LONG-TERM EFFECTS OF TREATMENT

Each treatment for clear cell cancer carries a risk of possible "unavoidable side effects" or complications (sometimes called secondary effects). It is important to ask your doctor about potential side effects of each treatment recommended. Because most women survive clear cell cancer, you will want to know how each treatment will affect your quality of life.


A preliminary survey of the quality of life of clear cell cancer survivors show that bowel complications (obstruction, constipation, diarrhea) occur more frequently after radiation therapy. Urinary complications (incontinence, weak muscle tone, lack of sensation) are more frequent when a woman undergoes radical pelvic surgery.

Other serious complications such as lymphedema (chronic, severe swelling of the leg), vaginal pain and vaginal dysfunction have also been reported.

"Not being able to have children didn't devastate me right away. My main concern was staying alive. Then it hit me, I can't have a child. It took me a long time to realize that reproductive organs don't make a woman."

WHAT TO ASK


Questions to ask your doctor about possible complications from treatment:

Survival


A number of factors influence survival after clear cell cancer: age at diagnosis, the cellular pattern of the tumor, and the stage of the cancer at the time of diagnosis.

The stage of the cancer at the time of diagnosis is the most important factor in survival. Cancer is generally staged according to how far a cancer has progressed (Stages I through IV). A lower stage of cancer means it is less invasive. A higher stage of cancer means it has grown beyond the original site, perhaps into the lymph nodes or the pelvic wall. Fortunately, most women survive clear cell cancer. Ninety-three per cent of patients with Stage I clear cell cancer survive five years. Eighty-seven percent survive more than 10 years.

"Every year I celebrate my victory of survival. We are women who have been dealt the unbelievable and have gone on to make full lives that include work, children, challenges, and good health. I like to stop once a year and celebrate."


Recurrence


A recurrence of clear cell cancer (when the cancer occurs again, at the same site or at a new location) is not common, but there are reported cases. It is critical in the years after treatment, to take good care of your health, and see a physician immediately about any unusual condition or pain. For early detection of a tumor in the years after original cancer treatment, it is important to continue to have yearly Pap smears and vaginal palpation examination even when you have had a vaginal reconstruction.

If clear cell cancer recurs, it is usually within 1 to 3 years after the original treatment and it most often occurs in the same location as the original cancer. In some cases an early recurrence might actually be cancer that was not completely destroyed. Clear cell cancer can spread to organs far from the original site, such as lungs and/or bone. Among the recurrences that have been reported, a common site of recurrence is the lung; therefore some doctors recommend having a chest x-ray on a regular basis.

It is important that your physician be aware that clear cell cancer can recur decades after the original cancer. Although uncommon, late recurrences of clear cell cancer have been seen in women 3 to 20 years after the original diagnosis. The approach to each patient's treatment should be individualized. A clear cell cancer patient experiencing a recurrence should consult an expert in the treatment of clear cell cancer recurrence.


WHAT TO ASK ABOUT RECURRENCE


Questions to ask your doctor about recurrence:
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