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Cancer / Oncology Treatments

Uterine Cancer

The uterus is a hollow organ, about the size and shape of a medium-sized pear. The uterus is where a fetus grows and develops when a woman is pregnant. The uterus has 2 main parts (see picture above). The cervix is the lower end of the uterus that extends into the vagina. The upper part of the uterus is called the body or the corpus. (Corpus is the Latin word for body.) Although the cervix is technically part of the uterus, when people talk about the uterus, they usually mean the body, not the cervix.

The body of the uterus has 2 main layers. The inner layer or lining is called the endometrium. The outer layer of muscle is known as the myometrium. This thick layer of muscle is needed to push the baby out during birth. The tissue coating the outside of the uterus is the serosa.

Hormone changes during a woman's menstrual cycle cause the endometrium to change. During the early part of the cycle, before the ovaries release an egg (ovulation), the ovaries produce hormones called estrogens. Estrogen causes the endometrium to thicken so that it could nourish an embryo if pregnancy occurs. If there is no pregnancy, estrogen is produced in lower amounts and more of the hormone called progesterone is made after ovulation. This causes the innermost layer of the lining to prepare to shed. By the end of the cycle, the endometrial lining is shed from the uterus and becomes the menstrual flow (period). This cycle repeats throughout a woman's life until menopause (change of life).

What is Uterine Cancer?

The most common cancer of a reproductive system of a woman is known as uterine cancer. This cancer starts in cell layers that form the lining of the uterus. This cancer can be detected in its early stage as it causes abnormal vaginal bleeding. The surgical removal of the uterus can cure uterine cancer.

Types of Uterine Cancer

Sarcoma: Sarcoma cancer grows in the supporting tissues of the uterine glands or in the myometrium. This cancer accounts for 2-4% of uterine cancers.

Adenocarcinoma: This cancer is considered as the main type of uterine cancer that grows from the cells in the uterus lining. Endometrial cancer is the other name of this cancer.

Endometrial stromal sarcoma and carcinosarcoma are considered as the rare types of uterine cancer.

  • Pink and watery vaginal discharge that changes into dark and foul smelling
  • Unusual heavy bleeding in between the periods or otherwise
  • Vaginal bleeding after menopause

Some of the less common symptoms are –

  • Pain during sexual intercourse
  • Discomfort or pain in the lower abdomen

Advanced symptoms include –

  • Pain in the legs or back
  • Loss of weight and appetite
  • Passing urine more than usual
  • Weakness or tiredness
  • Constipation
  • A feeling of being sick

diagnostic tests may include:

  • Ultrasound or transvaginal ultrasound. In transvaginal ultrasound, Gyne-oncologist inserts a wandlike device (transducer) into the vagina, which creates a video image of the uterus using sound waves.
  • Endometrial biopsy. In a biopsy, Gyne-oncologist removes cells from the lining of the uterus and examines them in a laboratory.
  • If Gyne-oncologist finds cancer of the uterine lining (endometrium) or uterine sarcoma, she may recommend exploratory surgery to determine how far the cancer has progressed.

    Surgery is the most common approach to treating uterine cancer. Additional therapy to destroy uterine cancer cells may include radiation, cancer-killing drugs (chemotherapy) and hormone therapy.
  • Surgery. During exploratory surgery, oncopathologist, who specialize in tissue study examine the cancer tissue so that Gyne-oncologist can determine how much tissue to remove. In most cases, Gyne-oncologist will recommend a hysterectomy (removal of the uterus) or a complete hysterectomy (removal of the uterus, fallopian tubes and ovaries). To find out whether the cancer has spread, Gyne-oncologist also removes tissue from the lymph nodes near the uterus and other abdominal sites.
  • Radiation therapy. Radiation (high-level beams) kills microscopic cancer cells that may remain after surgery. If the patient have an aggressive form of uterine cancer or are at high risk for recurrence, she may need radiation after surgery. Occasionally, Gyne-oncologist may recommend radiation instead of surgery, if the tumor can't be removed safely. She may receive external beam radiation or Brachytherapy. If she receives external radiation, Gyneconcologist may recommend Intensity Modulated Radiation Therapy (IMRT) or Image Guided Radiation Therapy (IGRT) to decrease damage to nearby healthy tissue.

Intensity Modulated Radiation Therapy (IMRT)

IMRT is now delivered through VMAT techniques in a continuous arc around patient effectively, from infinite delivery angles; reducing the integral dose to one tenth and treatment time to few minutes. IMRT is used for tumors arising from Head and Neck, Brain, Lungs, Lymphomas and Gynecological Cancers.

Image Guided Rad7iation Therapy (IGRT)

IGRT has been evolved to enable clinicians to treat the tumors that move with internal motion. IGRT provides a very effective means for mitigating the risk of tumor motion. Real time image guidance and adaptive radiation therapy involves constantly imaging the motion of the tumor during treatment delivery and changing beam delivery on the fly to compensate for undesired motion. IGRT is most suitable for Tumors of the Prostate, Urinary Bladder, Lungs and Gynecological cancers.

  • Hormone therapy. Gyne-oncologist may recommend progestin (synthetic progesterone) to help stop the cancer from spreading. Patient may take progestin with other medications.
  • Chemotherapy. In chemotherapy, drugs given by mouth or intravenously (through a vein) destroy cancer cells. Chemotherapy after removal of the tumor may improve treatment success if the patient has advanced endometrial cancer.

After the patient completed her treatment, Gyne-oncologist will provide follow-up care that includes physical exams, pelvic exams, Pap smears, chest X-rays and laboratory tests.

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