Uterine Cancers

What is uterine cancer?

Cancer Is The Uncontrolled Growth Of Cells Within The Body. Usually, All Of Our Cells Have A Specific Lifespan Of Days To Years That Is Genetically Programmed In Our DNA. When Our DNA Becomes Damaged, Either Through The Aging Process, Exposure To Toxins Such As Radiation Or Chemicals Or Through Inherited Genes, Some Cells Do Not Die A Natural Death But Continue To Grow. As They Do, They Form New Cells With The Same Genetic Misinformation. These Extra Cells May Form Masses Or Tumours That Can Be Either Malignant Or Benign. A Benign Tumour Is A Tumour That Does Not Invade The Surrounding Tissue Or Spread Around The Body And Stays In One Place. A Malignant Tumour Can Invade The Surrounding Tissue Or Spread Via The Blood Or Lymph Networks And Affects Other Cells And Organs.

Uterine Cancer, Womb Cancer Or Sometimes Endometrial Cancer Is A Common Type Of Cancer That Only Occurs In Women. The Majority Of Uterine Cancers Occur In The Endometrium – The Mucous Membrane That Lines The Inner Wall Of The Womb. It Is The Endometrium That Thickens During The Menstrual Cycle To Prepare For Pregnancy.

While Vulvar, Cervical And Ovarian Cancers Are Not A Subgroup Of Uterine Cancer, We Have Included Their Diagnosis And Treatment In This Article.

Uterine Cancer Can Be Curable But Usually Involves A Hysterectomy Or Surgical Removal Of The Womb. Later Stage Uterine Cancer Is Most Likely To Metastasize To The Colon, Rectum And Lungs.Cancer Of The Cervix Or Ovaries May Also Requires The Removal Of Extensive Areas Of Reproductive Tissue, Sometimes Including The Uterus. Cancer Of The Vulva Is Also Surgically Treated. Most Oncologists Recommend Additional Radiotherapy Before (Neoadjunct) Or After (Adjunct) Surgery. Chemotherapy And More Recent Targeted And Immunological Therapies Also Have Their Role To Play. Gynaecologic Cure Rates, Including Those Of Breast Cancer, Are Consistently Increasing Due To Advances In Treatment, Screening And More Awareness Of Symptoms In The General Population.

Whether You Have Been Diagnosed With Uterine, Ovarian, Cervical Or Vulvar Cancer Or Are In A High-Risk Group, Remedazo Can Put You In Touch With Expert Gynaecologists, Reproductive Endocrinologists And Oncologists For Up To Three Free Online Consultations To Discuss Every Possible Treatment Option.

Are there different types of uterine cancer?

The Uterus Is An Upside-Down Pear Shape With Three Layers Of Tissue. The Inner Layer, The Endometrium, Provides A Blood Vessel-Filled Bed That Allows Foetal Nutrition During Pregnancy. The Middle Layer – The Myometrium – Is Composed Of A Thick Layer Of Smooth Muscle. The Outer Layer Or Perimetrium Covers The Outside Of The Uterus. At The Bottom Of The Womb, The Narrow Cervix Leads Into The Vagina. Finally, The Folds Of The Vulva Surround The Openings Of The Vagina And Urethra.

Cervical And Vulvar Cancers Are Not The Same As Uterine Cancer. Ovarian Cancer, Often Linked To More Aggressive Cancer Types, Is Also A Separate Entity. However, Many Women Believe A Papanicolaou (PAP) Smear Test Will Detect Most Cancers Of The Reproductive System. This Is Not Correct. For Peace Of Mind And Early Detection, Screening For A Broad Range Of Cancers On An Annual Basis Is Advised. Remedazo Arranges Complete Diagnostic Health Checks Using Radiation-Free MRI And Ultrasound Imaging In All Medical Specialties.

For An Overview Of The Most Common Types Of Ovarian, Uterine, Cervical And Vulvar Cancers, Please Read On.

Endometrial hyperplasia

Endometrial Hyperplasia Or Excess Thickening Of The Endometrium Is Not Cancer But Can Lead To Uterine Cancer In Those Who Have Been Diagnosed. In The Presence Of High Levels Of Oestrogen In The Absence Of Progesterone, The Lining Of The Uterus Remains In Place If Fertilisation Of The Egg Or Ovulation Does Not Occur. This Means Irregular Periods With Little Bleeding As The Endometrium Becomes Thicker And Thicker.

If You Have Been Diagnosed With Atypical Endometrial Hyperplasia, You Will Need To Undergo Treatment To Remove Abnormal Cells Before They Have The Opportunity Become Cancerous. Endometrial Hyperplasia Is More Common After The Menopause But Increasing Numbers Of Young, Obese Women Are Experiencing Endometrial Hyperplasia.

Vulvar intraepithelial neoplasia

Vulvar Intraepithelial Neoplasia Or VIN Is Another Benign Diagnosis That May Increase Your Risk Of Developing Vulvar Cancer. Younger Women Usually Present With This Disease After Becoming Infected With The Human Papilloma Virus; Older Women Have A Slightly Different Type That Is Not Associated With A Sexually Transmitted Infection. This Precancerous Condition Can Be Treated As A Minimally-Invasive Outpatient Procedure.

Adenocarcinoma and squamous cell carcinoma

The Most Common Uterine Cancer Is Endometrial Adenocarcinoma. It Is Also One Of The Least Likely Uterine Cancer Types To Metastasize And Produces Symptoms At An Early Stage. Endometrial Cancer Is Quite Slow To Develop And Most Common In Post-Menopausal Women; However, Obese Women, Women With Type II Diabetes Or Those Who Have Had Hormone Therapy For Breast Cancer Are All High Risk. In Fact, Up To 40% Of Endometrial Adenocarcinoma Cases Occur In Women Who Are Obese. Very Few Cases Are Hereditary. When Uterine Endometrial Cancers Begin In Mucous-Producing Cells Of The Womb They Are Referred To As Adenosquamous Carcinomas.

Cervical Adenocarcinoma Is Another Form Of Gynaecologic Cancer But Is Less Associated With Post-Menopausal Women. Cervical Cancers Are Often The Result Of Sexual Activity With A Person Infected With Human Papilloma Virus (HPV). Where The Mucus-Producing Glands Produce Mutated Cells, The Diagnosis Will Be Squamous Cell Carcinoma Of The Cervix. This Type Of Cancer Can Also Be Found In The Vulva But Only Very Rarely In The Ovaries. A Verrucous Carcinoma Of The Vulva Is A Wart-Like, Slow-Growing Cancer That Responds Well To Treatment At Early To Mid Stages.

Vulvar melanoma

Melanoma Is Usually The Result Of Sun Damage And Growths Are Located On Exposed Areas Of Skin. This Is Not The Case With Vulvar Melanoma. Women With Melanoma On Other Areas Of The Body Are More Likely To Develop Vulvar Melanoma.

Papillary serous carcinoma

Papillary Serous Carcinoma Is A Rare Cancer Type That Begins In Either The Womb Or The Cervix. It Is Aggressive And Often Only Detected In Later Stages. Treatment Is Therefore Always A Combination Of Surgery, Chemotherapy And Radiotherapy.

Uterine sarcoma

Uterine Sarcomas Are Very Rare And Begin In The Connective Tissue Of The Uterus, Usually In The Thick Muscle Layer. They Can Develop On Their Own (De-Novo) Or After Radiation Treatment (RT Sarcoma). As With All Types Of Uterine Cancer, First-Line Treatment Is Surgery And Radiation Therapy; Your Oncologist May Additionally Prescribe Chemotherapy, Targeted Therapy, Immunotherapy Or A Combination Of These. Cervical Sarcoma Is Similarly Rare, As Is Ovarian Sarcoma.

Ovarian epithelial cancer

Most Ovarian Tumours Of The Outer Ovarian Surface (The Epithelium) Are Benign But Have The Potential To Become Cancerous And Should Therefore Be Closely Followed Up If Not Removed. Where Ovarian Epithelial Tumours Are Malignant, Lack Of Symptoms Can Mean The Disease Is Already Advanced. If Your Medical Report Mentions Low Malignant Potential Or LMP Tumours, These Do Not Yet Appear To Be Cancerous.

Ovarian germ cell tumours

The Cells That Produce Human Eggs Can Overgrow But Are Rarely Malignant. Cancerous Cases Are Usually Found In Young Women And Teenagers. If Your Daughter Has Been Diagnosed With A Germ Cell Tumour Of The Ovary, You Can Be Sure Remedazo Will Provide A Sensitive Team Of Support Staff, And Empathic, Expert Physicians And Nursing Staff For All Of Our Patient Partners. We Also Cater For All Accompanying Family Members.

Nearly All Cases Of Ovarian Germ Cell Cancers Are Curable And Future Fertility Is Left Unaffected After Treatment.

