It will take some time to recover from treatment. As well as physical changes, you will have to cope with the emotional impact.
Treatment side effects can vary. Some women will have a few side effects; others will have more. Side effects may last from a few weeks to a few months or, in some cases, years or permanently. There are often ways to reduce or manage the discomfort that side effects cause.
The ovaries produce the hormones oestrogen and progesterone. If both ovaries have been removed or if you’ve had radiotherapy in the pelvic area, you will no longer produce these hormones. If you are not already menopausal, these treatments will cause sudden menopause (when a woman’s periods stop and she is no longer able to become pregnant).
Menopausal symptoms include hot flushes, trouble sleeping and vaginal dryness. The symptoms are usually more severe than a natural menopause because the body hasn’t had time to get used to the gradual decrease in hormone levels.
If you have already been through menopause and have had surgery to remove your ovaries and/or radiation treatment for uterine cancer, the symptoms of menopause may come back.
While hormone replacement therapy (HRT) can help reduce symptoms of menopause, this treatment is not usually used in women with uterine cancer because there is a risk the hormones may make the cancer worse. If your menopausal symptoms are severe, talk to your gynaecological oncologist about the risks and benefits of taking HRT. If you were already on HRT when the cancer was diagnosed, you may need to consider stopping its use.
Menopause can also increase the risk of some other health conditions. These include:
It is common to feel tired or fatigued during and after treatment. Feeling tired is not only a side effect of the treatment itself. Travelling to hospitals and clinics for treatment and appointments can be exhausting. Dealing with your emotions can also cause fatigue. If you work during your treatment or if you have a home and a family to care for, fatigue may be a problem.
Your tiredness may continue for a while after treatment has finished. You might need to plan your activities during the day so you can rest regularly. It may help to talk with your family and friends about how you feel and discuss ways they can help you.
Surgery or radiotherapy for uterine cancer will mean you are unable to have children. Although most women are older and postmenopausal when they are diagnosed with uterine cancer, it does occasionally affect younger, premenopausal women.
If fertility is a concern for you, it is important to discuss this with your doctor before your treatment starts.
Learning that your reproductive organs will be removed or will no longer function and that you won’t be able to have children can be devastating. Even if your family is complete or you did not want children, you may still experience a sense of loss and grief. These reactions are not unusual. Speaking to a counsellor or a gynaecological oncology nurse about your feelings and individual situation can be very beneficial. You can also call 13 11 20 or see our Fertility and Cancer section.
Radiotherapy to the pelvic area can cause vaginal tissue to shrink, narrowing the vagina. If you have had surgery to remove your ovaries, your vagina may also become very dry. This may make vaginal examination by a doctor difficult or painful. It may also make it painful to have sex.
If you experience any of these problems, talk to your GP, specialist doctor or oncology nurse, as the symptoms can usually be relieved. They may advise you to use vaginal lubricant or a device to expand the vagina (vaginal dilator).
Your doctor may suggest you use a vaginal dilator to help keep the walls of the vagina open and supple, particularly if you are no longer sexually active. Used with lubricant, the dilator is usually inserted into your vagina for short periods of time, by yourself or with the help of a partner. Treatment staff can show you how to do this.
Bladder control may change after treatment. Some women find they need to pass urine more often, or feel that they need to go in a hurry. Others may leak urine when they cough, sneeze, strain or lift.
For ways to manage accidental or involuntary loss of urine (urinary incontinence), talk with your GP or a physiotherapist. You could also contact the Continence Foundation of Australia on 1800 33 00 66.
After surgery and radiotherapy, some women notice bowel changes. You may experience constipation or diarrhoea, or feel pain in your lower abdomen.
Constipation is when you have difficulty passing a bowel motion regularly or often. It is important to avoid constipation, especially in the days after surgery, because it may lead to more discomfort or cause you to strain when you’re sitting on the toilet.
The blood vessels in the bowel and bladder can become more fragile after radiotherapy. This can cause blood to appear in your urine or bowel movements, even months or years after treatment. Always seek advice from your specialist or GP if you notice new or unusual bleeding. Keep in mind that it may not be related to your treatment.
You may be able to make simple changes to your lifestyle to reduce constipation or diarrhoea. Talk to your dietitian or doctor about making changes to your diet or taking medication if you are experiencing bowel problems.
Diarrhoea is when you are passing frequent, loose stools from the bowels. If you have diarrhoea, drink plenty of water to replace lost fluid and prevent dehydration.
Try to avoid high-fibre foods, for example, wholegrain bread and cereals, nuts and legumes (such as beans and lentils). Fatty foods, alcohol, caffeine and spicy foods can also worsen the symptoms of diarrhoea. Some people who have radiotherapy find that they cannot have dairy products for a short time after treatment.
Ask a dietitian for suggestions on reducing the number of bowel movements. You can also talk with your doctor about medications that may help to reduce your symptoms.
Lymphoedema is a swelling of part of the body, usually a leg or arm. If lymph nodes have been damaged or removed, it may prevent lymph fluid from draining properly. This causes fluid build-up and swelling.
The skin of the legs is more susceptible to infection after removal of the lymph glands. This is called cellulitis.
Signs of cellulitis include redness, painful swelling in the legs, warm skin and fever. If you have any of these symptoms, you should see your GP as soon as possible. Symptoms are better managed if treated early.
For more information on managing lymphoedema and cellulitis, ask your health care team for a referral to a specialist physiotherapist or nurse.
Download a copy Cancer Australia's booklet Lymphoedema – what you need to know, or call Cancer Council 13 11 20 for more information about lymphoedema.