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Womb cancer Q&As
Published by Bupa's health information team, September 2008.
Answers to questions about womb cancer
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
Will treatment affect my sex life?
It could do. Treatment for cancer can affect how you feel about sex as well as how sex feels. You might find that after treatment sex feels uncomfortable or painful, or you may lose the desire to have sex. There are treatments available to help ease these symptoms and with time you should find that your sex life returns to what it was.
Treatment for womb cancer can affect your sex life although many of the effects of treatment can be prevented or treated. Being diagnosed with cancer and everything this involves can affect how you feel about having sex. Some of the treatments can also have side-effects which may make sex uncomfortable.
Having radiotherapy to your pelvis can cause a number of possible side-effects. Your vagina may become narrower and less stretchy which can make sex uncomfortable and sometimes painful. Your vagina may also become drier and the skin inside more delicate. These symptoms can be long-term but there are ways to ease them.
To prevent narrowing you can use a dilator regularly to stretch your vagina and make it more supple. Dilators are made of plastic or metal, are cone- or penis-shaped and are available in different sizes. You put the dilator gently into your vagina three times a week for about 10 minutes. By doing this you can help to stretch your vagina and prevent it from narrowing which will make sex more comfortable. It's important not to force this and if the dilator seems too big, switch to a smaller size. You may find you get a little light bleeding or spotting after using a dilator. This is usual, but if you have heavier bleeding or pain, you should see your doctor. You may find using a lubricant helps to make inserting the dilator easier and more comfortable.
You can start using a dilator between two and eight weeks after your radiotherapy finishes. You may need to carry on using it for the rest of your life. If you are having sex at least twice a week you don't need to use a dilator. Your doctor may also prescribe a hormone cream to put directly into your vagina. If vaginal dryness is a problem, a lubricant gel can help. You or your partner can apply it before or during sex.
It's very likely that you will need to have surgery to treat womb cancer. The kind of surgery will depend on the cancer, but you will probably be advised to have a hysterectomy. This will usually mean having your womb and both ovaries removed. If you haven't already reached the menopause, having your ovaries removed will cause this. Radiotherapy to your pelvis can also lead to the menopause causing symptoms, including:
hot flushes and sweating
dryness of the vagina
feeling low or anxious
feeling less interested in sex
Early menopause can come as a shock and because it's sudden the symptoms can be more severe than if it had occurred naturally. Early menopause can also be emotionally difficult as it means you can no longer have children. All these things can make sex more difficult because you don't feel like having sex or because when you do it's uncomfortable.
You may be able to have hormone replacement therapy (HRT) which gives you the hormones that your ovaries would usually produce. This can help to ease menopausal symptoms, although there may be side-effects which your doctor will discuss with you. You can also take steps yourself to keep cool and reduce the effect of symptoms like hot flushes and sweating. You may find lubricating gels helpful for overcoming vaginal dryness - you can use them before or during sex with your partner. HRT can also help with the emotional effects of menopause. You may find it helpful to talk to a counsellor about how you are feeling.
Having cancer has an enormous impact on every area of your life and your relationships with the people close to you. If you feel anxious or nervous about having sex again after your treatment, try not to worry or be too hard on yourself. You are likely to need time to come to terms with everything that has happened to you. It's important to talk to your partner so that he/she knows how you are feeling. If you think you need more help, your GP can put you in touch with a sex therapist.
Sex after treatment for cancer is safe and you won't make the cancer come back or make it worse. When you do have sex you might need to take more time over it to relax your vagina. Ask your partner to be gentle at first. With time you should find that things improve.
Will the cancer come back after I've finished my treatment?
It's difficult to answer this question as every woman is different. Generally however, womb cancer has one of the best recovery rates for any type of cancer and many women are completely cured after treatment. As with any cancer it's always possible that it will return, which is why it's important to keep your follow-up appointments and tell your doctor straight away if you have any symptoms.
There are many factors that can affect whether or not cancer returns. This is sometimes difficult information for people with cancer to read about so if you feel you aren't ready to know, come back to this question at a later date.
Womb cancer has one of the best recovery rates of all cancers as it's often found early because of its symptoms. Of those women diagnosed with womb cancer at least eight out of 10 will live for at least five years after their diagnosis. Many of these women will be completely cured and the cancer won't come back.
Whether or not your cancer comes back after your treatment will depend on the kind of cancer you had, where it was, whether it had spread and what stage it was when you were diagnosed. If your cancer had spread out of the lining of your womb or into your lymph nodes, the chances of it returning are higher than if your cancer was just in the lining of your womb. Researchers have also found that womb cancer is more likely to return in women who are older.
If you have bleeding from your vagina after your treatment has finished, this may be a sign that the cancer has come back. Vaginal bleeding isn't always due to cancer but you should visit your GP.
Will treatment affect my ability to have children?
Treatment for womb cancer means that you are unlikely to be able to have children. For most women the main options are surrogacy or adoption. Talk to your doctor for advice before starting your treatment.
If you have surgery or radiotherapy for womb cancer, it will mean that you will lose the ability to have children. Radiotherapy affects the lining of your womb and the ability of your ovaries to produce eggs. Even very small doses of radiotherapy can lead to infertility. Surgery for womb cancer is usually a hysterectomy and you might also have your ovaries removed. This means you can no longer have children yourself.
If you want the option of having a family in the future, you can have eggs collected and frozen before radiotherapy or before your ovaries are removed. This can give you the option of surrogacy once your treatment has finished. A surrogate pregnancy is where another woman carries a baby for a couple who are unable to have children. You may also wish to consider adoption.
If you have very early (stage one) cancer of the womb and want to have children, your doctor may offer you the option of treatment with a hormone medicine called progestin, rather than surgery or radiotherapy. This is still a relatively new area and there are no clear guidelines about who might benefit from this kind of treatment, how long to give treatment for and what the long-term effects might be. At the moment it's still seen as an experimental treatment and there may be risks involved. Talk to your doctor for more advice.
Losing your ability to have children can be very hard to come to terms with, especially on top of a diagnosis of cancer. Even if you didn't want to have children or have finished your family, you may feel a sense of loss - losing fertility can be the end of an important stage of your life. Having a hysterectomy can lead to grief and feelings of bereavement for women who have had their menopause as well as for women who haven't. For some women the womb is connected to a sense of womanhood and losing it can mean they feel a loss of femininity.
It can take time to come to terms with your feelings and you may find you need help to cope with them. You might find it helpful to talk to other women who have been through similar experiences or to see a counsellor. Your nurse or GP can put you in touch with these people.
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: September 2008