What does a 6% recurrence risk mean for my wife at age 58?

Question

Hello doctor,

My wife is 58 years old and recently completed treatment for grade 2, stage IA endometrial cancer. Following her surgery and vaginal brachytherapy, the oncologist briefly mentioned that she has approximately a 6 percent risk of recurrence at her age. However, this was not explained in detail, and we are unsure how to interpret that number in practical terms or what, if anything, we should do differently because of it.

She also has type 2 diabetes and is currently taking Metformin. Her HbA1c is 7.9%, which her endocrinologist considers suboptimally controlled and potentially relevant to her overall health outcomes. I have read that both diabetes and obesity may be independent risk factors for endometrial cancer recurrence. My wife's BMI is 31.

Her oncologist has scheduled follow-up appointments every six months, including transvaginal ultrasound examinations and CA-125 monitoring.

Could you please help us understand what a 6 percent recurrence risk means for a 58-year-old patient with grade 2, stage IA endometrial cancer? Is this generally considered a low and reassuring risk, or is it more concerning?

Additionally, could her poorly controlled diabetes increase this recurrence risk further? Given her diabetes and obesity, should she be undergoing more intensive surveillance than the current follow-up plan, or is the proposed schedule considered appropriate?

Kindly advise.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I completely understand your concern about your wife, and I appreciate how stressful this situation can be for both of you.

Let me reassure you that stage I endometrial cancer is generally not considered highly alarming, especially when it has been treated appropriately. The grade of the tumor is an important factor, and the specific histological cell type can also influence the overall assessment and prognosis.

Regarding what your doctor mentioned about the possibility of recurrence, this is simply a reality of cancer in general. Even when cancer has been treated successfully and is considered cured, there is always some residual risk of recurrence. A recurrence risk of approximately 6 percent would generally be considered relatively low and reassuring.

As for her weight and diabetes, these factors may slightly increase the risk of recurrence and can affect her overall health. Therefore, it would be beneficial for her to work toward gradual weight reduction and maintain good control of her blood sugar levels. Doing so may improve her overall health and potentially reduce future risks.

The possibility of tumor recurrence remains relatively low, but careful follow-up is still important. This may include monitoring tumor markers such as CA-125 (cancer antigen 125), when appropriate, and undergoing regular pelvic imaging, such as MRI (magnetic resonance imaging) or ultrasound examinations, as recommended by her treating physician.

Good follow-up care, effective diabetes management, and weight control are all important components of her ongoing care. However, this does not mean that recurrence is expected to occur, nor does it mean that recurrence is inevitable. It simply means that a reasonable degree of vigilance is warranted.

I hope this helps clarify the situation and eases some of your concerns.

I wish your wife continued good health and a full recovery.

Thank you.