All cancer survivors deal with the idea that cancer could return. Survivors and their partners must talk about the chances that the child will be raised by only 1 parent.
This decision is very difficult and personal. Consider talking with a counselor for guidance. Some cancer treatments make it difficult or impossible for survivors to have children.
All men and women who want to have children should talk with their health care team about potential infertility before treatment begins. They should also discuss options to preserve fertility. Having a baby is a big decision. No matter what treatment you have had, you should talk with your health care team about the potential risks of pregnancy and birth. Your doctor may need to check certain organs to make sure your pregnancy is safe.
You may be referred to an obstetrician. This is a specialized doctor who is trained to care for women during and shortly after a pregnancy.
Pregnancy after cancer treatment Often, pregnancy after cancer treatment is safe for both the mother and baby. How cancer treatments may affect pregnancy Treatments can affect a future pregnancy in many ways: Radiation therapy.
Fathering a child after cancer treatment Men can try to have a child after cancer treatment ends. Other concerns about having a child after cancer treatment Risk of children getting cancer. Talking with your health care team Having a baby is a big decision. This is a specialized doctor who is trained to care for women during and shortly after a pregnancy Questions to ask your health care team Consider asking the following questions: Will my cancer treatment plan affect my ability to have children?
Your doctor will be able to consider your circumstances and give you specific information about how long you should wait to try to get pregnant.
You can get more details about this type of treatment in Radiation Therapy. A female is born with all the eggs she will have. As she moves through puberty, hormones allow mature eggs to be released every month during the menstrual cycle until the female reaches menopause and the hormonal cycles eventually stop. Chemotherapy chemo works by killing cells in the body that are dividing quickly. The hormones, such as estrogen, needed to release eggs each month and prepare the uterus for a possible pregnancy are made in the cells of the ovaries oocytes.
Oocytes tend to divide quickly, so are often affected by chemo. This can lead to loss of those important hormones and can affect fertility. Sometimes a woman will go into premature or early menopause. Because all these factors need to be considered, it can be hard to predict if a woman is likely to be fertile after chemo.
Higher doses of these drugs are more likely to cause permanent fertility changes, and combinations of drugs can have greater effects. The risks of permanent infertility are even higher when females are treated with both chemo and radiation therapy to the belly abdomen or pelvis. Some other chemo drugs that have a lower risk of causing infertility in females include:.
Talk to your doctor about the chemo drugs you will get and the fertility risks that come with them. There are things that cause a female to have a higher risk for infertility, and others that might not affect fertility at all. Here are some examples:. If you are fertile or think you might be fertile, it's very important to avoid getting pregnant during chemo. Many chemo drugs can hurt a developing fetus, causing birth defects or other harm.
Some can contribute to having a miscarriage. Some women remain fertile during chemo, so it's best to use very effective birth control.
Remember, too, that some women can get pregnant even when their periods have stopped. If you remain fertile through treatment and want to get pregnant after it ends, be sure you know how long you should wait before trying. Studies about this are hard to find, but some suggest getting pregnant too soon after chemo can harm the fetus, cause birth defects, or cause a woman to miscarry.
See Chemotherapy for more information. Hormone therapies are often used to treat breast cancer or other cancers. It also tells if the cancer has spread to other parts of your body that are close by or farther away. Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the endometrium. Be sure to ask the doctor about the cancer stage and what it means for you. There are many ways to treat endometrial cancer.
Surgery is the main treatment for most women, but sometimes more than one kind of treatment can be used. A hysterectomy takes out the uterus and cervix. There are many ways to do this surgery.
Sometimes the ovaries and fallopian tubes are taken out at the same time. Nearby lymph nodes may also be taken out to see if they contain cancer cells. Any type of surgery can have risks and side effects.
Ask the doctor what you can expect. If you have problems, let your doctors know. Doctors who treat women with endometrial cancer should be able to help you with any problems that come up. Radiation uses high-energy rays like x-rays to kill cancer cells. This treatment may be used to kill any cancer cells that may be left after surgery. There are 2 main ways radiation can be given:. If your doctor suggests radiation treatment, talk about what side effects might happen.
The most common side effects of radiation are:. Most side effects get better after treatment ends. Some might last longer. Talk to your cancer care team about what you can expect. Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells. When recommended for endometrial cancer, chemotherapy usually is given after surgery.
Chemotherapy is also considered if the endometrial cancer returns after the person's initial treatment. A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or a combination of different drugs given at the same time.
