Ask CancerCare

A. The multiple challenges of being diagnosed and not having insurance can be stressful and emotionally difficult. Feelings such as anger, embarrassment or anxiety are very common, but these should not keep you from getting care. Give yourself credit for seeking help, and for learning about and using the resources that are available.

There are several options you can explore. Please keep in mind that it will require time and energy. It might be helpful for you to share with friends and family what you are experiencing and enlist them to make calls on your behalf. You may also contact local community or religious organizations that may be able to provide guidance and resources.

Being organized can help ease some of your anxiety. Keep a notebook with a list of people you want to call. Write down the name of the person with whom you speak, and what information they provide to you.

Here are more suggestions and resources that might be helpful:

• Contact local hospitalsto see what types of free care or charity care programs they offer. Speak with a financial counselor or social worker to explain your situation. Federal law requires that non-profit hospitals provide charity care in exchange for tax-exempt status, so ask!
• Medicaid is a jointly funded, federal-state health insurance program for people who need financial assistance for medical expenses. Medicaid can cover hospital and treatment costs. To find your local office, call 1-877-267-2323.
• The Patient Advocate Foundation (PAF) provides education, legal counseling, and referrals to cancer patients and survivors concerning managed care, insurance, financial issues, job discrimination, and debt management. Call PAF at 1-800-532-5274.
• For women who are diagnosed through screenings offered by the National Breast and Cervical Cancer Early Detection Program or who have been diagnosed but have not yet started treatment, there may be assistance through The Breast and Cervical Cancer Treatment Act. To find out more, contact the Centers for Disease Control (CDC) at 1-888-CDC-INFO.

A. Finding a specialist can be challenging for many women who are diagnosed with endometrial, or uterine, cancer. You deserve quality care, which includes getting information about your diagnosis, and being well informed of the treatment options and treatment goals.

A woman inevitably can feel overwhelmed at the time of diagnosis and finding a specialist will help you take control of the situation, and ease some of your concerns. To begin this process, consider locating a highly skilled gynecological oncologist. This is a doctor who specializes in the surgical care and medical treatment of women with cancer of the reproductive organs. Keep in mind that you want to choose a doctor who specializes in treating uterine cancer based on his or her credentials, as well as one with whom you feel comfortable and whose style you like.

Listed here are some resources that will help you in finding a specialist:

Gynecological Cancer Foundation
1-800-444-4441, website: www.thegcf.org
Provides doctor referrals through its toll-free number.

People Living With Cancer, the American Society of Clinical Oncology's website, allows you to search by doctor’s name, organization, location, specialty, and/or board certification.

National Cancer Institute (NCI) also provides information about finding a doctor.    

Additional tips:

• Ask your primary medical doctor for a referral. Don’t be shy about calling your primary doctor and explaining what you are going through. Most doctors are willing and able to help.
• Ask a friend or family member if they can recommend a specialist.
• Select a hospital based on its reputation for providing high quality cancer care (e.g., NCI designated facility). Most hospitals offer doctor referral services.

CancerCare offers a uterine cancer website section and a fact sheet, “Doctor Can We Talk: Tips for Communicating with Your Health Care Team that you might also find helpful.

A. Being diagnosed with cancer brings many complicated medical decisions. The uncertainty of infertility can create great emotional distress for women and their partners. Facing the possibility of not having your own children can be upsetting. This loss can affect your relationships and how you feel about yourself. If at all possible, before you make a decision about your treatment, take time to explore all the options available to you. Here are some other things you can do:

• Speak to your doctor before treatment about how the effects of surgery, specific chemotherapy drugs or radiation might affect your ability to conceive and have children. Ask about options to preserve your fertility or alternative ways to treat your cancer.
• Ask your doctor to make a referral to a reproductive specialist. Sperm and embryo cryopreservation are considered standard practice and widely available; other fertility preservation methods (such as ovarian tissue freezing, ovarian suppression or ovarian transposition) should be considered investigational and be performed in centers with the necessary expertise. 
• If you are uncertain about your fertility after cancer treatment, you can test your blood levels of FSH (follicle stimulating hormone) to determine your ovarian health.
• You can consider adoption and surrogacy.

The possibility that one cannot have a child, or an additional child, is a loss and, as with other losses, you need time and space to grieve. This can raise many feelings including anger and sadness. You may want to speak with a social worker or join an online or telephone support group to connect with other women who are experiencing similar feelings.

Other helpful organizations include:

• American Society for Reproductive Medicine, website: www.asrm.org
• Fertile Hope, website: www.fertilehope.org
• Lance Armstrong Foundation, website: www.livestrong.org
• People Living with Cancer, website: www.plwc.org

A. After a diagnosis of ovarian cancer, a woman can feel vulnerable and experience a lot of uncertainty. The emotional, social and physical experience of having ovarian cancer can be overwhelming and living with this experience often leaves one with a fear of this happening again.

While your fears are typical and at times they many even vary. For example, around the time of your check-up, blood tests or when a milestones or anniversary is approaching you may feel sad, irritable or anxious. Becoming aware of this, and allowing yourself to acknowledge and accept your feelings is the first step. Developing ways to manage these feelings is extremely important and a way to be kind to yourself. An important act of kindness to yourself is to live in the now and find ways to balance your fear of recurrence with enjoying your life, and the hope for continued wellness.

Here are some suggestions about things you can do:

• Get support. Many women find comfort in a support group. Share your feelings and learn how others are coping with challenging and common fears, which can provide you with a community of strength and understanding.
• Take good care of yourself. Get enough sleep and reduce stress. Find things to do that are comforting such as meditation, yoga class, writing in a journal, or spending time with your pet. We all have activities we find soothing and it is important to develop these and do them when you need to.
• Communicate. Share your feelings with the people who are important to you. Let them know how you are, and what they can do to help. Set limits if you need to by deciding what you can commit to and what you can do another day.

Remember, you can speak with a CancerCare oncology social worker about your concerns by calling 1-800-813-HOPE (4673). You can find additional information about recurrence concerns at the Lance Armstrong Foundation website and the People Living With Cancer website.