Endometrial Cancer from stage 1 to stage 4 out of the blue

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My mum was diagnosed with endometrial cancer in October, initially assessed as grade 3, stage 1. She had an MRI and CT scan in early November, which did not show any spread beyond the uterus. She then underwent surgery in mid-November to remove the cancer.

During the operation, the surgical team also took additional biopsies from surrounding areas. The post-operative pathology results later showed microscopic spread to the bladder, which meant the cancer was upstaged to stage 4. Chemotherapy has now been recommended.

I’m still trying to understand how the bladder involvement was not detected on the earlier MRI and CT scans, and whether this means the spread was already present but too small to be seen, or if it progressed between the scan and surgery.

At the moment, we are waiting for kidney function tests and blood tests to confirm she is fit to start chemotherapy.

I would really appreciate advice on:

  • Whether there are any supplements or nutritional support she can safely take at this stage

  • Whether Nestlé Oral Impact is appropriate before and after chemotherapy

  • What the next steps usually look like in this situation

  • And whether there is anything important she should prepare or do in advance of chemotherapy (nutrition, rest, medications, lifestyle adjustments, or warning signs to watch for)

Any guidance or clarification would be very helpful, as this has been a lot to process.

  • Hi Vincentl,

     

    Thanks for getting in touch. I’m Eileen one of the nurses on the Macmillan Support Line. I hope you find the online community a supportive and informative space.

     

    I’m sorry to hear about your mum’s diagnosis and can appreciate how confusing it can be trying to understand why scans were unable to correctly identify the stage of her disease.

     

    MRI and CT scans can be very effective in detecting tumours but there are limitations regarding their ability to detect cancer when a tumour is very small or the cancer is at a microscopic level. Whilst we are unable to confirm, it is likely that the disease was already present in your mum’s bladder.

     

    Regarding your mum’s nutritional needs, if she is thinking of taking any food supplements, it is important she talks to her cancer doctor, specialist nurse, pharmacist or dietitian first. If she has a good appetite we would suggest she eats a healthy well balanced diet with all food groups, as this will ensure she is getting the nutrients and vitamins/minerals that she requires.

     

    If her appetite is poor and you’re concerned about her intake there are ways of adding calories and protein to everyday foods that might help. Her GP or hospital team can also prescribe nutritional supplement drinks if there is a concern about her nutritional intake. These drinks contain a range of nutrients plus vitamins and minerals but not everyone preparing for or going through chemotherapy requires nutritional supplement preparations.

     

    If your mum’s kidney function and blood tests confirm she is fit for chemotherapy the next step should be meeting with the oncologist to discuss her treatment plan. This is an opportunity to ask questions to understand the risks and benefits of the treatment being proposed before consenting to go ahead with it.

     

    There are steps that can be taken to help prepare for treatments such as chemotherapy. We are aware that improving general fitness and nutrition in addition to reducing anxiety and enhancing mental wellbeing can help people to reduce the risk of complications from having cancer treatments and can aid recovery following  treatments. In addition making lifestyle changes and looking after wellbeing  can help people develop a feeling of taking some control of their health which can be beneficial.

     

     

    I hope this information helps. Please feel free to get back in touch if you want more information or support.

    Best wishes,

    Eileen M

    Cancer Information Nurse Specialist 

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email

     

    Ref: EM/KG

    Eileen M - Macmillan Cancer Information Nurse Specialist