My Uterus: The Problem Child

My uterus was always my problem child. I’ve known since I was 13 that I didn’t want children, so I’ve often said that it was a useless organ that only exists to cause discomfort every month. As it turns out, my uterus is sensitive to name-calling. 

Yesterday, I was diagnosed with endometrial cancer. It is very early and slow growing, and my doctor is confident that after my hysterectomy, I will not need any future treatment.  It is natural to think “what did I do to cause this?” when you receive any potentially serious diagnosis. Here’s what I came up with:    

Strikes against me:

• My weight: Women who are overweight have an increased risk. I’ve gone up and down my whole life (though in the last 5 years, it’s headed consistently downward.)
• Never having kids: Women who have never had children have an increased risk.
• Limited use of birth control:  I have been romantically unattached for large portions of my adult life, so I didn’t use birth control pills when I didn’t need them. Birth control pills can lower the risk of this cancer in women who have other risk factors.

Factors that gave me a false sense of security that I did not have cancer:

• My age:  I’m 37 years old. Less than 5% of these cancers occur in premenopausal women, and very few cases occur before age 40, even in women who have risk factors.  My doctor was shocked.
• My cycles: I’ve always had pretty normal cycles. Most of the time, I could predict them to the day. Women who have irregular cycles have an increased risk.  
• Exercise: I am a medical and science writer, so I have a sedentary job (that is a risk factor), but I’ve always made exercise a priority. Walking, cardio kickboxing, Pilates, whatever -- I make a point to move every day.
• My diet: My refrigerator looks like a damn farmer’s market. I’m a fishitarian -- 90% of the time I eat vegetarian and a couple times a week I eat fish.  The official term for fishitarian is “pescetarian,” but when I tell people that, they assume I belong to a cult.  

A word to anyone who considers themselves to be an Internet-taught nutrition professional: Before you try to tell me that I need to eat such-and-such food or take such-and-such supplement to prevent/treat cancer, please note that I went to school for 5 years for nutrition, I have a Bachelor’s and a Master’s degree in the field, and my degrees are in Dietetics, so I can practice nutrition clinically. That trumps whatever ”education” can be gained from reading non-credible, scientifically unsound, HOLY SHIT, EVERYTHING IS TOXIC! websites. In fact, let’s just assume that my personal nutrition is the one thing I am more than qualified to take care of. We now return to our regularly scheduled post.

What do women need to watch out for? 

Abnormal bleeding is the most common symptom, and it appears early. For some women, it’s just irregular spotting and for others it’s Niagara Falls. The severity of the symptoms does not necessarily correlate to severity of the disease. 

Other early signs include pelvic pain, unusual discharge (pink discharge or unusual clear watery discharge).

It’s important to note, that these are the exact same symptoms caused by a lot of other conditions, including fibroids (that was the original thought for me, because I have a strong family history of them), hyperplasia, polyps, and hormone imbalances.  There is absolutely no way to tell what you have without going to the doctor. Trust me, if there was a way for a non-doctor to tell the difference just by symptoms, I would surely have found it during my constant researching of symptoms these last few weeks.

How bad was the endometrial biopsy?

This varies from woman to woman, so if you need one, ignore the horror stories. Some women have claimed it was the worst pain they have ever felt. I felt almost nothing. A little cramping, and that’s it. (It should be noted that I may be impervious to pain, like the villain in Goldeneye. I had no pain after my wisdom tooth removal, either, and never took any pain medication for it.)  My doctor explained that women who are bleeding heavy during the procedure usually have a much easier time of it, so if you’re having a biopsy because you’re bleeding abnormally (the symptom seen in 90% of endometrial cancers), don’t work yourself up and assume the procedure will be awful. It simply may not be true for you. Even if you do experience pain, the procedure is very quick. It’s over in seconds.

Also, this was a surprise biopsy, so I took no pain killers beforehand, and I still did not have any pain. If you have the opportunity to schedule a biopsy, some doctors do prescribe a pain killer ahead of time to help with pain.

Three things I feel very fortunate for: 

• My symptoms were absolutely awful. Bleeding was my only symptom, but it was awful. I’ve only had symptoms for 3 months, but during the last two weeks waiting for my appointment, I could barely leave the house. This is not true for many women in the early stages. Some women receive their diagnosis after years of mild irregular spotting and some receive it just from unusual discharge. If my symptoms were mild, I might have passed them off as age-related changes and not visited my doctor until the symptoms worsened and the disease was more advanced.  So, ladies, ANY unusual symptoms -- even mild ones -- talk to your doctor.
• My doctor was incredibly thorough. Due to my strong family history of fibroids (and my symptoms aligning very close with other women in my family who had them), I almost passed on the biopsy until after the ultrasound (the test used to detect fibroids).  My doctor insisted I have one done. Due to my age, not all doctors would have insisted, because it was far more likely to be other things.  I will be forever grateful to her for being insistent. If your doctor is not insistent, or passes it off, YOU have to be the one who is insistent.  
• My support group.  Calling up my parents, brother, and friends and telling them I have cancer was the hardest thing I ever had to do, but the response I’ve received was incredible. I especially appreciate that everyone realized that I would have no tolerance for the “poor, poor you” comments and instead responded with humor. For all of you who have sent me pictures of uterus costumes to wear to my surgeon’s appointment, recipes for ovary-shaped cookies, and whatever the hell this is….. 

I salute you.