Ovarian stromal cell tumours

Hormone-Producing Cells Can, On Rare Occasions, Produce Stromal Tumours That Grow Extremely Slowly And Are Usually Detected At An Early Stage. This Means Their Treatment Is Nearly Always Curative.

Oestrogen-positive cancer

Some Types Of Mutated Cells That Cause Uterine, Ovarian Or Cervical Cancer Have Receptors On Their Outer Surfaces That Female Sex Hormones (Oestrogen And Progesterone) Can Attach To. When These Hormones Attach They Encourage Cancer Cells To Multiply At A Faster Rate. New Scientific Discoveries Allow Oncologists To Block The Receptors And So Slow Down Cancer Growth.

Oestrogen-Positive Cancers Grow More Quickly In The Presence Of Oestrogen. Progesterone-Positive Cancers Use Progesterone To Increase In Size. Women Taking Hormone Replacement Therapy During Or After The Menopause Sometimes Have A Higher Risk Of Developing Uterine Cancers.

HER2-positive cancer

Some Types Of Mutated Cells That Cause Ovarian, Uterine, Cervical Or Vulvar Cancer Have Receptors On Their Outer Surfaces That Substances Such As Proteins Can Attach To. When These Proteins Attach, They Encourage The Cancer Cells To Multiply At A Faster Rate. New Scientific Discoveries Allow Oncologists To Block These Receptors And Slow Down Cancer Growth.

One Protein That Encourages Gynaecological Cancer Growth Is Called HER2. If You Are Prescribed Trastuzumab, Your Uterine Or Ovarian Cancer Is HER2-Positive. Remedazo Can Arrange Free Second Opinions With Oncologists Up To Date With The Most Recent Therapies To Ensure You Have Access To The Latest Approved Treatments.

Triple negative cancer

When Cancer Cells Do Not Have Receptors For Oestrogen, Progesterone Or The HER2 Protein, They Are Known As Triple-Negative Cancers. This Term Is Most Commonly Used To Describe Breast Cancer Types But It Is Now Known That This Genetic Pattern Also Exists In Ovarian, Cervical And Endometrial Cancers And Possibly In Vulvar Cancer. Where A Biopsy Shows That Hormonal Or HER2 Inhibitory Treatment Will Not Work, Other Treatments Are Used.

Uterine cancer stages

Your Medical Notes May Have Listed A Number Of Codes Concerning Your Diagnosis. Or Perhaps You Are Waiting For Further Testing And Prefer To Be Well-Informed Before Receiving Your Results.

The Majority Of Oncologists Adhere To The Universal TNM Staging System. In Short, This System Uses A Scoring System For Tumour, (Lymph) Nodes And Metastasis According To Biopsy And Imaging Results.

T Stands For Tumour. T Plus A Letter Or Number Describes The Size (In Centimetres) And Location Of A Tumour. T Letter And Number Systems For Uterine, Cervical, Ovarian, And Vulvar Tumours Vary But All Can Be Described As A Group - Albeit In Slightly Less Detail - To Cover The Most Important Data:

TX: It Is Not Possible To Evaluate The Tumour Due To A Lack Of Data
T0: No Evidence Of A Primary Tumour
Tis: Carcinoma ‘In Situ’ – In One Location And Has Not Spread
T1: The Tumour Is In Situ And Small
T2: The Tumour Is In Situ And Slightly Larger
T3: The Tumour Is In Situ And Generally Large
T4: The Tumour Has Spread To Areas Beyond Its Immediate Location And Into Surrounding Tissues

N Stands For Nodes Or Lymph Nodes And The Following Codes Apply:

NX: Regional (Nearby) Lymph Nodes Cannot Be Evaluated Due To Lack Of Data
N0: No Spread To Regional Lymph Nodes
N1: Tumour Has Spread To The Closest (Sentinel) Lymph Nodes
N2: Tumour Has Spread To Nearby Lymph Nodes
N3: Tumour Has Spread To Non-Regional Lymph Nodes

Finally, M Stands For Metastasis. The Following Codes Apply:

M0: There Is No Spread To Distant Lymph Nodes Or Other Organs
M1: Cancer Is Present In Distant Lymph Nodes And/Or Other Organs.

Uterine Cancer Metastasis Is Most Likely To Affect The Lungs. Ovarian Cancer Metastasis Is Most Often Found In The Liver Or Intestines.

Most Cancer Is Then Further Grouped According To The TNM Results In Up To 5 Stages. Stage 0 Is A Carcinoma In Situ And At A Very Early Stage. Stage I Is Early Non-Metastasized Cancer With No Lymph Node Spread And A Small Tumour. Stage II Indicates A Larger Tumour With Minimal Regional Lymph Node Spread. Stage III Describes Non-Regional But Close-Lying Lymph Node Involvement And A Large Tumour. Stage IV Indicates Metastasis.

Additionally, You May Have Been Diagnosed With Recurrent Cancer After Being In Remission For A Time. Local Recurrence Refers To Cancer Reappearing In The Same Area As The Previous Cancer, Regional Recurrence To An Area Close To The Previous Cancer, And Distant Recurrence Refers To Metastatic Cancer.

What are uterine cancer symptoms?

The Symptoms Of The Different Anatomical Cancers Described Above Are Not All The Same And Have Even Led To Confusion In Some Women That Have Delayed Treatment. It Is Very Important To Be Aware Of The Different Symptoms And Your Level Of Risk. Arranging Once Or Twice-Yearly Gynaecological Check-Ups And Knowing Which Tests Are Available And Which Cancers They Apply To Can Significantly Lower The Risk Of Undetected, Later-Stage Cancer.

Most Uterine Cancer Is First Diagnosed When Post-Menopausal Women Or Older Women Who Have Never Have Children Are Invited To Be Screened By A Gynaecologist. Unlike Many Types Of Cancer, Symptoms Of Uterine Cancer Begin At Early Stages With Abnormal Vaginal Bleeding That Does Not Coincide With The Normal Menstrual Cycle Or That Occurs After The Menopause. Vulvar Cancer Is Associated With Itching Or Pain, Thickened Skin, Wart-Like Growths Or Open Sores. Cervical Cancer Symptoms Include Irregular Bleeding, Vaginal Discharge And Pelvic Pain. Ovarian Cancer Is More Likely To Produce Abdominal Bloating, Pelvic And Lower Back Pain, Low Energy And Urinary And Bowel Movement Changes.

If You Are Reading This Page, You May Have Been Diagnosed With Uterine (U), Ovarian (O), Cervical (C) Or Vulvar (V) Cancer Due To The Presence Of One Or More Symptoms. The List Of Common Symptoms Below Also Lists The Initials Of The Corresponding Cancer Types. These Symptoms Are Also Present In Non-Cancerous Pathologies That Include Infection, Hormonal Imbalances, Pregnancy And Even Irritable Bowel Syndrome.

Irregular Bleeding That Does Not Correspond With The Menstrual Cycle (U) (C)
Abdominal Bloating (O)
Pain During Sexual Intercourse (C) (U)
Unusual Vaginal Discharge (C) (U)
Pelvic Or Lower Back Pain (O) (C) (U)
Bowel Movement And Urinary Changes (O) (U)
Itchy Vulva (V)
Open Sores Or Warts On The Vulva (V)
Loss Of Appetite And Unexplained Weight Loss (U) (O) (C) (V)
Fatigue (U) (O) (C) (V)

National Screening Programs For The Detection Of Cervical Cancer In The General Population Are Common In The Form Of A Pap Smear That Removes Cervical Cells With A Swab. A Pap Test Does Not Test For Uterine, Ovarian Or Vulvar Cancers. Vulvar Diagnostic Tests Include Checking The Skin For Lumps And Growths. Ovarian And Uterine Cancers Require Transvaginal Ultrasound Where A Probe Is Inserted Into The Vagina To Create An Image On A Screen. If Abnormalities Are Detected Using Any Of These Methods, Further Testing By Way Of Medical Imaging Or Tissue Biopsy Is Necessary. These Diagnostic Measures Will Be Discussed Further On.

Can I prevent uterine cancer?

Not Many Uterine, Cervical, Ovarian Or Vulvar Cancers Run In Families; However, If A Family Member Has Had Colon Cancer This May Increase Your Risk Of Uterine And Ovarian Cancer Types, As Does Hereditary Non-Polyposis Colorectal Cancer (HNPCC). Increased Risk Of Uterine Cancer In Those Who Have Had Colon, Breast Or Ovarian Cancer Has Been Reported. This May Also Be Linked To Earlier Cancer Treatment With Drugs Such As Tamoxifen Or In Response To Repeated Radiation Therapy.

