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Unfortunately,
the various modalities, which are employed for treating Endometrial
Cancer, are not without their side effects. The severity and the quality
of these side effects depends largely upon the type of modality of
treatment employed, and also the general condition of the patient
during and before the treatment. Doctors and nurses play a very important
role in explaining to the patient the side effects and the symptoms
associated with the same during therapy. It is important that the
patient and her relatives ask the doctor about the side effects of
treatment, before the treatment is constituted.
After surgery, the common side effects which a
woman feels, include those which are due to anesthesia, and those
which are due to the surgery per se.
The effects of anesthesia include a soreness in the throat or hoarseness,
and a drowsiness if general anesthesia has been given. There also
could be a temporary limitation of physical activity.
The surgery has the following common complications- nausea and vomiting,
and some time before the woman regains normal bladder and bowel function.
Women should be prepared for the fact that, after the hysterectomy,
they will no longer have any menstrual periods. After the ovaries
have been surgically ablated, there is immediate menopause, and this
menopause is called surgical menopause.
All the symptoms of postmenopausal problems could be associated even
with surgical menopause, and these include hot flashes and other common
symptoms. While in the general population, after a normal menopause,
hormone replacement
therapy is commonly employed, hormone replacement therapy,
or HRT as it is known as, is usually not given
to patients of Endometrial Cancer, for the simple reason that the
common drug which is used in HRT, estrogen, may have a stimulative
effect on the development or recurrence of the uterine cancer. Although
there is no scientific evidence of the same, the patients are usually
not recommended hormone replacement therapy.
Research studies are in progress to determine whether the difficult
problems associated with postmenopausal phase of hysterectomy can
be safely treated with estrogen.
It is important to inform the patient that sexual activity, desire,
and sexual intercourse are usually not affected
by hysterectomy.
The commonest side effects associated with radiation
therapy depend largely upon the part of the body radiated,
and the dosage of the treatment, including the size of each fraction
of radiotherapy.
The commonest symptom is extreme fatigue, and, therefore, often patients
are requested to rest. One of the common symptoms, which are seen
after radiotherapy, is dry, reddened skin, and loss of appendages
of the skin such as hair, from the area radiated.
There is also a decrease in the white blood cell count that has got
an immunoprotective effect against infections.
Treatment may result in diarrhea, often intractable diarrhea, and
difficulty in urination.
Women sometimes complain of dryness, itching, tightening, and burning
in the vagina, and may be advised not to have intercourse during treatment
because they usually find it very painful; most, however, can resume
sexual activity as soon as treatment ends, or a few weeks thereafter.
Sometimes, there is a postradiational narrowing of the vaginal canal,
and women can be taught to use a lubricant or a dilator to help minimize
these problems.
As far as hormone
therapy is concerned, patients on progesterone experience
changes in appetite and weight, and they may find that they gain a
little weight due to fluid retention, which occurs with consumption
of progesterone. Fatigue is also a common symptom in these patients.
All those patients who are premenopausal may experience a total change
in the way their menstrual cycles occur.
If these problems become out of control, the patients should approach
their clinician to alleviate the same.
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