A Rare Uterine Cancer
- In 2009, mom of three Courtney Snailum, 23 at the time, was told she was pregnant again, then doctors discovered she had an extremely rare case of uterine cancer called PSTT, placental site trophoblastic tumor, which can occur from leftover cells that attach the placenta to the uterine wall during pregnancy.
- Uterine cancer, which can also be referred to as endometrial cancer, is a type of cancer that starts in the uterus. Treatments for this disease include surgery to remove the uterus, radiation, hormone therapy, and chemotherapy.
- Signs and symptoms of uterine cancer can include: irregular bleeding, pelvic pain, unusual discharge, unexplained weight loss or urinary problems. It is important to go get checked out by your doctor for any of these lingering signs.
According to Courtney’s doctors, there had only been 300 known cases on record back then.
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“The doctors says, ‘I’ve asked my colleagues. None of us know what this could be, but one thing we are confident in is that you do not in fact have a viable pregnancy,'” Courtney, now 39, said in a TikTok video describing the experience.
Following up with more tests, nothing showed up on an ultrasound. Finally, three months after the false positive pregnancy test, she received her diagnosis.
“I had no symptoms,” Courtney shared, noting she had a little breakthrough spotting in between periods, but nothing alarming.
Her doctors determined she had had the slow-growing disease for around 18 months, and thankfully it had not spread.
Courtney was able to have a hysterectomy, which is a surgical procedure to remove the womb, which removed the cancer, and is still disease-free to this day.
“The good news with endometrial cancer that we can say safely is that the majority of people will be diagnosed … quite early and for a lot of folks, surgery actually may be [the only treatment] that someone needs,” says Dr. Jennifer Mueller, a surgeon and gynologic oncologist at Memorial Sloan Kettering Cancer Center in New York.
Now lighthearted about the shocking medical ordeal, Courtney jokes that she loves “to tease her husband” about him having “his vasectomy for nothing.”
Learning About Uterine Cancer
Uterine cancer, which can also be referred to as endometrial cancer, occurs when cancer cells develop in the lining of a person’s uterus, which is a pear-shaped organ located in a woman’s lower abdomen.
In people with endometrial cancer, the cells in the uterine lining start to grow abnormally. This cancer can happen at any age, but is more common in women who have gone through menopause.
Fortunately, most people with this type of cancer are diagnosed early, when the cancer hasn’t spread beyond the uterus.
Those conditions are:
- Hypertension
- Diabetes
- Polycystic Ovarian Syndrome (which is marked by the absence of regular periods)
- Obesity
- Hyperandrogenism (elevated male sex hormones)
- Lynch Syndrome
The most common surgical procedure to remove the cancer is a hysterectomy, like Courtney had, which involves removing the uterus. In some cases, the surgeon may also remove the cervix and the fallopian tubes and sometimes the ovaries. Surgery helps to remove the cancerous tissue and is often followed by additional treatments to ensure that all cancer cells are eradicated.
“So in my practice, probably 90% of patients get surgery first as their first treatment for their endometrial cancer. And that is if you have a stage one or a stage two or a stage three, sometimes even a stage four cancer surgery is usually typically the first step in your treatment,” explains Dr. Dana Chase, an associate professor of UCLA Obstetrics and Gynecology in Los Angeles.
Signs and Symptoms
In general, Dr. Chase notes that it is imperative to go to the doctor for any type of irregular bleeding.
“It’s very, very important to spread the word that if you have irregular bleeding, even a pink discharge, it doesn’t have to be bright red blood, even a pink discharge, don’t hesitate or don’t be afraid to get that checked out,” Dr. Chase advises.
How Doctors Recognize and Diagnose Different Types of Endometrial Cancer
In addition to irregular bleeding, symptoms of endometrial cancer may include:
- Pelvic pain
- Pain during intercourse
- Unusual vaginal discharge (watery or blood-tinged)
- Unexplained weight loss
- Urinary problems (difficulty or pain when urinating)
Treatment for Uterine Cancer
If the uterine cancer is not localized, meaning unable to remove with a hysterectomy, other treatments may include radiation, chemotherapy and hormone therapy.
Radiation Therapy
Radiation therapy uses high-energy rays to stop cancer cells. It can be administered externally, where the radiation comes from a machine outside the body, or internally, where radioactive materials are placed inside the body near the cancer cells. Radiation therapy is often used after surgery to kill any remaining cancer cells and reduce the risk of recurrence.
“There are some features of the cancer that make you high risk for recurrence. And what that means essentially is the doctor could be scared that maybe even just a single cancer cell escape the uterus and could eventually grow back with time.,”Dr. Chase explains. “And if that’s the situation, your doctor might recommend radiation treatment.”
Chemotherapy
Chemotherapy involves using drugs to kill cancer cells. These drugs can be taken orally or injected into the bloodstream. Chemotherapy is often used in cases where the cancer has spread beyond the uterus or when there is a high risk of recurrence. It can be used alone or in combination with other treatments.
Chemotherapy is often given in conjunction with other therapies such as radiation or immunotherapy.
Dr. Jennifer Mueller, a gynecologic surgeon at Memorial Sloan Kettering Cancer Center, explains how surgery can help determine treatment path
Dr. Marta Crispens, a professor and director of the division of gynecologic oncology at Vanderbilt University Medical Center in Nashville, explains that when chemotherapy is given along side of other types of treatment it is even more effective. She points to studies that looked at combining standard chemotherapy with immunotherapy drugs that strengthen the immune system’s response for fighting cancer.
“If you gave the patient with advanced recurrent disease, endometrial cancer chemotherapy with standard chemotherapy for six treatments, which would be the standard combined with immunotherapy, followed by a maintenance period of immunotherapy, that patients had much better outcomes than if they were treated with chemotherapy alone,” Crispens says.
Hormone Therapy
Some endometrial cancers are hormone-sensitive, meaning they grow in response to hormones like estrogen. Hormone therapy involves taking medications that lower hormone levels in the body or block their effects on cancer cells. This type of therapy is often used for advanced or recurrent endometrial cancer.
“Hormonal therapy commonly works because most of endometrial cancers are estrogen receptor positive,” Dr. Michael Toboni, an assistant professor in the division of gynecologic oncology at the University of Alabama at Birmingham notes to SurvivorNet.
“So if you give progesterone, it can counteract the estrogen feeding the cancer. This is commonly given with multiple anti-estrogen medications or an anti-estrogen medication in combination with another medication that inhibits a common pathway in endometrial cancer.”
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