Side effects of treating uterine cancer

Friday 30 September, 2011

Reviewed: Assoc. Professor David Allen, Surgical Oncologist, Peter MacCallum and Mercy Hospital for Women; Dr Pearly Khaw, Gynae-Radiation Oncologist, Peter MacCallum; Dr Sam Leung, Radiation Oncologist, Radiation Oncology Victoria

On this page: Tiredness | Menopause | Bladder problems | Bowel problems | Lymphoedema

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.

Tiredness

Many women find that tiredness is a major problem. You may hear health professionals call it ‘cancer fatigue'. This tends to be 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. Some people having cancer treatment say their tiredness is overwhelming and unlike any tiredness they have felt before. Sometimes it cannot even be fully relieved with rest.

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.

You can't always stop your tiredness but you can find ways of managing it. If your fatigue is caused by low red blood cells or the side effects of drugs that you are taking, your doctor may be able to treat that cause. There are medications that may help to boost your energy, such as steroids. Otherwise you may have to learn to take short cuts and get help from others to make sure your tiredness doesn't take over your life.

Tips on how you can help to relieve your tiredness

Not all of these things will work for everyone but you may be surprised how small changes can help to save your energy.

  • Plan your day. Set small, manageable goals.
  • Don't be afraid to ask for help: ask a friend to do the shopping or come to clean the house once a week.
  • Plan ahead. For example, get all your clothes ready before you shower or bath; this way you only have to walk to your wardrobe once!
  • Rest before you get too tired. Learn to recognise when this will be.
  • Try not to rush: leave plenty of time to get to appointments.
  • Sit down to do some household chores if you can, like cutting up vegetables.
  • Say no to things you really don't feel like doing. Try not to feel you must please others all the time.
  • If you are fit enough and your doctor has said it is okay, get some exercise. This may be the last thing you feel like doing. But research shows that exercise can boost energy levels and make you feel better - even if you just walk around the garden or block a few times a week. It all helps.
  • Leave chairs around the house so that you can sit down whenever you feel tired.
  • Sit down when you are talking to people on the phone.
  • Smoking reduces your energy. If you smoke, talk to your doctor or the Quitline on 13 7848 about stopping.
  • Don't do the shopping during busy times. Write a list of what you want to save time thinking on your feet!
  • If you have young children or grandchildren, try to play with them sitting or lying down: board games, puzzles and drawing are good ideas.
  • Eat nutritious meals and snacks throughout the day to keep your energy levels up.
  • Try to take some time out to do things that you enjoy. For example, having a relaxing bath, listening to some music or just being with your dog may help you relax and for a short time take your mind off how tired you feel.
  • Join a Cancer Support Group. Talking about your feelings can ease the burden of fatigue, and you can hear how other people in similar situations have managed. Call 13 11 20 to find a group.

Menopause

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.

Menopause can cause several different symptoms. Not everyone will have them all. They may include:

  • hot flushes and night sweats
  • vaginal dryness
  • mood and memory changes
  • effects on your sex drive (libido)
  • weight gain
  • fatigue
  • sleep disturbances
  • bladder changes.

Menopause can increase your risk of other health conditions such as osteoporosis (weaker bones leading to a higher risk of fracture).

Symptoms can have little or no impact on some women. For others they can be severe. The important thing is that you feel you have the medical and emotional support you need to cope.

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 on HRT when your cancer was diagnosed, you will need to weigh up the risks with your specialist of continuing HRT.

Lifestyle changes can also help relieve some symptoms and allow women to cope better with menopausal symptoms: for example, diet changes to help with weight gain and finding time to relax to help with any emotional changes.

Remember it is okay to ask for help. Many women find menopause a difficult time. It can help to tell those around you what you are feeling and going through. Having the support and understanding of those close to you will be reassuring and helpful with managing symptoms.

If menopause and its symptoms begin to really get you down you may benefit from speaking with a professional counsellor. Call the Cancer Council Helpline on 13 11 20 for further information or speak with your GP.

Bladder problems

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.

Bowel 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 dietician about your symptoms. There may be some simple treatments they can advise. Some women may need to change their diet or take medication.

Lymphoedema

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, phone 13 11 20.

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