The Most Common Non-Familial Risk Factor For Cervical And Vulvar Cancer Is Infection With The Human Papilloma Virus (HPV). This Is Not The Case With Uterine Or Ovarian Cancer. Vaccination Of Teenage Girls And Boys Is A Highly Effective Preventive Measure For These Two Cancer Types. If You Are HPV-Positive, A Biannual Appointment With A Gynaecologist And Annual Papanicolaou Test (Pap Test) Will Pick Up Abnormal Cells In The Cervix At An Early Stage. For Ovarian And Uterine Cancer, A Blood Test Called The CA125 Test May Indicate Both Malignant And Benign Abnormalities; A Positive Result Certainly Does Not Indicate Cancer But Can Provide A Reason To Test Further.

Endometrial Hyperplasia And Vulvar Intraepithelial Neoplasia Increase The Risk Of Developing Uterine And Vulvar Cancer Respectively. Removal Of These Areas Of Overgrowth With Minimally Invasive Treatments Can Be An Effective Preventive Measure.

Obesity Is Linked To A Wide Range Of Cancers, Especially Those Linked To Hormone Imbalances. Fat Tissue Produces Oestrogen, Causing Long-Term Hormonal Imbalance. Women With A BMI Of 28 Or More Might Want To Arrange More Regular Screening Appointments From A Younger Age, Lose Weight And Eat Foods Low In Animal (Saturated) Fats. Post-Menopausal Women Are At A Higher Risk Of Uterine And Ovarian Cancer, And Those Taking Hormone Replacement Therapy Also Vary Slightly Increase Their Risk Of Developing Ovarian And Uterine Cancer. Additionally, Women With Diabetes May Be Up To 25% More Likely To Develop Ovarian And Uterine Cancers And Should Try Their Best To Manage The Disease With Regular Blood Glucose Monitoring, The Correct Medication And Healthy Lifestyle Changes.

Many Risks Can Be Diminished Through Taking The Combined Contraceptive Pill For More Than 10 Years, Use Of A Progestin-Secreting Intrauterine Device (IUD), Pregnancy, Breastfeeding, Combined Oestrogen And Progesterone Hormone Replacement Therapy And Surgical Removal Of The Ovaries In Women Who No Longer Wish To Have Children.

While CT Scans And X-Rays Can Detect A Range Of Illnesses, They Also Emit Large Amounts Of Radiation And Can Cause Damage To Cell DNA. This Damage Can Lead To Cancer. MRI Scans Do Not Use Radiation But Electromagnetic Energy And Are Therefore Much Safer; However, They Are Not As Cost-Efficient As Radiation-Emitting Machines And Hospitals Tend To Limit Their Use. A Less Expensive Option Is Ultrasound That Uses Soundwaves To Produce An Image. Arranging Your Own Diagnostic MRI Scans At A Private Hospital Can Be A Good Idea.

It Is Also Important To Mention That People Who Regularly Travel On Long-Haul (High Altitude) Flights Can Be Exposed To Higher Radiation Levels And Should Opt For The MRI Scan (Or Ultrasound) Rather Than A CT Scan Or X-Ray Whenever Possible.

How are uterine cancers diagnosed?

Whether You Are Experiencing Symptoms, Present With Risk Factors Or Simply Want Increased Peace Of Mind, All Gynaecologists Follow The Same Diagnostic Pathways When Ruling Out Gynaecologic Cancers. Before Any Gynaecological Diagnostic Test It Is A Good Idea To Empty Your Bladder And Bowels. Do Not Use A Tampon If You Are Menstruating - You Can Temporarily Replace It With A Sanitary Towel. Some Diagnostic Tests Will Ask You To Reschedule Your Appointment If Menstruating. If This Time Coincides With Your Appointment, Let The Doctor Know At Least 24 Hours Beforehand So Your Trip Is Not Wasted.

Your First Visit Will Include Giving Information About Your General Health And Family History, Details Of Pregnancies, Miscarriages Or Plans For Children, Blood Tests To Check For Hormonal And CA125 Levels, Clinical Observation Of The Breasts And Lower Abdomen, Ultrasound Of The Lower Abdomen, An Ultrasound-Assisted Transvaginal Examination And A Colposcopy.

If You Have Not Had A Recent Pap Test For The Screening Of Cervical Cancer, This Will Be Done During The Colposcopy.

Discolouration, Growths Or Lumps Detected In The Breasts, Vulva, Vagina, Cervix, Uterus Or Ovaries, Blood Tests Pointing To Abnormal Hormonal Levels, Or Positive Pap Test Results Will Requre A Second New Appointment. For Breast Diagnostics, Please Visit The Breast Cancer Page.

The Next Step After Detection Of Abnormality May Be Another Colposcopy Where A Small Amount Of Tissue Will Be Taken From The Vagina, Cervix Or Lower Womb (Biopsy). Fine-Needle Aspiration Under Ultrasound Guidance Inserts A Thin Needle Into The Lower Abdomen Under Local Anaesthetic To Remove Multiple Samples Of Ovarian Tissue. In The Upper Womb, Alternative Biopsy Procedures Such As Dilation And Curettage (D&C) Or Hysteroscopy May Be Required. These Latter Procedures Are Described In More Detail Further On As They Are Also Treatment Methods. Biopsy Samples Are Tested For Cancer Spread And Staging, Cell Type And The Presence Of Receptors For Oestrogen, Progesterone And Certain Proteins. This Information Will Enable Your Oncologist To Select The Most Effective Treatment Pathway.

Medical Imaging Will Also Be Prescribed. These Diagnostic Methods Include CT, PET Or Dotatate PET And MRI Scans.

Vulvar Biopsies Can Be Taken Under A Local Anaesthetic In The Gynaecologist’s Office. Changes To The Vulva Can Be Detected By Way Of The Toluidine Blue Dye Test. This Involves Applying A Blue Dye To The Tissue Of The Vulva And Using A Special Light That Shows Up Unusual Cells. A Biopsy Of This Tissue Can Then Be Immediately Taken.

During A Vulvar Biopsy The Visible Area Of Abnormal Tissue Is Often Completely Excised. This Can Be A Curative Procedure And Is Also The Approved Treatment For Benign Lumps And Warts Of The Vulva. Such Abnormalities Can Be Removed By Laser, Application Of Extreme Cold (Cryotherapy) Or A Scalpel.

An Alternative Diagnostic Test Of The Womb Is The Fluid-Contrast Ultrasound Or FCUS. This Is A Full Pelvic Ultrasound That Measures The Thickness Of The Endometrium And Shows Any Changes In Texture Due To Benign Or Malignant Growths. A Thin Catheter Is Inserted Into The Uterus Using A Colposcope. Sterile Saline Is Slowly Administered Through The Catheter Before Imaging Commences. The Injected Fluid Makes Visualization Of Abnormalities Much Easier.

How are gynaecologic cancers treated?

Treatments For Uterine, Ovarian, Cervical And Vulvar Cancers Vary And Will Be Discussed Separately At First, With The Various Surgeries And Non-Surgical Treatments Described In A More Generalised Manner Further On.

Practically All Womb, Ovary, Vulva And Cervix Cancer Cases Require Surgery. For Younger Women, This Can Be A Life-Changing And Upsetting Event As It Is Sometimes No Longer Possible To Have Children. Finding The Right Balance Between Disease And Future Family Life Makes These Situations Particularly Challenging. A Highly Experienced And Knowledgable Gynaecologist With An Empathic Approach And The Ability To Listen Is Essential For The Best Possible Outcome.

How is ovarian cancer treated?

Nearly All Ovarian Cancer Is Treated Surgically. Before And/Or After Surgery, Chemotherapy Is Prescribed. Only Inoperable Ovarian Cancer Uses Chemotherapy As A First-Line Treatment To Control Cancer Growth. Unlike The Other Cancer Types Described Here, Ovarian Cancer Is Rarely Treated With Radiotherapy.

Localized Ovarian Cancer Is Removed During A Salpingo-Oophorectomy (Surgical Removal Of The Ovaries And Fallopian Tubes) Either On One Side (Unilateral) Or Both Sides (Bilateral). A Unilateral Operation In Combination With Chemotherapy And Other Treatments Can Significantly Affect Your Fertility But It May Still Be Possible To Have Children.

If The Cancer Has Spread Or Is Of A Type That Is More Likely To Spread, The Womb And Close-Lying Lymph Nodes May Also Be Removed During A Laparoscopic Or Robotic-Assisted Hysterectomy With Lymphadenectomy. An Additional Omentectomy Removes The Fatty Flap Of Tissue That Covers The Intestines. A Combination Of Staging And Observable Cancer Removal May Be Advised – This Operation Type Is Known As A Debulking.

