Early vigilance leads to happy outcome for endometrial cancer survivor
It was dinnertime on a Thursday afternoon in September 2018 when time suddenly stood still for Sherri McArdle-Krautter.
She had gone to her parents’ house to help out, because her father wasn’t feeling well. A fly was buzzing around and driving him crazy; when Sherri’s phone rang, she kept moving from room to room so the caller wouldn’t overhear him yelling at her mother to help him swat the fly.
It was her gynecologist, calling to report the results of a biopsy: Sherri had endometrial cancer.
“The world just stops,” said Sherri, a nurse practitioner at Magee-Womens, UPMC Hamot. Despite her professional background, in that moment, “I was a person being told you have cancer. The medical part of it went out the door.”
It was already a difficult time in Sherri’s life; she was going through a divorce, which strained her relationship with her daughter, an only child. When she got the call, she lost her composure.
“You need to just listen to what I’m saying,” her doctor told her. “This was caught very early, and this is a very curable cancer.”
But deep inside, she was scared.
Looking back on the months that led up to her diagnosis, the signs were there — if she was paying attention. In February 2018, she started feeling as though something wasn’t right. It started with a vaginal discharge that started out clear and watery, then progressed to daily spotting. Her pelvis felt full.
Although she is a nurse practitioner, Sherri believes her education and experience were secondary to the simple fact that she was listening to what her body was trying to tell her. A Pap smear came back normal. Still, the symptoms persisted.
An ultrasound revealed an abnormally thickened endometrium, which is the lining of the uterus. That triggered a memory: in the 1990s, when Sherri was trying to get pregnant, her then-gynecologist — now deceased — pointed out that her endometrium had thickened.
“He made the comment to me at that time that ‘if you were over 50, I would be extremely concerned about endometrial cancer.’ And that stuck with me,” she said. Now that she was over 50, she wanted a biopsy. And as it turned out, that decades-old comment was prescient: she did have cancer.
Endometrial cancer is the most common cancer of the female reproductive organs, accounting for about 65,620 new cases each year, according to the American Cancer Society.
A key risk factor is obesity; with the rising rates of obesity in the United States comes a parallel rising rate in endometrial cancer. Other risk factors include untreated, irregular periods and family history.
If caught early, the five-year survival rate is over 90 percent. But ignoring symptoms can be deadly; survival rates fall below 30 percent for Stage IV.
After her gynecologist broke the news, Sherri saw Dr. Jessica Berger, a Magee surgeon specializing in gynecologic oncology who also works at the Erie location, which allows women from across the region to access care locally instead of traveling to Pittsburgh. Sherri’s sister came with her for support.
Dr. Berger took Sherri’s hand and sat beside her.
“I’m so sorry. Nobody wants to hear that you have cancer,” was the first thing she said. “We’ll take good care of you.”
“She just took her time and sat and answered all of my questions and my sister’s questions,” Sherri recalled. “I left there feeling like the weight of the world was off my shoulders.”
“That’s kind of how I approach all my patients,” Dr. Berger said. “When you’re told you have cancer, even minor problems in your life suddenly seem monumental. It’s hard to cope. A lot of people need reassurance that they aren’t alone; other people have walked that path before them, and I’m there to walk that path with them.”
She echoed Sherri’s belief that women can be their own best defense against endometrial cancer, by seeking treatment when symptoms first appear. And the earlier endometrial cancers are caught, the easier they are to treat.
“We should put it on a billboard: bleeding after menopause is not normal,” Dr. Berger said. “Abnormal bleeding should be evaluated. That’s the public service announcement that I’d like everybody to know.”
The day of her surgery, Sherri was overwhelmed. She remembers being wheeled to the operating room at Hamot where she had been to assist with cesarean sections so many times as part of her job. She knew the nurse anesthetist. She saw the da Vinci surgical robot, and blurted out, “that thing is huge,” and asked, “is all of this stuff for me?” It was.
The surgery was successful, and because nothing had metastasized, it cured Sherri’s cancer. The recovery time was unusually lengthy, and Sherri battled fatigue. Chronic urinary tract infections brought her back to Magee, where she met Dr. Halina Zyczynski, a practicing urogynecologist and medical director of Magee-Womens Research Institute-Erie.
Recurring UTIs are “really common in postmenopausal women,” Dr. Zyczynski explained, in part due to changes in the vagina’s microbiome or bacterial ecosystem which occur with diminished estrogen.
Dr. Megan Bradley, an investigator with Magee-Womens Research Institute, studies the unique risk factors, bacteria, and patterns of antibiotic resistance in UTIs for postmenopausal women.
Her goal is to improve the lives of patients who previously suffered through the infections, thinking it was a normal part of aging.
“These aren’t things that women just have to deal with,” says Dr. Bradley. “We want to treat them; we don’t want them to suffer in silence.”
She also studies patient perceptions of UTIs in hopes of better understanding what they do and do not know about the condition; for example, many women believe cranberry juice helps, but fear estrogen.
Cranberry juice “is probably not our most effective therapy, but it’s the one everyone knows about,” Bradley says.
Today, Sherri is back to work, rebuilding her relationship with her daughter, and cancer free. She is also making lifestyle changes that she hopes will reduce her chances of the cancer recurring.
Having struggled with her weight for most of her life, and later with Type II diabetes, she is working to become less sedentary. Now she’s walking, biking, and watching her diet.
“I’m very lucky to have a happy ending. I’m very blessed. With all of the stressors I have gone through during the cancer and recovery, you still have to take those blessings – here I am to talk about it.”
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