How endometrial cancer treatments change your body
Treatments for endometrial cancer can affect how your body looks and functions. And both are very much related to our identity and how we see ourselves.
When cancer treatment changes your body’s appearance, function, or both, it can affect how you see yourself socially, in your relationships, sexually, and even at work, he says. Jeanelle Folbrecht, PhDclinical health psychologist and head of psychology at City of Hope in California.
Below are the most common changes that can affect body image in women who have undergone treatment for endometrial cancer.
Surgical effects
Surgery is usually part of the treatment for endometrial cancer. Depending on the stage, it may involve removing the uterus, cervix, fallopian tubes, and ovaries.
Physical scars from surgery may fade over time, but the emotional impact can be deeply personal, he says Barbara Buttin, MDgynecologic oncologist at City of Hope in Chicago. For many women, the uterus represents femininity, identity, and the ability to have children. “Defeated [your uterus] it can lead to feelings of grief, loss, or questions about femininity and self-worth,” she says.
For Heide Spence, a single mother of two who was diagnosed with stage 1 endometrial cancer at age 36 and treated with a hysterectomy, the physical and emotional effects were difficult to process. “Without having a part of myself, losing an organ that allowed me to give life, it was a struggle that I had to begin to understand in my brain,” says Spence, now an ambassador for the Endometrial Cancer Action Network for African Americans (ECANA). “None of my friends could understand it. Some were still having babies.”
Hormonal changes and early menopause
If you had an oophorectomy (removal of the ovaries) as part of the treatment and have not yet gone through menopause, you will enter surgical menopause. When your ovaries are removed, your body immediately stops producing hormones (such as estrogen and progesterone) that help regulate mood, temperature, and metabolism. This change may seem sudden and intense.
Many women report hot flashes, weight gain, mood swings, and vaginal dryness after an oophorectomy, says Dr. Buttin. These symptoms can be especially difficult if you’re dealing with the side effects of chemotherapy or radiation, she says. The sudden loss of hormones can also trigger emotional challenges such as anxiety and depression, along with health problems such as an increased risk of bone loss and heart disease.
Spence experienced sudden hormonal changes, causing weight gain, mood swings and depression. And being younger than most women with the diagnosis made her feel isolated, she says.
Weight fluctuations
Weight changes are common during and after cancer treatment. Some women lose weight due to nausea, appetite changes, and fatigue. Others notice weight gain, especially if they have entered surgical menopause, are receiving medications such as steroids, or are less active during recovery.
After Treatment “I didn’t want to do anything. I just wanted to eat whatever was easy, including junk food, but it didn’t help my emotional or mental state,” Spence says. He remembers how the weight kept increasing and the unpredictable mood swings made everything more difficult.
Hair loss and skin changes
Chemotherapy and radiation can cause hair loss and dry or darkening skin. “While some of these effects are temporary, they can have a lasting impact on the way patients see themselves,” says Buttin. Many women describe feeling less confident, less attractive and disconnected from their own bodies during this time, she says.
While Spence controlled her weight gain, her long, healthy hair was something she held on to for confidence. But when she started oral chemotherapy and her hair started falling out in clumps, she felt like she was losing another part of herself. “That became another battle,” he says.
sexual adjustments
For some, intimacy becomes another area affected by treatment. “Women with endometrial cancer often express fear of sexual interactions,” says Priscilla Chang, PsyD, a postdoctoral fellow in psychology in the department of supportive care medicine at City of Hope.
Surgery, radiation, and chemotherapy can cause physical changes to the vagina and genital area, which can make sexual intercourse uncomfortable or painful. Beyond the physical appearance, there is often an emotional component: feeling less desirable, worrying about how your partner sees you, or simply no longer feeling connected to your body in an intimate way, says Dr. Chang.
Spence admits to feeling frustrated and even angry at how cancer changed her confidence. “I was single and I kept thinking, ‘Who’s going to love me now?’ I was already struggling to feel like myself and trying to cope with weight changes,” she says.
She remembers the uncertainty of deciding how much to share about her diagnosis when they were dating. He had to figure out when and how to explain what happened to him and hope the other person wouldn’t run in the opposite direction, he says. “It took time, but I realized that what happened to me not only changed my body, it changed my life. It also gave me a new sense of purpose,” Spence says.
Living with a urostomy or colostomy
Some women need a urostomy or colostomy after treatment, which means using an external bag to collect urine or stool. This may seem like a huge loss of privacy and normality, Buttin says.
It’s a deeply personal adjustment that can affect confidence and social comfort. Learning how to manage an ostomy takes time, and many women feel self-conscious about their body and worry about odor, leaks, and how it looks under their clothes.