Chemotherapy Treatment For Ovarian Cancer Can Be Neoadjuvant (Before Surgery) Or Adjuvant (After Surgery). When Cancer Is Diagnosed, Up To 4 Cycles Of Chemotherapy May Significantly Shrink The Tumour Before It Is Surgically Removed. This Pre-Surgical Treatment Requires Anywhere Between 8 To 12 Weeks. Adjuvant Chemotherapy Is Often Given In Higher Doses For Shorter Lengths Of Time - Common Drug Combinations Are Carboplatin And Paclitaxel. Remission Rates Increase With Additional Targeted Therapy In The Form Of Bevacizumab. Many Different Combinations Of Pharmaceuticals Are Possible.

How is uterine cancer treated?

Nearly All Uterine Cancer Is Treated By Way Of A Hysterectomy. Before And/Or After Surgery, Radiotherapy And Possibly Chemotherapy Is Prescribed. Only Inoperable Cancer Implements Chemotherapy As A First-Line Treatment To Control Cancer Growth.

Localized Uterine Cancer Requires A Laparoscopic Or Robotic-Assisted Hysterectomy With Or Without Lymphadenectomy (Removal Of The Lymph Nodes). Where Cancer Has Spread Into The Cervix, A Radical Hysterectomy Removes The Uterus, Cervix And Upper Part Of The Vagina. Woman Who Are Close To Or Have Reached The Menopause Will Also Undergo A Bilateral Salpingo-Oophorectomy. An Additional Omentectomy Removes The Fatty Flap Of Tissue That Covers The Intestines. Combination Staging And Cancer Surgery May Be Advised – This Operation Type Is Known As A Debulking.

For Recurrent Uterine Cancer, Total Pelvic Exenteration In Which The Ovaries, Uterus, Cervix, Vagina And Sometimes The Bladder And/Or Lower Bowel (Rectum) Are Removed Is Performed. This Is A Complex Surgery With An Option To Undergo Vaginal Reconstruction At A Later Date. Due To The Rarity Of This Procedure, It Is Not Discussed Any Further In This Article. If This Treatment Course Has Been Advised To You, Request Your Free Second Opinion And We Will Put You In Touch With Gynaecologists Experienced In Complex Abdominal And Gynaecological Surgeries.

Radiotherapy Is More Likely To Be Advised After Hysterectomy Or In Inoperable Cases Of Endometrial Cancer. MRI-Guided External Beam Radiation Or Vaginal Brachytherapy Are The Most Common Approaches.

Chemotherapy Treatment For Uterine Cancer Is Only Used For Later Stages And Can Be Neoadjuvant (Before Surgery) Or Adjuvant (After Surgery). It Does Not Replace Radiotherapy But Can Be An Additional Therapy For Those In Otherwise Good Health. In Combination With Surgery And Radiotherapy, 3 Cycles Of Chemotherapy May Help To Kill Any Remaining Cancerous Cells. This Requires Approximately 9 Weeks. Common Chemotherapy Drug Combinations Are Carboplatin And Paclitaxel Or Cisplatin And Doxorubicin. HER2-Positive Uterine Cancer Remission Rates Increase With Additional Targeted Therapy In The Form Of Trastuzumab. Many Different Combinations Of Pharmaceuticals Are Possible. You Can Discuss Complete Treatment Pathways With All Accommodation, Transportation, Home Nursing Care, Catering And Follow-Ups By Contacting A Member Of The Remedazo Team Or Speak To Experienced Oncologists During Your Free Second Opinions.

How is cervical cancer treated?

All Earlier Stage Cervical Cancer Is Treated Surgically. Advanced Forms Are Treated With Radiotherapy With Or Without Chemotherapy.

Localized Early-Stage Cervical Cancer Can Be Treated With A Large-Loop Excision Of The Transformation Zone (LLETZ). Transformation Zone Refers To A Location With Changed Cell Types (Cancer Or Benign Lesions). This Procedure Is Performed Under A Local Anaesthetic Using A Colposcope In The Gynaecologist’s Office.

If Cancer Has Spread Or Is Of A Type That Is More Likely To Spread, Surgery Under A General Anaesthetic Is Required In The Form Of A Laparoscopic Trachelectomy (Removal Of The Cervix And Upper Vagina), A Laparoscopic Trachelectomy With Simple Hysterectomy (Removal Of Cervix, Upper Vagina And Uterus) Or A Radical Hysterectomy (Removal Of Cervix, Upper Vagina, Uterus, Lymph Nodes And Ovaries).

Pelvic Exenteration Is Used To Treat Recurrent Cervical Cancer. In This Complex Surgery, The Ovaries, Uterus, Cervix, Vagina And Sometimes The Bladder And/Or Lower Bowel (Rectum) Are Removed. There Is An Option To Undergo Vaginal Reconstruction At A Later Date. Due To The Rarity Of This Procedure, It Is Not Discussed Any Further In This Article.

Radiotherapy Is Occasionally Advised After Surgery Or In Advanced Cases Of Cervical Cancer. MRI-Guided External Beam Radiation And Vaginal Brachytherapy Is A Common Combination Approach That Lasts For Up To 8 Weeks.

Chemotherapy Treatment For Cervical Cancer Can Be Neoadjuvant (Before Surgery) Or Adjuvant (After Surgery). It Is Often Combined With Radiotherapy. When Cancer Has Been Diagnosed Up To 4 Cycles Of Chemotherapy, A Course That Takes 9 To 12 Weeks, May Significantly Shrink The Tumour. Adjuvant Chemotherapy Is Usually Administered In Higher Doses For Shorter Lengths Of Time; Commonly Used Cytotoxic Drugs Are Cisplatin, Topotecan, Carboplatin And Paclitaxel. Remission Rates Increase With Additional Targeted Therapy In The Form Of Bevacizumab. Many Different Combinations Of Pharmaceuticals Are Possible.

How is vulvar cancer treated?

Nearly All Vulvar Cancer Is Treated Surgically, As Is VIN. Before And/Or After Surgery For Advanced Stage Vulvar Cancer, Chemotherapy Is Usually Prescribed. Radiation Therapy May Be Used To Shrink Tumours Before Surgery Or Destroy Remaining Cancer Cells Afterwards.

Localized Vulvar Cancer Requires A Partial Vulvectomy Where The Tumour And Surrounding Tissue Are Removed. This Can Be Done Under A Local Anaesthetic With Or Without Sedation And Performed Using Lasers Or A Scalpel. Larger Tumours Or Those Which May Spread Will Require The Removal Of Larger Areas Of Tissue For Which A General Anaesthetic Is Advised. Radical Vulvectomy Removes The Entire Vulva But Is Rarely Performed; Newer Methods (Modified Vulvectomy) Allow Surgeons To Remove Larger Areas With The Same Treatment Outcomes But Significantly More Positive Psychological Outcomes. In Some Cases, A Lymphadenectomy (Removal Of The Regional Lymph Nodes) Is Necessary.

Chemotherapy Treatment For Vulvar Cancer Can Be Neoadjuvant (Before Surgery) Or Adjuvant (After Surgery). When Cancer Is Diagnosed, Up To 4 Cycles (9 To 12 Weeks) Of Chemotherapy May Significantly Shrink The Tumour. Adjuvant Chemotherapy Is Usually Given In Low Doses Over A Longer Period Of Time And Is Almost Always Combined With Radiotherapy. The Most Common Chemotherapy Drugs For The Treatment Of Advanced Or Metastatic Vulvar Cancer Are Cisplatin, Fluorouracil, Capecitabine, Carboplatin And Paclitaxel. Remission Rates Increase With Additional Targeted Therapy In The Form Of Cetuximab And Erlotinib.

Why do I need uterine cancer treatment?

Treatment Is Necessary For Any Type Of Cancer To Try To Prevent Cancerous Cells From Travelling To Other Organs Via The Surrounding Blood And Lymph Vessels. When Treated At An Early To Mid-Stage, Gynaecologic Cancers Can Be Cured; Even Advanced Cancers Can Be Kept Under Control For Long Periods Of Time With Rapidly Increasing Treatment Options. New Therapies And Procedures Are Continuously Enhancing Advanced Uterine, Ovarian, Cervical And Vulvar Cancer Remission And Survival Rates.

How do I prepare for uterine cancer treatment? What can I expect?

Approximately 2 To 4 Weeks Before Surgical Cancer Treatment Or Other Therapy Pathways You Will Be Asked To Supply The Results Of Your Blood Tests And Copies Of Any Diagnostic And Imaging Results (Ultrasound, CT, MRI, Biopsy And/Or PET). This Means We Can See How Your Cancer Is Progressing And Will Help Us To Advise The Best Treatment Options. We Will Also Need Any Information Regarding Medication Use, Other Illnesses Or Disorders And Your Overall State Of Health.

You Will Need To Undergo An MRI, PET Or CT Scan And Possibly A Bone Scan – If These Have Not Yet Taken Place - Which Will Help Us To See If Cancer Has Spread To Other Organs.

