The primary surgery for uterine cancer is a total hysterectomy with bilateral salpingo-oophorectomy. The uterus is removed along with both ovaries and fallopian tubes and sometimes the pelvic lymph nodes. In a radical hysterectomy, the uterus, cervix, surrounding tissue, upper vagina and usually the pelvic lymph nodes are removed. A hysterectomy can be done either through the abdomen or the vagina, depending on a patient's medical history and overall health.
Some uterine cancer patients may undergo a lymphadenectomy, or lymph node dissection. Lymph nodes are removed from the pelvic area and examined for the presence of cancerous cells, helping doctors determine the exact stage and grade of the cancer. This surgery may be done as a part of a hysterectomy. The procedure can be done through an abdominal incision or by laparoscope.
Radiation therapy may be used to treat uterine cancer after a hysterectomy or as the primary treatment when surgery is not an option. Depending on the stage and grade of the cancer, radiation therapy may also be used at different points of treatment.
There are two types of radiation therapy and in some uterine cancer cases, both types are given.
External beam radiation involves a series of radioactive beams precisely aimed at the tumor from outside the body. Intensity-modulated radiation therapy and proton therapy are examples of external beam radiation. Patients generally undergo daily outpatient treatments five days a week for four to six weeks, depending on the treatment plan. Brachytherapy involves tiny radioactive seeds that are inserted through the vagina into the uterus wherever cancer cells are located. The seeds remain in place for two to three days and then removed or can be done as an outpatient where the seeds remain in place for a shorter time. Depending on your cancer, several treatments may be needed. Because brachytherapy delivers radiation to a localized area, there is little effect on nearby structures such as the bladder or rectum.
The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have receptors where hormones can attach, drugs can be used to reduce the production of hormones or block them from working. In hormone therapy, progesterone-like drugs known as progestins are used to slow the growth of cancer cells.
New treatments are always being tested in clinical trials and some patients with cancer may want to consider participating in one of these research studies.
These studies are meant to help improve current cancer treatments or obtain information on new treatments. Talk to your doctor about the clinical trials that may be right for you.