Stage3 Endometrial Cancer at 70

[momsangel]

HI! After a life with pretty much NO illness (even a common cold), my mom came to see me March 30 and said she had vaginal bleeding.  She just last week had her 71st birthday so is quite post-menapause.  After a quick stay at the ER and a trip to my OB-GYN she was diagnosed within the week with endometrial cancer stage 3.  A huge mass had already come through her uterus making her belly seem like a "17 week pregnant" woman. Considering she is old school and there was "never anything wrong so why should I go to a doctor" obviously it was a huge blow to both her and I. Never having taken any medication either other than her daily Geritol Complete vitamin she seriously took almost 2-3 weeks of convincing to do any sort of treatments. Finally got her to do a three rounds of Chemo (taxo/carbo) of which she pretty much flew through the first two with no problem.  The third one took a bit of a toll and the gyne-oncologist wants to do surgery at the end of this month as the tumor has already shrunk immensly.

Being that she has NEVER been sick before and was running around like a crazy person until the day before this all happened this has come to be quite a blow to her. I know its no surprise but she absolutely REFUSES to see/talk to anyone or take any medication for anxiety/depression as she claims she can "talk herself out of it" or is "not depressed". I have had her in and out of hospitals as she just stops eating/drinking. Even during the first couple of chemos she still ate like a trooper. But now is down to 105# at 5'5". The concern is that she will not be physically up to the surgery. They say that they cannot exactly know how bad the cancer has spread until she has the surgery. She does smoke and has COPD that we found out about when she went in the hospital for the first time of not eating. She is taking Megace for appetite and claims she is eating (even though we know she is eating very very little)  Is there anything else we can try or what should I do?

[Annekathryn Goodman, M.D.]

Hi There,
thank you for all the information. I missed you question so I am sorry for my delay.

You should ask her doctor about the possibility of radiation first before surgery. Without examining her or seeing her CT scan, it is hard for me to be specific about the right treatment. Prognosis for advanced endometrial cancer will depend on whether there has been travel to lymph nodes or distantly to the lungs. If the cancer is just big but localized to the pelvic are, aggressive treatment is very appropriate.

Megace is a good anticancer agent fro endometrial cancer and is also good for appetite. It can cause gas, constipation, depression, and a sensation of breathlessness.

You should also look into any group groups for family members of people with cancer. You could call the local branch of your cancer society ( if you are in the USA, the American cancer society.) They will have a listing of local groups. Also at the cancer center, there may be a list of resource.
take care

[momsangel]

Also she has been plagued by a foul smelling vaginal discharge that is now getting worse so she no longer goes out anywhere. Upon talking to the regular oncologist last week he seems to think she has a fistula. This has sent her into another fit of not eating and claiming things are so bad she might as well just die. The doc does not even want to do the test to see if she has the fistula right now because she is in such a weakened condition. He is trying to get hold of her gyne-oncologist, but he is on vac for another week.

She complains constantly about lower back pain (which she is taking Vicodin now for) and has an incredible amount of gas which she says she thinks is causing her back pain. Could this be from the Megace? She pretty much had no side effects from the chemo (no nausea at all, but just some constipation). With the constipation that she experienced and this gas/foul smell, do you think that the cancer has spread so far already in her that it is not even worth trying to get her to surgery.

Its pretty difficult to know where to turn anymore as I am pretty much all she has anymore.  My dad has been gone quite a while and I have siblings that neither one of us have spoken to in years.  I am married, am raising two little ones and have a full time job.  Pretty much at this point pulling my hair out not knowing how to help her at all anymore.  She lives down the street from me, so I can watch alot of what she does but not everything.  How do I convince her that life does not have to be over at 71 and that she CAN get through this?  Also what do I do about getting her to eat?  She says she has an appetite from the Megace, but takes 2-3 spoonfulls and is "FULL".  I am wondering if the gas/bloating is not the problem too.  

PLEASE HELP ASAP!!!  I love my mom very much and we are very close.  She constantly tells people that I am her guardian angel, at the beginning I know I was a great help, now I just feel totally helpless.....