Uterine Cancer Patient Advocate, Navigator or Health Advocate
The concept of patient advocacy in its current form was developed in 1950’s as the treatment of cancer patients grew more and more technically complicated, as a means to make the voice of the patient more readily heard. In today’s world of constantly evolving medical techniques, treatments, and services, the average individual cannot be expected to be thoroughly acquainted with any and all this material. So it becomes the function of the uterine cancer patient advocate to perform a variety of services to ease the burden of the patient, and their family, as they learn to deal with every aspect of the disease.
The primary concern of the uterine cancer advocate to the support the cancer patient in all aspects of life with the disease, whether they be physical, emotional, or financial. An advocate can assist the patient in investigating available treatment options and educating the patient on the efficacy of each of them, be it pharmacological or surgical. By educating the patient, the advocate can be of great assistance in helping them make an informed decision about their course of action, and the possible side effects and outcomes. Support may also involve recommending counseling services for the patient, and their family members, to help them cope from day to day. Uterine cancer patient advocates may also be of assistance in helping the patient, and their caregivers, deal with any physical debilitation resulting from the disease, and its treatment.
Another aspect of uterine cancer patient advocacy is assistance in navigating the financial aspects of treating the disease. An advocate can act as a liaison between the patient and his or her insurance company, assuring that the patient receives any and all benefits to which they are entitled. When one is dealing with a serious disease, it is quite easy to lose track of other aspects of your life. An advocate can help to seek out sources of assistance which can ease the financial burden of the patient.
Education is also a major function of a cancer advocate. Both the patient, and their caregivers, are often in need of information about how the disease will affect their lives, both during its progression, and in its aftermath. Patients must be informed about how their condition will affect their mobility, the ability to care for themselves, and if they will be left with any permanent impairment to their lifestyle. Caregivers need to be instructed in mechanisms, or techniques they must use to cope with the patient’s daily care, such as injections, proper care of surgical dressings, etc.
The cancer patient, above everything else, needs to know that there is someone in their corner. Someone who will help them find their way through the confusing, and sometimes daunting, world of modern medicine. Someone who will have their best interests in mind as they face challenges presented every day in their struggle to find, secure, and finance the best treatment available.
What is Uterine Cancer?
This is the most common cancer affecting women. It is mostly seen in women who have reached menopause. This type of cancer develop on the inner lining of the uterus – endometrium. This is different from those cancers that develop from within the uterine muscles referred to as uterine sarcomas. There are a number of different types of this cancer. The commonest one is endometrioid adenocarcinoma which forms about 75% of cases. Clear cell carcinoma follows at 5%. The rest are rarer ones but by no means any less important. The treatment for each of the cancers is slightly different.
Vaginal bleeding is the main complaint. This can be together with an abnormal discharge or heavy spotting between periods for those who have not reached menopause. Other symptoms include:
· Difficult and painful micturition.
· Dyspareunia – painful coitus.
· Pain in the pelvis.
· May present with symptoms reflecting areas affected by metastasis.
· Other non-specific symptoms may include weight loss. Anorexia and advancing weakness.
Causes of Uterine Cancer and Risk Factors
Like many other cancers, the exact cause is not known or understood. Certain factors however, do favor the cancer’s development. One of this is when estrogen levels dominate in the blood circulation. This hormone is responsible for promoting the growth of endometrial cells. If there is not enough progesterone to counter this proliferation, then malignancy may develop. Other risk factors include:
· Those aged over 50 years.
· Those whose menarche came as early as 12 years and menopause delayed into early 50s. The reason here is that there has been prolonged estrogen in circulation for a relatively long time.
· Primary infertility.
· High fat diet
· Exposure to radiation.
· Low levels of progesterone.
· Ovarian conditions like the polycystic ovarian syndrome.
· Genetics and family history of the disease.
· Use of the drug Tamoxifen (usually used in the treatment of breast cancer).
· HRT (hormone replacement therapies).
· Any condition that lead to proliferation of the endometrial cells.
· Diagnosis can be made early during routine screening of symptomless women.
· Occasionally a Pap smear may pick early uterine cancer but it is not an effective or reliable test to use for this.
· Dilatation and curettage to get endometrial tissue which may show cancer cells.
· Endometrial biopsy.
· Hysteroscopy – telescopic examination of the uterus.
· If the cancer is suspected to have spread to the bladder and/or rectum, then cystoscopy and proctoscopy may be necessary.
· Imaging tests may include X-rays, vaginal ultrasound, MRI, CT scans and others that the team involved with the patient may find necessary.
Treatment of Uterine Cancer
Surgery is necessary and even recommended in most cases. It involves complete removal of the uterus, fallopian tubes and ovaries – total abdominal hysterectomy (TAH). Certain lymph nodes may also be removed to see whether there are metastases already.
Radiotherapy. This is done either before or after surgery as well as a palliative measure to reduce cancer pain for those with advanced cancer. It can be done with the radiation machine outside the body or from within the body where a probe is inserted into the uterus and irradiation is done from there.
Chemotherapy treatment includes drugs like Paclitaxel, Carboplatin, Doxorubicin and Cisplatin.
Hormone therapy includes using hormonal drugs to increase circulating progesterone or others to suppress estrogen.
U.S Statistics for Uterine Cancer
The country’s statistics for the year 2015 indicates that about 55000 new cases will be diagnosed. About 10000 women will die from the cancer. The cancer is not common in women under 45 years of age. The risk of getting the cancer is 1:37.
The cancer is more prevalent in white women but blacks die from it more. Currently there are more than 600000 women survivors of uterine cancer.