a bunch of prescriptions at the pharmacy ... extra strength Tylenol and morphine for when I'm in pain (so far, I'm not) and Dalteparin syringes (I have to use for a month to prevent blood clots).

No heavy lifting, pools, baths, etc. for six weeks.  I'm working from home for the next three weeks and have had any meetings and work travel I'd had scheduled covered and/or postponed.  I go back to see my gyno in six weeks.

Thank you to Dr. Shore and her surgical team and the staff on the 15th floor at St. Mike's for taking such good care of me!


Teresa said...

Get well soon. I've been wrestling with a similar issue in that department for the past couple of years. Had another biopsy in October. Take care and feel better.

Karen said...

My sister went through this five years ago. Hope you have a good recovery. The future is good. 😁