Post-Surgery

After surgery we advise good pain relief, breathing and gentle leg exercises whilst in bed. You will be told how to care for your wound after a procedure. Usually, you will have dissolvable stitches, but some women require removal of non-dissolvable stitches or staples. Ultimately, we recommend only touching around the wound with clean hands and washing with simple tap water.

After surgery, you are at greater risk of blood clots in the lungs or legs. We therefore advise that you use the blood thinning injections (enoxaparin or other so-called ‘low molecular weight heparins’) we provide for 28 days.

If you experience a raised temperature, problems passing urine, difficulties with bowel motions or vaginal bleeding (more than just spotting), please seek medical attention urgently.

We advise against any heavy lifting or strenuous exercise for 12 weeks after open surgery and 6 weeks after laparoscopic or robotic surgery. You may not be covered by your car insurance within this time frame, so we recommend contacting your insurer before you drive. We advise against penetrative sex, sex toys or placing fingers in the vagina for 6 weeks.

Following your treatment, you will be seen regularly in the outpatient department. This will include your doctor asking about your symptoms as well as performing an internal examination. Initially, these will be once every few months, but eventually they will take place only once a year. If you have any worries between appointments, you can contact your cancer nurse specialist. If after 5 years you remain disease free you will be discharged back to your GP. This is because the chances are the cancer coming back after this period of time are extremely low. The duration of follow-up may be shorter, depending on your doctor/treatment centre.

Stage 1 Grade 1 cancer sufferers will be often offered self-monitoring (i.e. not have follow-up visits) due the extremely low risk of the cancer coming back.

If you were not previously menopausal, you may experience the following if your ovaries have been removed:

- Hot flushes and sweats. Medications are available to assist with this.

- Impact on your sex life with vaginal dryness and low sex drive. Water-based lubricants and non-hormonal creams can help with this.

- Emotional symptoms such as anxiety, depression and mood swings. There are counselling services and also medications available to help you with this.

- Some women encounter issues with concentration and memory.

- Bone thinning (osteoporosis) may occur due to a fall in hormone (oestrogen, normally produced by the ovaries) levels. Your healthcare provider will assess your risk for developing this, as extra scans and medications may be needed to ensure that you are not at increased risk of breaking bones.

Hormone replacement therapy (HRT) is not usually advised after womb cancer because it contains oestrogen – this could increase the risk of your cancer coming back. This is because most endometrial cancers are dependent upon oestrogen for their development and growth. However, some specialists will prescribe this if your symptoms (vasomotor i.e. hot flushes and night sweats, brain fog) are severe. You can raise this issue with them at your follow-up appointments. If you have a Stage 1 Grade 1 cancer and are premenopausal, you are likely to be prescribed oestrogen patches which are considered safe in this context. Although for some high-grade endometrial cancers (e.g. carcinosarcoma, high grade serous, clear cell, high grade endometrioid) it may be prudent not to be offered HRT, there are other ways of managing menopausal symptoms including so-called ‘phyto-oestrogens’ and selective serotonin reuptake inhibitors (SSRIs; a type of antidepressant medication).

Who is there to support you?

As well as friends and family, your GP and specialist nurses will be there to support you and help coordinate your care. Hospital social workers can give you information about benefits e.g. meals on wheels or someone to help at home.

This is an upsetting and stressful time, and your doctor can help to refer you to a counsellor who specialises in supporting people with cancer. Alternatively, you can call the Macmillan cancer support number below.

Macmillan Cancer Support

Freephone 0808 808 0000

(open 7 days a week 8am-8pm)

www.macmillan.org.uk

Daisy Network

Support group for women who have early menopause and related issues