Elizabeth C. Talks About Being Treated for Endometrial (Uterine) Cancer
Endometrial (uterine) cancer is normally common in women around 60 to 70 years old. So when 40-year-old Elizabeth C. was diagnosed with Grade 3 endometrial cancer, she didn't fit the normal profile and required special treatment. On the recommendation of Dr. Dwight Heron at Magee-Womens Hospital of the University of Pittsburgh, Elizabeth chose to be treated with Varian's SmartBeam™ IMRT.
Describe the type of cancer you have.
Endometrial cancer is also known as uterine cancer. It is the uncontrolled growth and spread of abnormal cells from the inner lining of the uterus. It is the most common cancer of the female reproductive organs. Women diagnosed with endometrial cancer are usually post-menopausal. Their average age is about 60.
How/When did you discover you had cancer?
I was having some symptoms of abnormal menstrual bleeding and went to see my gynecologist who performed an endometrial biopsy. The results that came back on July 30, 2001, confirmed that I had endometrial cancer. Doctors believe it is caused by excessive estrogen in the body.
What was your reaction?
Shock and disbelief. I was numb. My gynecologist did give me some good news initially. He told me that endometrial cancer was usually a curable cancer with surgery. However, on August 22, when I went into Magee-Womens Hospital in Pittsburgh for this surgery, they discovered that my cancer was very advanced and had extended out of the uterus and into the cervix and the pelvis itself. So there was an actual tumor outside of the uterus that increased the grade and staging of my cancer to a stage 3b on a scale of 4. I already suspected this because I was originally scheduled for laparoscopic surgery, but when I woke up in the recovery room, I realized I'd had open surgery. As an experienced nurse, I knew this change of plan was bad news for me.
Endometrial cancer is usually found in women around 60 to 70 years old. At 40, I did not fit into any of the profiles or risk factors, and this diagnosis was totally unexpected. My doctor recommended radiation and chemotherapy and suggested I participate in a radiation and chemotherapy clinical trial.
What did you do?
When I returned to Magee on August 31st for my post-op visit, I spoke with the nurse/practitioner about the clinical trials. I took some information home and mulled over it for around five weeks while I healed from the surgery. I then went back to Magee and saw Dr. Dwight E. Heron to discuss my options.
Who told you about IMRT?
Dr. Heron. He explained that the clinical trial involved traditional radiation therapy and told me about IMRT. He said it was relatively new, had been around for two or three years and it was producing virtually no or minimal side-effects compared to traditional radiation. He told me that with IMRT they were able to guide the beams more specifically to the areas that they needed to treat, in the process sparing healthy tissue such as my colon and therefore sparing me the unwanted side-effects. He gave me the analogy that it comes out like a shower of rays versus one big beam of traditional radiation.
What other treatment options were you given?
Dr. Edwards told me that while there was no standard chemotherapy treatment for my cancer, I should still undergo chemo as an extra insurance policy to complement the radiation. But there were no guarantees. I decided to go with IMRT first then get the chemo after I'd finished radiation.
Did you do any further research?
Dr. Heron gave me a pamphlet on IMRT. I looked on the Internet and found that there was no standard chemotherapy for my cancer, as my other doctor had said. I discovered that many women just have traditional radiation and that a lot of them have to stop their treatments because they end up with something called radiation colitis, which is profuse diarrhea. Avoiding these side-effects was a big factor in my choice of IMRT.
What was the treatment like? Was it painful?
My treatment began on October 8, 2001 and lasted for 28 days—Monday thru Friday—through until November 2, 2001. Each treatment took about 15 minutes. Then I had two internal standard radiation treatments, which were a week apart. The IMRT treatment itself was simple and not at all painful. I was anxious to get the treatment started but the professionals at Magee-Women's Hospital took the necessary time to set everything up so it was exactly right for me. They made sure I was always located in the exact same position for each one of my treatments.
Were there any side effects?
None. No bone-marrow suppression like you get with traditional radiation; no diarrhea, no skin burns—nothing.
How are you doing now?
Good. After my treatments, I had the PET (positron emission tomography) CT scan, which is the Cadillac of CT scans because it is supposed to detect cancer down to the cellular level. It came back negative for any type of cancer. I also completed six chemotherapy treatments so that may have something to do with it too. But I do believe the IMRT was a big factor.
What's your advice to others?
Get information and compare. People should certainly make the decision for themselves, but I would definitely recommend IMRT from my experience. I was interviewed in April 2002, as part of a segment run by WPXI-TV Channel 11 (NBC) Television, Pittsburgh on local cancer centers upgrading their treatment equipment. I agreed to the interview then for the same reason I agreed to this interview now; being a nurse, I feel comfortable talking about my experience and I know how important it is to educate people and get word out about positive experiences. My thoughts were: I wish I could have seen or heard somebody talk about their cancer experience, their chemo, their radiation. Because when you're first diagnosed, all sorts of thoughts go through your mind—particularly when you're a nurse and you start imagining the worst. You have questions like: Am I going to be able to work? What's it going to do to me, am I going to lose my hair? A million things were racing through my mind. So to see someone like me who looks fairly well and has managed to work full-time throughout the whole ordeal, I believe is encouraging. In fact, I was back to work in October of 2001, the week I started the radiation. I was only out sick during my recovery from the surgery. I'd like to think it gives some hope to people out there who have just received the news they have cancer; that it helps cut the fear.
As for being a nurse . . . it was upsetting to be a patient. I hadn't been a patient since I was a kid. But I put my trust in the doctors and the treatment and so far so good. The most empowering thing for me was going back to work. It was good for my self-esteem and it helped to take the focus off of the cancer. It also helped me maintain a positive attitude, which, combined with my faith, saw me through what could have been a depressing and debilitating time.