Approximately 2 Weeks Before Your Treatment You Will Need To Ask Your Home Doctor To Take Blood For A Preoperative Or Pre-Treatment Blood Test. Remedazo Will Inform You Well Beforehand Which Tests Your Doctor Will Need To Take Blood For. For Some Procedures, Blood-Thinning And Other Medications Will Need To Be Temporarily Stopped, Others Do Not. Our Or Your Own Doctor Will Advise You What To Do.

Gynaecologic cancer treatment

The Information Below Covers All Available Treatments For Gynaecologic Cancers At Remedazo. Breast Cancer Treatment Can Be Found Here. If You Would Like Information On Any Therapy Not Covered In This Section, Please Do Not Hesitate To Contact Us.

Surgical cancer treatment

When The Results Of A Biopsy Are Positive For Uterine Cancer And This Cancer Has Not Spread To Areas Far From The Original Tumour, Surgical Removal Is Always The First-Line Treatment. Surgery Methods And Results Range From Minimally Invasive To Life-Changing.

Dilation and curettage

This Minor Surgery Dilates The Cervix To Allow The Gynaecologist Access To The Inner Lining Of The Uterus. D&C Is The Most Common Procedure For The Removal Of Benign Lesions, Tissue For Biopsies, Placement And Removal Of Intrauterine Devices, And Expulsion Of Tissue Left Behind After Miscarriage Or Childbirth.

Depending On The Amount Of Tissue That Is To Be Removed And Your Personal Preference, A D&C May Be Carried Out With A Local Anaesthetic Injected Directly Into The Cervix With A Little Sedation, A Spinal Anaesthesia Or A Light General Anaesthetic. This Is An Outpatient Procedure Carried Out In A Gynaecological Position. Cramps May Be Felt For Up To 48 Hours Afterwards And Light Bleeding Is Expected. You Will Need To Avoid Having A Bath, Swimming And Sexual Intercourse For 3 To 4 Days After A D&C.

Hysteroscopy

If The Gynaecologist Wants To Observe The Lining Of The Womb, Hysteroscopy Is The Procedure Of Choice. This Is A Diagnostic Or Therapeutic Operation That Inserts A Light And Camera Into The Womb Via The Vagina In A Gynaecological Position. Without Accompanying Procedures, Hysteroscopy Can Be Carried Out In The Gynaecologist’s Office With A Little Local Anaesthetic And Sedation. When Combined With A Laparoscopy Or Dilation And Curettage, The Procedure Will Take Place In The Operating Theatre. With An Accompanying Laparoscopy, The Outside Of The Uterus, Fallopian Tubes And Ovaries Can Also Be Observed Via An Endoscope Placed Through An Incision In The Navel. A General Anaesthetic Is Required For Any Laparoscopic Procedure. The Combined D&C And Hysteroscopy Can Be Performed Under Sedation With Local Anaesthesia, Spinal Anaesthesia Or General Anaesthesia.

The Timing Of This Operation Is Often Important. For The Best View Of The Inner Lining Of The Womb, Hysteroscopy Should Take Place Approximately 1 Week After Menstruation In Non-Menopausal Women. This Is Sometimes Difficult To Arrange, Especially If You Suffer From Irregular Periods. In Such Cases, Remedazo Will Place You On A Stand-By List To Ensure You Are Promptly Seen By Your Specialist Gynaecologist Of Choice At Exactly The Right Time.

Salpingo-oophorectomy

Localized Ovarian Cancer Is Removed Via A Salpingo-Oophorectomy (Surgical Removal Of The Ovaries And Fallopian Tubes) Either On One Side (Unilateral) Or Both Sides (Bilateral). After Your General Anaesthesia, Your Doctor Will Also Carry Out A D&C And Remove Endometrial Tissue For Further Testing. If He Or She Wants To View The Inside Of The Womb, A Hysteroscopy (See Above) Will Also Take Place.

As This Is A Laparoscopic Procedure, Your Choice Of Specialist Can Also Observe The Outside Of The Womb. A Simple Salpingo-Oophorectomy Takes 40 Minutes To 1 Hour. When Carried Out As A Robotic-Assisted Procedure Surgery Will Take Approximately 90 Minutes. For Both Procedures You Will Probably Need To Stay In The Hospital Overnight.

A Bilateral Salpingo-Oophorectomy Means You Will No Longer Be Able To Have Children. A Unilateral Operation In Combination With Chemotherapy And Other Treatments May Significantly Affect Your Fertility But It Can Still Be Possible For You To Have Children.

After Bilateral Ovary Removal, You Will Have Reached The Menopause. The Pros And Cons Of Hormone Replacement Therapy According To Your Personal Medical History Can Be Discussed During Your Free Online Second Opinion.

Vulvar excision

Removal Of A Cancerous Or Benign Lump With Or Without A Margin Of Healthy Tissue Is Usually A Curative Procedure And Can Be Carried Out In The Gynaecologist’s Office Under A Local Anaesthetic And Perhaps A Little Sedation.

For Localised Benign Tumours, Laser Ablation Under Local Anaesthetic Is The Treatment Of Choice.

Vulvectomy

Removal Of A Layer Of Or A Section Of The Vulva To Ensure The Excision Of Cancerous Cells Is A Possible Treatment Course For Vulvar Cancer In Cases Where Vulvar Excision Is Considered Insufficient.

A Skinning Vulvectomy Removes The Upper Layer Of Vulvar Skin In The Presence Of Precancerous Cells (Vulvar Intraepithelial Neoplasia). Removal Of The Entire Top Layer Of The Vulvar Skin Is Only Recommended In Women With Multiple Precancerous Lesions. A Skin Graft May Be Necessary And The Operation Is Carried Out By A Gynaecologic Oncologist Or Plastic Surgeon. This Is Surgery That Requires A General Or Spinal Anaesthetic With A Hospital Stay Of 3 To 4 Days. A Urinary Catheter Protects The Area From Bacteria And Is Removed Just Before Discharge From Hospital.

A Simple Vulvectomy Removes All Of The Vulva, Although Often Leaves The Clitoris Intact. A Modified Radical Vulvectomy May Sound More Invasive Than A Simple Vulvectomy But This Is Not Necessarily True. A Modified Radical Procedure Removes Anywhere From A Third To Nearly All Of The Vulva And Some Of The Surrounding Lymph Nodes And Tissue. Skin Grafts Are Often Necessary. Both Surgery Types Are Carried Out Under General Or Spinal Anaesthesia And Involve Hospital Stays Of 4 To 6 Days. A Urinary Catheter Protects The Area From Bacteria And Is Removed Just Before Discharge From Hospital.

Hysterectomy

Removal Of The Womb Is Performed Using Abdominal, Laparoscopic Or Transvaginal Techniques. Hysterectomy Is Not Only Performed For Cancer But Also For The Treatment Of Fibroids (Benign Growths), Severe And Recurrent Endometriosis And Pelvic Inflammatory Disease. Hysterectomy In These Cases Is Considered A Last Resort; This Is Rarely The Case After A Uterine, Ovarian And Occasionally Cervical Cancer Diagnosis.

When Both Ovaries Are Removed Without Hysterectomy, Very Little Oestrogen Is Produced And A Women Becomes Infertile. Hormone Replacement Therapy May Be Advised To Avoid (Early) Menopause Side Effects. When Only The Uterus Is Removed, The Body Still Produces Oestrogen And So The Menopause Will Not Be Entered As A Result Of Surgery; Reaching The Menopause Will Be The Result Of Natural Ageing. It Is Potentially Possible To Harvest Your Eggs For Surrogate-Assisted Pregnancy But Without A Womb, It Is Not Possible To Be Pregnant Yourself. When The Uterus And Both Ovaries Are Removed You Enter The Menopause And Are Unable To Produce Eggs, Making This Operation A Psychologically Challenging One For Women Of All Ages.

You May Have Been Advised To Undergo One Of Four Different Hysterectomy Procedures:

Subtotal Or Partial Hysterectomy (Uterus)
Total Hysterectomy (Uterus And Cervix)
Hysterectomy And Bilateral Salpingo-Oophorectomy (Uterus And Both Ovaries)
Radical Hysterectomy (Uterus, Both Ovaries, Cervix, Part Of The Vagina, Lymph Nodes And Supporting Ligaments)

Removal Of The Ovaries Is Sometimes A Prophylactic (Preventive) Part Of A Hysterectomy. If You Do Not Have Cancer Of The Ovaries But Have Been Advised To Undergo This Additional Treatment This May Be Due To The Type Of Uterine Cancer. Your Gynaecologist Should Inform You As To Why He Or She Recommends A Prophylactic Excision.

An Abdominal Hysterectomy Requires A Horizontal Or Vertical Incision Above The Pubic Hairline Or Running From Under The Navel To Just Aabove The Pubic Hairline. Many Women Opt For A Laparoscopic Operation To Avoid A 15 To 22 Cm Scar, Although This May Not Be Possible When A Tumour Is Large As The Uterus Must Be Removed Via A Sufficiently Large Incision. An Abdominal Hysterectomy Requires A 1 To 3 Night Hospital Stay And Up To 8 Weeks Of Rest Until The Lower Abdominal Muscles Have Healed. Until This Point, Heavy Lifting And Activities That Involve Significant Bending Should Be Avoided.

