Uterus, the womb, where the fertilized eggs resides and develops during pregnancy period, gives women her childbearing ability. The cancer of uterus occurs when cells of cervix (neck of uterus) or endometrial tissue of corpus (body of the uterus) gradually undergo morphological changes called dysplasia, which may finally become cancerous.
The pre cancerous stage may not necessarily lead to cancer but any women with dysplasia, too need to be examined and treated to prevent being cancerous. In its earliest stage, the cancer is curable and metastatic spread can be avoided.
In absence of timely treatment, cancer cells spread into deep layers of uterus, adjacent organs like vagina, rectum or bladder and further reach to distant parts, infecting those too. A multi-disciplinary team of doctors that includes oncologists and gynecologic oncologist, work together to develop best treatment plan for each patient based on correct cancer staging and its progression.
Different Treatment Approaches
Uterine cancer treatment plan includes no. of different treatments from surgery, chemotherapy, radiation therapy to hormonal therapy. Each of these treatments is performed from different available options, which is decided based on various factors like type and stage of the cancer, probable side effects and overall health, and also, considering the patient’s preferences linked to age, family plans and fertility.
The concerns of women afflicted with uterine cancer, about treatment effects on their sexuality and fertility should be addressed in details with the oncologist team, so that the patient is completely convinced that they are being provided the best possible treatment plan for recovery.
Pre Cancerous Stages
Cryotherapy is performed to destroy tissues of cervix, using extremely cold temperature or through elctrocoagulation process, where the tissue damage is brought about by use of intense heat, generated through electric current, in early or precancerous stages in order to maintain childbearing capacity of the women. Precancerous cells changes of endometrium can be easily treated using medicines of progesterone hormone.
Recommended Therapies for Uterus Cancer
Surgery involves the removal of tumor cells and the tissue adjacent to them through an operation. It is considered as the first treatment for uterine cancer recovery.
A simple hysterectomy or radical hysterectomy (upper part of vagina and surrounding tissues are also removed, along with uterus and cervix) is performed by the surgeon. In case, cancer has spread to lymph nodes adjacent to tumor, these will also be removed. For patients, who have passed menopause phase, a bilateral salpingo-oopherectomy (removal of ovaries and fallopian tubes) is performed.
Hysterectomy ends the potential of women to be pregnant and removal of ovaries halts any production of sex hormones in the body and cause premature menopause (for those who have not passed through menopause). Women should be aware about the emotional, sexual side effects and reproductive health issues of cancer treatment.
The use of drugs to kill cancerous cells by inhibiting the cells ability to grow and divide is termed as chemotherapy. The goal is to destroy remaining cancer cells after surgery. It can be provided orally but most drugs to treat uterine cancer are injected intravenously. The side effects may vary from fatigue, nausea, appetite loss, and diarrhea to risk of infection. But these usually go away with treatment completion.
Therapeutic High Energy Waves
The use of high energy rays or X-rays to kill cancerous cells is termed radiation therapy. The most common form is known as external beam radiation therapy which utilizes an external machine to direct radiation onto the body.
Radiation treatment provided using implants, is known as brachytherapy (internal radiation therapy). For uterine cancer, brachytherapy is being used by injecting small amounts of radioactive particles into the tumor.
It is performed for number of times over a period to ensure killing of each left over cancer cells after surgery. In case, a woman cannot undergo surgery, doctor may recommend going for radiation therapy as an alternative.
Hormone therapy is being utilized to slow down the growth of cancer cells of the uterus. For treatment of uterine cancer, hormone therapy includes progesterone, given in form of a pill. Other drugs that may also be given are tamoxifen and aromatase inhibitors (AIs) like anastrozole. AI drugs help to lower the amount of estrogen production in a woman by inhibiting organs and tissues (except ovaries) that produces it.
Hormone therapy is useful for women who could not undergo surgery or radiation therapy or follow other types of treatment. Side effects may include weight gain, fluid retention and gain of appetite. Also, potential childbearing women may experience alterations in their menstrual cycle.