What are the warning signs of a gynaecological cancer recurrence?
A common worry after completing gynaecological cancer treatment is fear of the cancer coming back. This is a natural reaction. When cancer returns after a period of remission, this is called a recurrence.
Cancer can recur in the organ it originally developed in (local recurrence) if it has been only partially removed; or in other parts of the body, such as the lymph nodes inside the pelvis and the abdomen, the peritoneum (inner lining of the abdomen), or liver and lungs (distant recurrence). For patients who carry a high risk of tumour recurrence, the early detection of tumour by follow-up care could be lifesaving.
Several factors determine the likelihood that the cancer may return, including the type of cancer, the stage and grade of the original cancer, and which treatments you received. For example, the recurrent gynaecological cancer rate is lower for those with early-stage disease.
Follow up will not protect from recurrence. However, it should allow for early detection of problems. During the follow-up appointments I will ask about any symptoms that might point to cancer recurrence (bleeding or pain) or side effects of treatment.
If the risk of problems that could possibly develop is remotely low, I can safely release patients and ask them to contact me straight away if they develop any unusual symptoms. For example, patients with ovarian borderline tumours who were diagnosed at stage 1 where the disease is limited to the ovaries and who had optimal surgical treatment. Or patients with endometrial cancer, where only a few cells were cancerous and all cancer has been safely removed. The risk of these patients to develop a recurrence is remotely low. However, if the tumour was of an aggressive nature I will recommend regular follow up.
Symptoms of Gynaecological Cancer Recurrence
If you have symptoms like those when you were initially diagnosed, or you notice other unusual and persistent changes to your health, these may be an indication of cancer recurrence.
Symptoms of gynaecological cancer recurrence include:
- Abdominal pain
- Vaginal bleeding
- Nausea or vomiting
- Shortness of breath
- Changes in bowel or bladder habits.
Women may have one or multiple symptoms. However, developing symptoms does not always mean the cancer has come back. Many of these symptoms also indicate benign conditions and may have nothing to do with cancer.
If tests or symptoms suggest your cancer has recurred, a gynaecological oncologist will perform a physical examination, bloods test (such as CA125 level) and it may be confirmed by medical scans.
Depending on the cancer type, treatment may be with hormones and/or chemotherapy with radiotherapy. Surgery may be considered if the recurrent disease is isolated to one area.
Late effects of cancer treatment
Cancer treatment may also leave adverse effects and they can become worse over time, especially if they are not recognised at an early stage. This adds to the importance of follow-up care. For example, swelling of the legs might indicate lymphoedema, which can be managed more successfully when diagnosed early. If lymphoedema is diagnosed too late, skin damage may occur and might be irreversible.
In summary, monitoring symptoms and followup care might recognise problems early when those problems may still be easily treatable. Speak to your gynaecological oncologist if you are concerned.
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