A Vaginal Hysterectomy Removes The Uterus Through The Vagina And Requires A Shorter Hospital Stay (0 To 1 Day) As Recovery Is Much Quicker. No Muscles Are Damaged During This Operation And You Will Be Able To Return To Your Normal Activities Within 2 To 4 Weeks; However, Sometimes The Emotional And Psychological Effects Of Such Surgery Require More Time. This Type Of Procedure Can Only Be Carried Out If The Womb Is Not Particularly Large. More Commonly, A Laparoscopically-Assisted Vaginal Hysterectomy (LAVH) Helps The Surgeon Remove A Larger Womb By Cutting It Into Smaller Sections And Allows Easier Separation Of The Womb From The Body. This Procedure Has The Same Recovery Times Of A Vaginal Hysterectomy And Three 1.5 – 2.5 Cm Scars (One Of These Inside The Navel, The Other Two To The Lower Left And Right Of The Navel). Your Gynaecologist Must Have Significant Laparoscopy Skills In Order To Perform This Operation.

Laparoscopic Hysterectomy Can Be Performed With The Surgeon Standing Beside You And Manually Manipulating Special Instruments Known As Trocars While Watching Progress On A Screen Or As A Robotic-Assisted Procedure Where He Or She Sits At A Distance And Uses Magnified 3-D Imagery And Hand Controls To Manipulate Previously-Positioned Robotic Arms. Both Procedures Require Specialist Surgeons. Remedazo Partners With Numerous, Carefully-Selected Laparoscopy-Specialised Surgeons; These Include Renowned Gynaecologists And Surgical Oncologists.

Advances In Robotic Surgery Now Allow Two Different Procedures. These Are Robotic Multiport Hysterectomy (RMPH) And Robotic Single-Site Hysterectomy (RSSH). The Latter Involves The Use Of Multiple Instruments Through A Single Incision In The Navel And Requires New And Significant Laparoscopy Skills. However, More Recent Reports Do Not Recommend Either Surgery As A Sole Technique For Cancer Treatment. This Is Because, In Order To Remove The Uterus Through These Tiny Scars, It Needs To Be Disected Into Smaller Pieces When Still In The Abdomen. This Can Lower The Risk Of Cancer Spread. Your Surgeon Will Therefore Perform A Vaginal Hysterectomy And Keep The Womb Intact. This Means Your Eligibility For Either Procedure Depends On A Broad Groups Of Factors Including Your Weight, Medical History, Age And Current Health Level, Your Cancer Type, Location And Size, And The Size Of Your Womb. You Can Discuss Eligibility With Surgeons Experienced In RMPH And RSSH For Free With Remedazo.

Conventional Laparoscopy Involves 3 To 4 Incisions Of 2 To 3 Cm In Length. Robotic Multiport Procedures Require 5 Incisions Of Between 2 To 4 Cm And, As Already Mentioned, RSSH Involves A Single Incision Inside The Navel.

Sexual Intercourse Should Be Avoided For At Least 6 Weeks After Any Type Of Hysterectomy. You Will Need To Use Sanitary Pads As Bloody Discharge Is Possible For As Long As A Month After This Procedure.

It Is No Longer Possible To Become Pregnant After A Hysterectomy. Your Menstrual Cycle Will Stop And You May Wish To Start Hormone Replacement Therapy Once You Have Recovered From Surgery. Younger Women May Wish To Preserve Their Fertility Or Save Eggs. Speak To An Experienced And Empathic Gynaecologist During One Of Your Three Free Second Opinion Sessions.

Debulking

Debulking Is An Operation In Which The Surgeon Attempts To Remove As Much Visible Cancerous Tissue As Possible From Areas Into Which It Has Spread. Some Cancers May Show Up In Multiple Areas Causing Symptoms (Or Not) And Your Surgeon May Prefer To Use This Hands-On Approach Rather Than Resect Areas Indicated On Medical Imaging Results. In Simpler Terms, This Means A Larger Incision (Laparotomy) That Allows The Surgeon To Access To A Wider Area, Personally Visualise Areas Of Abnormal Cell Growth And Remove It As He Or She Finds It. Biopsies May Be Taken For Further Testing Unless The Cancer Is Known To Be Advanced. A Number Of Surgeons Are Prepared To Use Robotic-Assisted Surgical Techniques.

Debulking Surgery Is Often Called Initial Cytoreductive Surgery And You May Need A Further Operation According To This Procedure’s Biopsy Results. Debulking Is Also Used To Increase Comfort In Cases Of Metastatic Cancer. It Can Keep More Advanced Cancers Under Control But May Involve Significant Tissue Removal.

A Laparotomy Involves A Large Incision Through The Abdomen And An Epidural Catheter That Is Inserted Before You Are Anaesthetised For Postoperative Pain Control. A General Anaesthetic Is Always Necessary. Hospital Stays Of At Least 3 Days And Up To 6 Days Are Normal.

After A Gynaecological Debulking Procedure That Nearly Always Removes The Ovaries And Womb, You Will Have Reached The Menopause. The Pros And Cons Of Hormone Replacement Therapy According To Your Personal Medical History Can Be Discussed During Your Free Second Opinion.

Peri-operative uterine cancer surgery care

Minor Surgical Procedures Carried Out In The Gynaecologist’s Office Need Little Preparation. Make Sure You Go To The Toilet Within The Hour Before A Procedure And Remove Tampons If Inserted. If Your Procedure Will Take Place In The Operating Theatre, The Following Information Will Apply.

You Will Be Admitted To Your Chosen Clinic On The Day Of The Procedure. Certain People Such As Those With A Very High BMI, Breathing Difficulties, Diabetes Or Other Chronic Illnesses Usually Benefit From Spending The Night Before The Operation In A Hospital Setting.

From Midnight Of The Day Before Your Surgery, You Will Be Asked To Refrain From Eating. Undigested Stomach Contents Can Create Serious Complications During General Anaesthesia. Smokers Should Stop Smoking At Least One Week Before Surgery; Stopping Smoking Beforehand Improves Oxygen Levels Throughout The Body. Between Midnight And Six Hours Before Anaesthesia You May Only Drink Water Or Clear Liquids. You Are Not Permitted To Eat, Drink Or Smoke In The Six Hours Preceding Anaesthesia. Failure To Comply May Mean The Anaesthesiologist And Surgeon Will Be Forced To Postpone Your Procedure. This Is Purely For Your Own Safety. It Is Possible To Brush Your Teeth During This Period But No Water May Be Swallowed. In Certain Circumstances, Medical Staff Will Administer Oral Medications With A Little Water. This Is Administered Under The Advice Of The Anaesthesiologist And Is Therefore Permitted. If Your Operation Is Planned To Proceed Under A Local Or Spinal Anaesthetic You Might Still Be Asked To Refrain From Eating Or Drinking Before Surgery. This Means That If You Find The Surgery Or Situation Too Uncomfortable, The Anaesthetist Has The Option To Administer A General Anaesthetic That Will Increase Your Comfort.

Approximately Thirty Minutes Before The Planned Procedure Time You Will Be Collected From Your Room And Brought To The Surgical Department Either In Your Bed, On A Gurney, In A Wheelchair Or On Foot.

Preoperative Gynaecologic Cancer Surgery Preparation Requires:

An Intravenous Line
A Blood Pressure Cuff Placed On The Upper Arm
The Completely Painless Placement Of Electrodes To The Chest To Measure Heart Activity
A Finger Or Ear Sensor To Measure Oxygen Levels In The Blood
A General, Local Or Spinal Anaesthetic.
A Urinary Catheter (Placed After You Are Asleep) To Prevent The Contamination Of Wounds During Surgery (24 Hours) Or To Protect Vulvar Incisions (5 – 6 Days).
For Debulking, Robotic-Assisted Or Extensive Surgery You Will Need An Arterial Catheter And Perhaps A Second Intravenous Line.
For Some Laparotomy Procedures, An Epidural Catheter Will Be Inserted For Postoperative Patient-Controlled Pain Medication Administration.

At The Surgeon’s Signal, You Will Be Anaesthetised.

What happens after uterine cancer surgery? What can I expect?

You Will Be Woken By The Anaesthesiologist Immediately After Surgery And Transported From The Operating Theatre To The Recovery Room. Where A Spinal Anaesthetic Has Been Given You Will Remain In The Recovery Room Until You Can Move Both Legs. For Epidural Catheters, Your Patient-Controlled Pain Pump Will Be Started While You Are Still In The Recovery Area. All Patients Remain In The Recovery Ward Until They Are Fully Responsive And Any Pain Is Well Under Control. If You Have Undergone A Procedure Under Local Anaesthetic You Can Return To Your Chosen Accommodation The Same Day.