The goal of chemotherapy is to destroy cancer remaining after surgery or to shrink the cancer and slow the tumor's growth if it comes back or has spread to other parts of the body. Although chemotherapy can be given orally, most drugs used to treat uterine cancer are given by IV. IV chemotherapy is either injected directly into a vein or through a catheter, which is a thin tube inserted into a vein.
The side effects of chemotherapy depend on the individual, the type of chemotherapy, and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.
Advances in chemotherapy during the last 10 years include the development of new drugs for the prevention and treatment of side effects, such as antiemetics for nausea and vomiting and growth factors to prevent low white blood cell counts and reduce the risk of infection. Talk with your doctor before treatment starts if you want to preserve your fertility.
Rarely, some drugs cause some hearing loss. Others may cause kidney damage. Patients may be given extra fluid intravenously to protect their kidneys. Talk with your doctor about what side effects you may experience with chemotherapy and how they can be prevented or managed.
Hormone therapy is used to slow the growth of certain types of uterine cancer cells that have receptors to the hormones on them. These tumors are generally adenocarcinomas and are grade 1 or 2. Hormone therapy for uterine cancer often involves a high dose of the sex hormone progesterone given in pill form. Other hormone therapies include hormone-expressing intrauterine devices IUDs and aromatase inhibitors AIs , such as anastrozole Arimidex , letrozole Femara , and exemestane Aromasin , which are often used for the treatment of breast cancer.
An AI is a drug that reduces the amount of the hormone estrogen in a woman's body by stopping tissues and organs other than the ovaries from producing it. Hormone therapy may also be used for women who cannot have surgery or radiation therapy, or it can be used in combination with other types of treatment.
Side effects of hormone therapy may include fluid retention, increase in appetite, insomnia, muscle aches, and weight gain. Most side effects are manageable with the help of your health care team. Talk with your doctor about what you can expect. This type of treatment blocks the growth and spread of cancer cells and limits damage to healthy cells.
Not all tumors have the same targets. To find the most effective treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor.
This helps doctors better match each patient with the most effective treatment whenever possible. In addition, research studies continue to find out more about specific molecular targets and new treatments directed at them.
Learn more about the basics of targeted treatments. Targeted therapy for uterine cancer is available in clinical trials and, in some instances, as part of standard-of-care treatment regimens.
Targeted therapy for uterine cancer includes:. Anti-angiogenesis therapy. Anti-angiogenesis therapy is focused on stopping angiogenesis, which is the process of making new blood vessels.
Bevacizumab Avastin is a type of anti-angiogenesis therapy used to treat uterine cancer. Mammalian target of rapamycin mTOR inhibitors. In endometrial cancer, mutations in a pathway called mTOR are commonly found. People with advanced or recurrent uterine cancer may be treated with a drug that blocks this pathway, such as everolimus Afinitor. Other drugs that target this pathway are being studied, such as ridaforolimus and temsirolimus Torisel , a targeted therapy approved to treat a type of kidney cancer called renal cell carcinoma.
Targeted therapy to treat a rare type of uterine cancer. Uterine serous carcinoma is a rare but aggressive type of endometrial cancer. In a phase II clinical trial, researchers found that trastuzumab Herceptin combined with a combination of chemotherapy was effective in treating these kinds of tumors. Different targeted therapies have different side effects.
Talk with your doctor about these possible side effects and how they can be managed. Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. Uterine cancers with mismatch repair defects dMMR; see Introduction are more sensitive to immunotherapy.
The immunotherapy drug pembrolizumab Keytruda is approved to treat tumors that have either high microsatellite instability MSI-high or dMMR, regardless of the tumor's location in the body. Pembrolizumab can be used to treat uterine tumors with dMMR if other previous treatments have not worked. A combination of lenvatinib Lenvima , a targeted therapy drug, and pembrolizumab is also approved to treat advanced endometrial cancer.
This combination can be used to treat disease that is not MSI-high or dMMR, has not been controlled by systemic therapy, and cannot be cured with surgery or radiation therapy.
Lenvatinib may cause high blood pressure. In April , the FDA approved the immunotherapy drug dostarlimab Jemperli to treat recurrent or advanced endometrial cancer with dMMR that has progressed either while on or after completing platinum-containing chemotherapy. Dostarlimab is given by vein every 3 weeks. Its most common side effects are fatigue, nausea, diarrhea, and constipation.
Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes.
Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy. Cancer and its treatment cause physical symptoms and side effects, as well as emotional and social effects. Managing all of these effects is called palliative care or supportive care.
It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer. Cancer treatment can also have financial side effects. You can bring financial concerns up with your multidisciplinary team, which may have social workers or financial counselors available to help.
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