Understanding Womb Cancer
- Actress Alex Kingston, 62, was diagnosed with womb cancer, a rare gynecologic cancer also known as endometrial or uterine cancer, after dismissing her symptoms of bloating, discomfort and hemorrhaging to be from a “bad UTI or fibroids.”
- Endometrial cancer begins when cancerous cells form in the tissues of the endometrium, or lining of the uterus. Symptoms typically associated with this type of cancer include vaginal bleeding and pelvic pain.
- Surgery is the most common treatment option for endometrial cancer. Chemotherapy and radiation are also options; however, they are more useful when the cancer is in more advanced stages.
- A hysterectomy is a procedure that removes part or all of the uterus (or womb), often along with the cervix. Women who receive a diagnosis of uterine, ovarian, and cervical cancer may have their cancer treated with a hysterectomy.
The 62-year-old actress shared her health news in a recent interview with The Independent, where she detailed the day she started bleeding heavily while performing at the Chichester Festival in England last year.
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She continued, “The wardrobe women were incredible. I ran off stage and said, ‘Grab me some pads!’ We shoved some pads in my pants and I went back on stage and carried on. That was how we finished the show.”
About 18 months ago, an unexpected health crisis struck—after years of living with persistent bloating and discomfort, something she likened to “old age.”
The hemorrhaging and seeing blood in her urine prompted her to finally confront a doctor, although she “never went down the cancer road” in her mind,” adding, “It was a shock, because I have a very positive outlook on life in general. Even though my body was telling me there was something very seriously wrong, I kept thinking, ‘Oh, I’ve got a bad UTI or fibroids.'”
Understanding Gynecologic Cancers
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- 5 Possible Symptoms That May Indicate Gynecological Cancer
- Understanding the Risks and Symptoms of Uterine Cancer
- FDA Approves Combination of Keytruda & Lenvima For Treatment Of Advanced Uterine Cancer: What Women Need To Know
- New Research Finds That Deaths From Uterine Cancer Among Black Women Are On the Rise in the U.S.: How to Close the Cancer Care Gap
Kingston, who has impressively taken to the dance floor in the newest season of Strictly Come Dancing, received her diagnosis of womb cancer—also referred to as uterine or endometrial cancer, as it develops in the tissue that lines the inside of the uterus, known as the endometrium—in the summer of 2024 and concluded her treatment toward the end of the year.
According to the National Cancer Institute (NCI), “Uterine cancers can be of two types: endometrial cancer (common) and uterine sarcoma (rare). Endometrial cancer can often be cured. Uterine sarcoma is often more aggressive and harder to treat.”
As per City of Hope, “Endometrial cancer is the most common form of uterine cancer. Because the endometrium (the inner lining of the uterus) is part of the uterus, endometrial cancer is often referred to as uterine cancer.
“Endometrial cancer, sometimes described as cancer of the uterine lining, is the most commonly diagnosed gynecologic cancer (which includes cancers of the uterus, cervix, ovaries, vulva, vagina and fallopian tubes).”
Kingston’s treatment involved a hysterectomy, followed by a course of radiation therapy.
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About six weeks after the hemorrhaging episode—just as she was wrapping up the play she’d been performing in—she went for a medical checkup. Further tests at a nearby hospital revealed cancer in her fallopian tubes, though it had not yet spread to her ovaries.
Kingston, who described feeling “myself again” after undergoing surgery, is now urging other woman not to ignore symptoms and prioritize checkups.
She explained, “Womb cancer is really tricky because it is so sneaky. What I would say is, the body does know – and that was the body saying to me, ‘Help! There’s something really wrong.’
“It’s so important to seek advice and have a check-up.”
WATCH: New Immunotherapy Approvals Provide Hope for Women With Advanced Endometrial Cancer: What to Know
Helping You Understand Endometrial Cancer
Endometrial cancer begins when cancerous cells form in the tissues of the endometrium, the inner lining of the uterus.
After a woman has been diagnosed with endometrial cancer, her doctor will stage the cancer based on its spread within the body. A pelvic exam and imaging tests help your doctor learn if the cancer has spread or metastasized.
WATCH: Different Types of Endometrial Cancer
Some common risk factors for endometrial cancer include:
- Obesity
- Taking estrogen-only hormone replacement therapy after menopause
- Having never given birth or started menstruation at an early age
- Having a family history of endometrial cancer
Common symptoms of endometrial cancer may include:
- Pelvic pain: Some women may experience pain or discomfort in the pelvic area.
- Pain during intercourse: This symptom is less common but can occur in some cases.
- Unusual vaginal discharge: Watery or blood-tinged discharge may be a sign of endometrial cancer.
- Weight loss: Unexplained weight loss can sometimes be associated with cancer.
- Urinary problems: Difficulty or pain when urinating.
Treating Endometrial Cancer
Treatment for this type of cancer varies depending on the stage of the disease, the patient’s overall health, and other factors. Here’s an overview of the treatment options available for endometrial cancer.
Surgery
When the disease is localized, surgery is usually the first treatment considered and that alone may be all that’s required. More advanced stages often require a newer, more targeted treatment approach such as immunotherapy.
The most common surgical procedure is a hysterectomy, 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.
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. Marta Crispens, a professor and director of the division of gynologic 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.
Dr. Jennifer Mueller, a gynecologic surgeon at Memorial Sloan Kettering Cancer Center, explains how surgery can help determine treatment path.
“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.
Immunotherapy
Immunotherapy is a newer form of treatment that helps the body’s immune system fight cancer.
“For a long time, patients with early-stage endometrial cancer generally do very well with a combination of surgery, maybe some radiotherapy,” says Dr. Shannon Westin, a professor in the department of gynecologic oncology and reproductive medicine at the University of Texas, MD Anderson Cancer Center in Houston, TX.
“However, there’s a population of patients that are diagnosed at a later stage, stage three or four, or that have their cancer come back after initial therapy. And those patients have had a really hard time,” she adds.
According to Westin, the latest treatments combine immunotherapy with standard chemotherapy plus a drug that prevents cancer cells from fixing their own DNA.
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 gynologic 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.”
Advocating For Yourself Can Help Reduce Your Risk of a Misdiagnosis
When you see a doctor for a problem, don’t hesitate to ensure that your questions are fully answered and that you are comfortable with the plan moving forward. From a doctor’s perspective, every problem should have a diagnosis, a treatment plan, a follow-up plan, and a contingency plan for what to do if the treatment doesn’t work.
In addition to ensuring that you and your doctor agree about your diagnosis and potential treatment, seeking other opinions is equally important.
Doctors do not always agree on whether your symptoms merit further testing and whether specific treatment methods work best for you.
Dr. Steven Rosenberg, chief of surgery at the National Cancer Institute and one of America’s most renowned cancer doctors, agrees.
WATCH: The value of getting a second opinion.
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care because finding a doctor who is up to the latest information is important,” Rosenberg previously told SurvivorNet.
“It’s always important to get other opinions so that you can make the best decisions for yourself in consultation with your care providers,” Dr. Rosenberg continued.
Contributing: SurvivorNet Staff
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