When The Anaesthesiologist Is Satisfied You Are Fully Awake And Comfortable You Will Be Brought To A Surgical Ward. Pain Medication Is Given As Standard But Postoperative Pain, Even For Debulking And More Radical Procedures, Is Easy To Control Due To Epidural Catheters And Intravenous Medications. Only The Most Extensive Debulking Or Laparotomy Procedures Give Cause For A Night Or Two In A Medium Or Intensive Care Facility. This Also Applies To Some Longer Robotic-Assisted Laparoscopies.

Your Intravenous Catheter Will Continue To Administer Fluids For Up To 24 Hours And Any Drains Will Be Removed By A Trained Nurse Or Doctor Within 2 Days. Urinary Catheters Placed For Hysteroscopy Are Removed Before You Leave The Recovery Room. For Other Procedures, The Urinary Catheter Stays In Place For 24 Hours. In The Case Of Vulvectomy, Urinary Catheters Will Be Removed After 4 To 5 Days As Urine Coming Into Contact With Healing Wounds Is Not Only Likely To Cause Infection But Can Cause Much Discomfort.

The Majority Of Gynaecologic Cancer Patients Are Out Of Bed Within 4 Hours Of Exiting The Recovery Room. Average Hospital Stays For Localised Cancers Range From 0 To 2 Days. More Invasive Surgeries With Or Without Laparotomy May Mean A Hospital Stay Of 2 To 5 Days.

Upon Discharge From Hospital You Will Be Transported To Your Accommodation And Supported By Your Personal Remedazo Team Until You Have Safely And Comfortably Returned Home Or Have Completed Further Treatment. In Most Instances You Will Be Able To Travel Within 2 Days Of Discharge. You Will Need To Wear Compression Stockings When Travelling And Perhaps Split Longer Journeys Into Shorter Trips.

Long-Term Postoperative Care Includes The Removal Of Laparoscopic Or Abdominal Stitches After 5 To 8 Days. This Can Be Done By Your General Practitioner At Home If You Are Not Attending Further Treatment Sessions. Full Recovery From Minor Surgery Only Requires A Few Short Days. For Laparoscopic And Robot-Assisted Surgeries Expect To Rest For 1 To 3 Weeks. Larger Incisions Such As Those Of A Laparotomy Or Skin Grafts Such As In Vulvectomy Require 2 To 4 Weeks To Recover. Further Radiotherapy Or Chemotherapy Is Prescribed After The Majority Of Gynaecological Cancer Procedures.

Non-surgical uterine cancer treatment

While Many Surgical Procedures Cure Uterine, Ovarian, Cervical And Vulvar Cancer, Most Oncologists Recommend Courses Of Non-Surgical Therapies To Lower The Risk Of Recurrence Or Kill Cancer Cells That May Have Been Left Behind. The Most Common Non-Surgical Treatment For Invasive And Non-Invasive Gynaecologic Cancer Is Radiotherapy.

Nonsurgical Treatments Are Also Offered To Those Unable To Undergo Surgery Due To Low Overall Levels Of Health Or Those Who Need To Keep Metastatic Or Potentially Recurring Cancer Under Control.

Gynaecological cancer chemotherapy

Early Stage Cancers Are Treated With Surgery In Combination With Radiotherapy. Sometimes The Advice Is Given To Undergo A Course Of Chemotherapy In Cancer Types That Are Known To Recur. Chemotherapy May Be Given To Shrink Tumours Prior To Surgery, To Treat Cancer Types With The Potential To Return, And Also To Destroy Any Cancer Cells That May Have Been Left Behind After Surgery.

Specific Drugs And Chemotherapy Cycles Can Be Found In The Separate Treatment Sections For Ovarian, Uterine, Cervical And Vulvar Cancers Above.

Where Surgery Is Not Indicated, Chemotherapy Is A Primary Or Secondary (To Radiotherapy) Cancer Treatment Usually Supported By Other Non-Surgical Therapies. Chemotherapy For Metastatic Gynaecologic Cancer Can Significantly Slow Tumour Growth And Spread. Multiple Cytotoxic (Cell-Toxic) Combinations Exist, All Of Which Can Be Discussed With A Remedazo Oncology Specialist.

Chemotherapy Drugs Are Administered Intravenously Via A Portacath, PICC Line Or Central Venous Catheter. A Single Cycle Usually Last For 21 Days And, Depending On Your Type Of Cancer, May Be Repeated Up To 4 Times. This Can Mean Up To 4 Months Of Therapy With Regular Blood Tests And Follow Ups Of Symptoms And Side Effects. Ask Remedazo For More Information Regarding Longer-Term Stays Where All Of Your Physical, Psychological And Emotional Needs Are Catered For During This Stressful Time. Alternatively, We Can Arrange Similar Accommodation And Familiar, Trusted Team Members For Regular Returns To Your Clinic Of Choice And Cater For Your Accompanying Family Members Or Friends.

Gynaecologic cancer radiation therapy

If You Need To Have Your Uterus (And Cervix) Removed, Your Oncologist May Advise To Treat The Upper Part Of The Vagina With Vaginal Brachytherapy. This Treatment Inserts A Source Of Radiation By Way Of An Applicator Into The Vagina Under The Guidance Of Ultrasound, CT Or MRI. The Applicator Tube Feels Similar To A Tampon. The Locally Administered Radiation Affects The Area Of The Vagina That Is In Contact With The Cylinder And Is Not Significantly Associated With Bladder Or Rectum Exposure. There Are 2 Types Of Brachytherapy Used For Endometrial Cancer - Low-Dose Rate (LDR) And High-Dose Rate (HDR). LDR Leaves The Applicator In Place For Up To 4 Days And You Will Need To Stay In A Hospital Bed During This Time. After LDR You Will Also Not Be Able To Fly Home Immediately; This Is Not To Do With Radiation But Because Staying In Bed For This Amount Of Time Can Increase The Risk Of Blood Clot Formation. Various Preventive Measures Such As Medication And Special Leg Cuffs (Intermittent Pneumatic Compression) Will Be Used To Lower The Risk.

HDR Uses Higher Doses Of Radiation And Each Applicator Remains In Place For Less Than 20 Minutes, After Which You Can Return To Your Accommodation. This Treatment Continues At Daily Or Weekly Intervals Until The Total Dose Has Been Given. The Risk Of Blood Clot Formation Or Deep Vein Thrombosis (DVT) Is Significantly Reduced And You Can Fly Home After Treatment Has Ended.

Radiotherapy For Gynaecological Cancer Is Composed Of Two Main Types – External Beam Radiation Therapy (EBRT) And Stereotactic Body Radiation. If Cancer Has Spread To The Bone Tissue (Bone Metastasis), Patients May Be Offered Radiopharmaceuticals. These Are Injected Drugs That Contain Radioactive Substances That Settle In Areas Of Damaged Bone. Here, They Emit Radiation That Kills Cancer Cells. These Drugs Also Relieve Bone Pain Caused By Metastasis And Can Extend Life.

Fractionated External Beam Radiation Therapy (EBRT) Is Usually Prescribed To Prevent The Growth Of Potentially Remaining Cancer Cells After Surgery. This Therapy Is Given Over The Course Of 3 To 5 Weeks. More Recently, Stereotactic Body Radiation Therapy (SBRT) Has Provided Some Patients With The Option Of A Higher Dose With A Shorter Course.

External Beam Radiation Therapy Focuses Beams Of Radiation Into The Affected Area Of Tissue And Requires Short (10 To 30 Minute) Visits To The Hospital 5 Times A Week For Several Weeks. Long-Term Stays With All Accommodation, Home Nursing Care, Catering, Transportation And Follow Ups Can Be Seamlessly Arranged By Your Remedazo Team.

EBRT Is A Painless Treatment And Recent Technology Now Enables Oncologists To Be Even More Precise With Dosage And Range. Additional Options Such As Three-Dimensional Conformal Radiation Therapy Or 3D-CRT Use Computers To Map The Area That Requires Treatment And Shape The Radiation Beams To Avoid Damaging Non-Cancerous Tissues. The Even More Advanced Intensity Modulated Radiation Therapy (IMRT) Machine Moves Around The Patient, Shapes The Beams And Adjusts Radiation Intensities. This May Be Done With Built-In Scanners (Image Guided Radiation Therapy Or IGRT) Or Using A More Rapid But Not Necessarily More Effective Technique Called Volumetric Modulated Arc Therapy Or VMAT. You Will Be Able To Discuss All Of These Alternatives With A Remedazo Oncology Specialist.

