It will take some time to recover from the physical and emotional changes caused by treatment. Treatment side effects can vary – some people experience many side effects, while others have few. Side effects may last from a few weeks to a few months or, in some cases, years or permanently. 

It is common to experience fatigue and lymphoedema, as well as impacts on your sexuality. 

Menopause

If both ovaries have been removed or if you’ve had radiation therapy to the pelvic area, you will no longer produce oestrogen and progesterone and you will stop having periods. This is called menopause. For most women, menopause is a natural and gradual process that starts between the ages of 45 and 55.

If you have not already entered menopause, some treatments will cause sudden menopause. If you have already been through menopause, the symptoms of menopause may come back. These include hot flushes, night sweats, dry or itchy skin, mood swings, trouble sleeping, tiredness, aching joints, vaginal dryness, weight gain and bladder problems. You may also have a decreased interest in sex (low libido).

The symptoms of menopause caused by cancer treatment are usually more severe than during a natural menopause because the body hasn’t had time to get used to the gradual decrease in hormone levels.

Menopause may cause other changes in the body. For example, your cholesterol levels may rise, which can increase your risk of heart disease. Over time, your bones may become weak and brittle, and break more easily. This is called osteoporosis. Radiation therapy to the pelvis can also weaken the bones. 

Some tips for managing menopausal symptoms:

• Vaginal moisturisers available over the counter at pharmacies can help with vaginal discomfort and dryness.
• Your doctor can suggest non-hormonal medicines to relieve the symptoms of menopause.
• Talk to your doctor about having a bone density test or taking medicine to prevent your bones from becoming weak. Regular exercise will also help keep your bones strong.
• Have your cholesterol levels checked. If they are high, regular exercise and a balanced diet may help. Cholesterol-lowering drugs are also available.
• Learn meditation and relaxation techniques, which may reduce stress and lessen some of the symptoms of menopause.
• You can also call Cancer Council on 13 11 20 to talk to a health professional about your concerns.
  
  

Fertility issues

Surgery or radiation therapy for cancer of the uterus may mean you are unable to become pregnant. It may be possible to preserve the ovaries and sometimes the uterus so you can still have children. However, this is not standard treatment and is an option only in certain cases.

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 cancer nurse about your feelings and individual situation can be helpful. You can also call Cancer Council on 13 11 20 to talk to a health professional about your concerns.

Bladder changes

Treatment for cancer of the uterus can cause bladder problems. Most bladder side effects are temporary or can be managed.

Urinary incontinence

This is when urine (wee) leaks from your bladder without your control. Some people find they need to pass urine more often or feel that they need to go in a hurry. Others may leak a few drops of urine when they cough, sneeze, strain or lift.

The pelvic floor muscles control the flow of urine, so strengthening them can help manage urinary incontinence. Using continence pads can help you manage any leakage and prevent any embarrassing accidents. Contact the National Continence Helpline on 1800 33 00 66 for more information. 

Radiation cystitis

Radiation therapy can irritate the lining of the bladder. You may feel like you want to pass urine often or have a burning sensation when you wee. This is known as radiation cystitis. Try to drink plenty of water to make your urine less concentrated. Urinary alkalisers are available over the counter from pharmacies and can help by making the urine less acidic. Your doctor may also prescribe medicine to treat cystitis.

Blood in urine

The blood vessels in the bladder can become more fragile after radiation therapy. This can cause blood to appear in your urine, even months or years after treatment. Always let your doctor know if you notice new or unusual bleeding and keep in mind that it may not be related to your treatment. 

Bowel changes

Surgery, radiation therapy and medicines can cause changes to the way the bowels work. These changes are usually temporary, but for some people, they are permanent and can have a significant impact on quality of life.

Constipation

Constipation is when you have difficulty having a bowel movement 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. Ways to manage constipation include:

• Drink more water – aim for at least 8 glasses during the day.
• Eat regular meals throughout the day.
• Try to eat more fibre-rich foods, e.g. wholegrain breads and cereals, legumes such as beans and lentils, vegetables, fruits, nuts and seeds.
• Avoid drinking alcohol.
• Do some gentle exercise, such as walking.
• Cut down on sweets, soft drinks, takeaway food, fried foods, potato chips and other savoury snacks.
• Limit foods containing added sugars and salts.
• Take medicines for constipation as directed by your doctor.

Diarrhoea

Diarrhoea is the frequent passing of loose, watery faeces (poo) from the bowels. A dietitian can suggest changes to your diet to reduce the number of bowel movements. Ways to manage diarrhoea include:

• Drink plenty of fluids such as water, herbal teas, sports drinks and electrolyte-replacing fluids.
• Avoid alcoholic drinks.
• Eat more low-fibre foods, e.g. white rice, white pasta, white bread, potatoes.
• Limit spicy, fatty and greasy foods, as these can make diarrhoea worse.
• Cut down on coffee, cola and other drinks that contain caffeine.
• Choose low-lactose or soy-based dairy products (small amounts of cheese and yoghurt are usually okay).
• Take medicines for diarrhoea as directed by your doctor.

Radiation proctitis

Radiation therapy can damage the lining of the rectum, causing inflammation and swelling known as radiation proctitis. This can cause a range of symptoms including blood in bowel movements, frequent passing of loose, watery faeces (diarrhoea), the need to empty the bowels urgently, and loss of control over the bowels (faecal incontinence).

Blood in bowel movements

Blood vessels in the bowel can become more fragile after radiation therapy. This can cause blood to appear in your faeces, even months or years after treatment. 

Vaginal narrowing and dryness

Radiation therapy to the pelvic area can cause vaginal tissue to lose its elasticity and shrink, narrowing the vagina (vaginal stenosis). If your ovaries were removed, your vagina may also become very dry. These side effects may make vaginal examination by a doctor uncomfortable or difficult, and make it painful to have sex.

Your treatment team may recommend using a vaginal moisturiser or lubricant (available over the counter from pharmacies) or a hormone cream (available on prescription and safe with many uterine cancers). They may also advise you to start using vaginal dilators (or have sexual intercourse regularly) some weeks after radiation therapy ends.

Follow-up appointments

After treatment ends, you will have regular appointments with your specialists to monitor your health, manage any long-term side effects and check that the cancer hasn’t come back or spread. During check-ups, you will usually have a pelvic examination and you may have imaging scans. 

For some people, uterine cancer does come back after treatment, which is known as a recurrence. This is why it’s important to have regular check-ups and to report any symptoms (e.g. vaginal bleeding, pain in the abdomen, swelling, unexpected weight loss, unexplained cough) immediately.

Most uterine cancers that come back do so in the first 2–3 years after treatment. If you have had a hysterectomy, cancer of the uterus usually comes back in the vagina or pelvic lymph nodes. If the cancer does recur, you will usually be offered further treatment to remove the cancer or help control its growth.