Powerful Lesson In Multiple Medical Opinions
- “The Nanny” actress turned cancer survivor and advocate Fran Drescher, 67, hopes patients seek multiple opinions after she sought out eight different doctors before being diagnosed with uterine (also called endometrial) cancer.
- 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.
- Drescher’s experience emphasizes the value of seeking a second or third opinion for your diagnosis and treatment plan. By doing this, you advocate for your health and ensure you get the correct treatment you need.
Years before Drescher knew she had cancer, she would experience regular staining between periods and cramping after sex.
Read MoreAccording to the U.S. Department of Health & Human Services, women are diagnosed with menopause after they have gone one year, or 12 months, without a period. Menopause is diagnosed when a woman is in her 40s or 50s. However, the average age of menopause in the United States is 51.
Some women experience intense symptoms during menopause:
- Hot flashes
- Problems with sleeping
- Bone thinning
- Pain during sex
As a result, doctors may prescribe hormone replacement therapy, which controls the levels of estrogen and progesterone in a woman’s body.
For people with hormone-responsive cancers, which are fueled by certain hormones, Dr. Bobbie Rimel from Cedars Sinai Medical Center explains the added hormones can exacerbate their cancer risk. For example, the uterus requires progesterone, which can cause weight gain, but if “estrogen alone over and over [is given], you’ll develop uterine cancer.”
RELATED: The Heightened Cancer Risks of Hormone Replacement Therapy With Estrogen
Drescher explained that the hormone replacement therapy made her feel worse.
The actress’ doctor told her to stop taking hormone replacement therapy. “It was probably just the wrong amount of estrogen,” Drescher recalled her doctor saying at the time.
Drescher visited eight different doctors for tests and possible treatments, many of which were to no avail. Then, doctor number eight suggested she do an endometrial biopsy. This type of biopsy takes a small sample of tissue lining the uterus and checks it for abnormalities.
RELATED: Breast cancer risk for post-menopausal women – Taking hormones can increase your risk.
Three days after the endometrial biopsy, Drescher says her doctor called with a confirmed cancer diagnosis.
“She called and said, ‘I am very surprised. You have adenocarcinoma. I said, ‘What is that?’ And she replied, ‘uterine cancer,’” Drescher said.
Uterine and endometrial cancer are often referred to interchangeably. The Ovarian Cancer Research Alliance says, “uterine cancer is an umbrella term that includes two distinct cancer types — endometrial cancer and uterine sarcoma.”
Endometrial cancer affects the lining of the 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.
WATCH: Endometrial Cancer Risk Factors
Drescher said she felt “betrayed” by the medical community because it took her two years and involved eight different doctors to obtain an accurate diagnosis. Since her diagnosis, “The Nanny” actress has become a staunch advocate for cancer patients.
“If you are a cancer patient or were just diagnosed with cancer, you may undoubtedly be very frightened. I know that I was,” Drescher told SurvivorNet.
“Some of the recommendations that I can make for you immediately is to open your world up to people, start looking at your lifestyle, and become educated so you can see what all of your options are. The best decision is an informed decision,” Drescher added.
Expert Resources to Help Patients Living With Endometrial Cancer
- Advanced or Recurrent Endometrial Cancer Patients Have New Hopeful Combination Therapy Option
- Combo Immunotherapy-Chemo Treatment May Help Slow Progression of Advanced Endometrial Cancer: Studies Show Promising Results
- Hope for Endometrial Cancer: FDA Approves Durvalumab/Chemotherapy Combination for Hard-to-Treat Advanced Disease
- ‘The Google Earth of Endometrial Cancer’ — a New, Molecular Snapshot Could Lead to Better Treatment of the Disease
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.
Endometrial Cancer Treatment Options
Treatment for endometrial cancer includes surgery, radiation, chemotherapy, hormone therapy, and targeted therapy. Surgery is the most common treatment method.
“There are a lot of new exciting treatments for advanced endometrial cancer that we’ve just discovered over the last couple of years,” Dr. Dana Chase, gynecologic oncologist at the David Geffen School of Medicine at UCLA, says.
“So even if you’re diagnosed with an advanced stage, ask your treating doctor what are the latest treatments or even potentially is there a clinical trial I can participate in for my endometrial cancer? … There’s a lot of research on new treatments for endometrial cancer, which is very exciting,” Dr. Chase continued.
The most common procedure is a hysterectomy, where the surgeon removes the uterus. They often also remove both ovaries and fallopian tubes in bilateral salpingo-oophorectomy. This helps lower the risk of the cancer spreading or coming back.
WATCH: What to Know About Endometrial Cancer-Related Surgery
“Doctors usually treat early-stage endometrial cancer with surgery as the main approach,” explains Dr. B.J. Rimel, a gynecologic oncologist at Cedar-Sinai Medical Center in Los Angeles. “During the surgery, doctors may also perform staging to see how far the cancer has spread. This involves taking out and examining nearby lymph nodes and tissues.”
Chemotherapy and radiation are options, particularly when the cancer is in more advanced stages.
Treating endometrial cancer with hormone therapy involves removing hormones or blocking their ability to help cancer cells grow. Targeted therapy treatment uses drugs designed to target specific cancer cells.
“Hormonal therapy commonly works because most 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, tells 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.”
Each treatment method can have side effects, and the impact on the body may vary depending on the type of treatment. If you are undergoing treatment for endometrial cancer, discussing potential side effects with your doctor and strategies to minimize their impact is crucial.
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.
Questions to Ask Your Doctor
If you’re battling cancer or on the other side of it, and you’re struggling with your outlook on life, here are some questions you may consider asking your doctor to get the conversation started:
- What can I do if I’m struggling to be thankful for what I have in my life?
- Are there local resources for people wishing to improve their mental health?
- What else can I do to help reduce my stress level during my cancer journey?
- It’s difficult for me to find happiness and joy. How can I find help?
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