The Side Effects Of Radiation Therapy Often Depend On Its Effects Upon Healthy Tissues That Are Found Close To The Uterus Including Major Blood And Lymph Vessels, Intestines, Bladder And Rectum. In Addition, Radiation Treatments Can Make You Feel Tired For Weeks To Months. At Remedazo, All Associated Information Will Be Given Upon Or Shortly After Your Consultation; You Can Then Make An Informed Decision Regarding The Types Of Radiotherapy Available To You.

Gynaecologic cancer hormone (endocrine) therapy

As Already Discussed, Gynaecological Cancers Can Use Oestrogen (And Progesterone) To Increase In Size. Biopsy Reports Tell The Oncologist Whether Cancer Cells Contain Receptors For Certain Substances. If They Do, Stopping These Substances From Being Used By Cancer Cells Can Slow Or Stop Their Growth. Hormonal Therapy Is Not Used For Triple-Negative Cancer Types.

Hormonal Treatment Is Long-Term Therapy That Needs To Be Taken For 5 To 10 Years. These Therapies Lower The Amount Of Oestrogen In The Body Or Stop Oestrogen From Connecting With The Cancer Cells And Encouraging Them To Grow. However, When The Uterus And/Or Ovaries Are Removed, The Body Produces Much Less Oestrogen Or Progesterone. This Is Why Hormone Therapies After These Surgeries Are Unlikely To Be Prescribed.

Tamoxifen Is The Most Well-Known Anti-Oestrogen That Stops Oestrogen From Connecting With Cancer Cells In The Breast; However, It Is Much Less Used For Hormone-Sensitive Gynaecological Cancer Types Because It Is Selective And Only Blocks The Action Of Oestrogen In The Breast Tissue, Not In Other Organs That Produce Oestrogen Such As The Bones And The Womb. It May, However, Be Prescribed In The Treatment Of Recurrent Ovarian Cancer.

Drugs That Stop Oestrogen From Being Produced In The Body Are Another Option. Most Oestrogen Is Made In The Ovaries. When Surgery Or The Menopause Stops Oestrogen Production In The Ovaries, A Small Amount Is Still Produced In Fat Tissue. This Is The Reason Why Being Obese Increases The Risk Of Gynaecological Cancers. This Small Amount Can Still Cause Hormone-Sensitive Cancers In Post-Menopausal Women And In Younger Women Who Have Had Both Ovaries Removed. When This Production Is Completely Stopped Through Aromatase Inhibitor Drugs Such As Letrozole Or Exemestane, Early And Advanced Uterine And Ovarian Cancer Can Be Prevented Or Slowed.

Uterine Cancer In Younger Women Can Also Be Treated By Stopping Oestrogen Production In The Ovaries. Drugs Known As Luteinizing Hormone Releasing Hormone Agonists (LHRH) Include Goserelin And Leuprolide

Uterine cancer immunotherapy

Checkpoint Inhibitors Allow Your Immune System To Respond To The Presence Of Specific Cancer Cells And Attack Them. This Response Is Often Absent During Tumour Growth. It Has Been Shown That Some Advanced Uterine Cancers Respond Well To Immunotherapy Treatment But This Certainly Does Not Apply To All. Ask About Immunotherapy Options During Your Free Second Opinion.

Drugs Such As Atezolizumab Block The Activity Of A Protein That Prevents Your Immune Cells From Recognizing And Attacking Inflamed Tissues And Cancer Cells. This Drug Seems To Work More Effectively In Combination With Targeted Therapy. Oncologists Partnered With Remedazo Are Renowned For Their Knowledge Of The Most Recent Clinical Studies And Research Pertaining To Effective And New Cancer-Fighting Drugs.

Each Intravenous Immunotherapy Treatment Requires At Least A 2 Hour Stay In A Clinical Setting And Should Be Repeated Every 2 To 3 Weeks. Immunotherapy Has Been Shown To Increase Survival Times In Metastasised Cancer; However, It Is Rarely Offered Before Other Types Of Therapy Have Been Tried. This May Change As Research Continues.

The Side Effects Of Immunotherapy Are Many And Can Be Serious. Those Offered This Type Of Treatment Are Given In-Depth Information Regarding Side Effects And The Detection Of Their Early Signs. Remedazo Can Put You In Touch With One Of Our Specialist Oncologists To Discuss Your Eligibility For Immunotherapy Based Upon Your Personal Medical History.

Uterine Cancer Targeted Therapy

New Treatment Methods Are Constantly Being Researched And Developed. One Of The More Recent Pharmaceutical Cancer Breakthroughs Is Targeted Therapy And Its Many Options And Combinations. Gynaecologic Cancers May Respond To Various Types That Have Differing Actions.

PARP Inhibitors

PARP-Inhibitors Block The Natural Mechanisms That Repair Damaged DNA Even In Cancer Cells. Where There Are No Mutations In BRCA Genes (BRCA1 And BRCA2), PARP-Inhibitors Can Be Used. This Is A Very New Treatment Course Offered With Oral Drugs Such As Olaparib.

Anti-Angiogenesis Inhibitors.

Anti-Angiogenesis Inhibitor Drugs Block The Action Of A Protein Called Vascular Endothelial Growth Factor (VEGF). This Effect Can Make Cancer More Responsive To Various Treatments And Lower Recurrence Rates. These Drugs Stop The Tumour’s Blood Supply And Starve It Of Nutrients. Bevacizumab Is An Anti-Angiogenesis Inhibitor That Seems To Be Effective In The Treatment Of Ovarian Cancer. Another Promising Drug Is Lenvatinab.

Benefits of uterine cancer treatment

Uterine Cancer Surgeries Aim To Remove Cancer In Its Entirety And So Have The Potential To Be Curative Procedures. Surgery Is Always Recommended In Cases Of Non-Metastatic Cancers; However, Most Treatment Pathways Integrate Multiple Therapies. In The Case Of Uterine, Ovarian, Cervical And Vulvar Cancer These Are Most Commonly Radiotherapy And, For Later Stage Or More Aggressive Cancer Types, Chemotherapy. Uterine Cancers Have Benefitted From Extensive Research And Even Invasive Types Can Be Treated.

Uterine Cancer Surgery Is Not Linked To High Levels Of Pain And Recovery Times And Hospital Stays Are Usually Short. All Treatment That Removes Cancer Cells, Slows Or Stops Their Growth And Lowers Their Risk Of Returning Once Treated Is Of Benefit. Hormone Replacement Therapy Can, In Many Cases, Soothe Longer-Term Symptoms.

Disadvantages of uterine cancer treatment

Postoperative Infection Is A Risk With This Type Of Surgery And Patients Are Sometimes Administered Antibiotics As A Preventive Measure Before Surgery Commences. Other Short-Term Risks Include Bleeding, Adverse Reactions To The Anaesthesia, Higher Risk Of Blood Clots And Breathing Problems After General Anaesthesia.

Long-Term Complications Of Uterine Cancer Surgery Are Early Menopause In Younger Women With Associated Infertility And Loss Of Libido. This Can Be Psychologically Demanding, Especially In Combination With A Diagnosis Of Cancer. Visible Results Of More Extensive Vulvectomy Procedures Can Also Be Psychologically Upsetting. Damaged Pelvic Floor Muscles Through Surgery Or Radiotherapy May Lead To Urinary Incontinence. Where Larger Numbers Of Lymph Nodes Are Removed, It Is Possible That Lymphedema Will Cause Swelling In One Or Both Legs.

Nearly All Surgical Procedures Require Further Radiotherapy Treatment That Can Last For A Number Of Weeks, Bringing With It A Number Of Unpleasant Side Effects. Chemotherapy Is Also A Method That Is Associated With Serious Health Complications. Undesired Side Effects Are Also Linked To Immunotherapy And, In A Lesser Degree, Targeted Therapy.

Uterine cancer alternatives

It Is Possible That You Have Been Given A Choice Of One Or More Alternative Treatments Or Have Not Yet Made An Appointment For Your Free E-Consult And Are Simply Browsing The Possibilities.

The Accepted And Current Uterine, Ovarian, Cervical And Vulvar Cancer Treatment Alternatives Have Been Described In Detail Above. Recent Advances Mean That Some Stage IV Cancers Can Go Into Remission For Significant Periods Of Time. Complementary Cancer Remedies Are Unproven And Should Not Take The Place Of Accepted Treatment Courses. Cancer Stem Cell Therapies Are, As Yet, Insufficiently Developed To Be Used As First-Line Treatment.

Of Course, There Is No Alternative For Professional Medical Advice. Please Call Us To Arrange Your Free E-Consult And The Opportunity To Speak Personally With Specialist Surgical Oncologists, Gynaecologists And Radiologists To Determine The Best Treatment Type For You. You Can Discuss All Gynaecological Cancer Treatment Alternatives With Them, Ask For Second Or Third Opinions, And Take The First Step Towards Your Personalised Remedazo Holistic Care Package.

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