What will happen after treatment for endometrial cancer?
For many women with endometrial cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. (When cancer comes back after treatment, it is called recurrence.) This is a very common concern in people who have had cancer.
It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are living full lives. Our document, Living With Uncertainty: The Fear of Cancer Recurrence, gives more detailed information on this.
For other women with this cancer, the cancer may never go away completely. They may get regular treatments with chemotherapy, radiation therapy, or other therapies to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. It has its own type of uncertainty. Our document, When Cancer Doesn't Go Away, talks more about this.
When treatment ends, your doctors will still want to watch you closely. It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you may have and may do exams and lab tests or x-rays and scans to look for signs of cancer or treatment side effects. Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. This is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.
An important part of your treatment plan is a specific schedule of follow-up visits after treatment to see if the cancer has come back. How often you need to be seen depends mostly on what stage your cancer was.
Women who had low grade endometrioid cancers (grades 1 and 2) that were stage IA may be seen every 6 months for the first year after treatment, and then yearly after that. If the cancer was stage IB or II, follow-up visits are more frequent – every 3 months for the first year, then every 6 months for the next 4 years, and then once a year.
For women with higher stage or grade cancers (stages III or IV, or cancers that were grade III, including papillary serous, clear cell, or carcinosarcomas), follow-up visits may occur even more often. Experts recommend visits every 3 months for the first 2 years, every 6 months for the next 3 years, and then yearly after that. Most endometrial cancer recurrences are found within the first few years of follow-up.
During each follow-up visit, the doctor will do a pelvic exam (using a speculum) and check for any enlarged lymph nodes in the groin area. A Pap test may also be done to look for cancer cells in the upper part of the vagina, near the area where the uterus used to be, but it is no longer recommended as a matter of routine due to the low chance of detecting a recurrence. Sometimes a CA 125 blood test is done as a part of follow-up, but this is also not needed in all patients. The doctor will also ask about any symptoms that might point to cancer recurrence or side effects of treatment. Most endometrial cancer recurrences are found based on symptoms, so it is very important that you tell your doctor exactly how you are feeling.
If your symptoms or the physical exam results suggest the cancer may have come back, imaging tests (such as CT scans or ultrasound studies), a CA 125 blood test, and/or biopsies may be done. Studies of many women with endometrial cancer show that if no symptoms or physical exam abnormalities are present, routine blood tests and imaging tests are not needed.
It is important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.
Should your cancer come back our document, When Your Cancer Comes Back: Cancer Recurrence gives you information on how to manage and cope with this phase of your treatment.
Seeing a new doctor
At some point after your cancer diagnosis and treatment, you may find yourself seeing a new doctor who does not know anything about your medical history. It is important that you be able to give your new doctor the details of your diagnosis and treatment. Make sure you have this information handy:
- A copy of your pathology reports from any biopsies or surgeries
- If you had surgery, a copy of your operative report(s)
- If you were hospitalized, a copy of the discharge summary that doctors prepare when patients are sent home from the hospital
- If you were treated with radiation, a copy of your treatment summary
- If you had chemotherapy (or hormone therapy), a list of the drugs, drug doses, and when you took them
The doctor may want copies of this information for his records, but always keep copies for yourself.
Last Medical Review: 07/25/2012
Last Revised: 01/17/2013