Uterine Cancer Surgery

Uterine Cancer Surgery

Surgery for uterine cancer is conducted to remove the malignant tumor of the uterus. A gynaecologist is a surgeon who specialises in the treatment of female reproductive tract problems.

Gynecologic once surgeons are surgeons or gynaecologists who have received additional training in treating cancers of the female reproductive tract.

Total abdominal hysterectomy (removal of the uterus) and bilateral salpingo-oophorectomy are the primary treatments for uterine cancer (removal of the fallopian tubes and ovaries). In addition to the uterus and ovaries, the surgeon will remove the pelvic and para-aortic lymph nodes to detect if cancer has spread.

Uterine Cancer Surgery

Stages of Uterine Cancer

Stage I: The cancer has only been found in the uterus or womb and has not progressed to other parts of the body.

Stage IA: The cancer is only identified in the endometrium or in less than half of the myometrium.

Stage IB: The tumour has progressed to at least half of the myometrium.

Stage II: The tumour has spread from the uterus to the cervical stroma but has not progressed to the rest of the body.

Stage III: The cancer has progressed beyond the uterus but is still confined to the pelvic region.

Stage IIIA: The cancer has spread to the uterine serosa and/or fallopian tube and ovarian tissue but not to other regions of the body.

Stage IIIB: The tumour has progressed to the vaginal or uterine cavity.

Stage IIIC2: The cancer has spread to the para-aortic lymph nodes and may have migrated to the regional pelvic lymph nodes as well. The cancer has spread to the rectum, bladder, and/or distant organs at this stage.

Stage IVA: The cancer has progressed to the rectum or bladder mucosa.

Stage IVB: The cancer has spread to the lymph nodes and/or to distant organs such as the bones or lungs.

Hysterectomy

Depending on the degree of the cancer, the surgeon will either conduct a simple hysterectomy (removal of the uterus and cervix) or a radical hysterectomy (removal of the uterus, cervix, the upper part of the vagina, and nearby tissues). For menopausal patients, the surgeon would often conduct a bilateral salpingo-oophorectomy, which is the removal of both fallopian tubes and ovaries.

A hysterectomy can be performed through abdominal incision, laparoscopically or robotically (with numerous small incisions). A hysterectomy is typically performed by a gynecologic surgeon, who is a surgeon that specialises in female reproductive system surgery. A camera and tools are inserted through small, keyhole-sized incisions in robotic-assisted surgery. The robotic devices are guided by the surgeon to remove the uterus, cervix, and surrounding tissue.
Additional therapy may not be required if a woman has no cancer left in the tissue removed during a hysterectomy. However, regular screening and testing to check for cancer recurrence is advised including cancer

Lymph node removal is a surgical procedure that involves the removal of lymph nodes. The surgeon may remove lymph nodes near the tumour at the same time as the hysterectomy to assess if the cancer has spread beyond the uterus.

This can be accomplished with a procedure known as a sentinel lymph node biopsy or lymphadenectomy. A sentinel lymph node biopsy may entail injecting dye into the uterus during the hysterectomy and removing the few lymph nodes where the dye accumulates. In uterine cancer, this surgery has become more common than lymphadenectomy. A lymphadenectomy, also known as lymph node dissection, is a surgical surgery that removes a group of lymph nodes.

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Frozen Section: Intra operative frozen section may be used at times to help the surgeon the extent of dissection or tissue removal.

What can you expect following a Hysterectomy for Uterine Cancer?

Your doctor will examine 4 to 6 weeks after the hysterectomy. In 6 to 8 weeks, you should be able to resume all of your normal activities. Light bleeding or spotting is to be expected for up to 6 weeks after a hysterectomy.

Radiation Therapy

The use of high-energy x-rays or other particles to eliminate cancer cells is known as radiation therapy. A radiation oncologist is a doctor who specialises in the use of radiation therapy to treat cancer. A radiation therapy regimen, or schedule, typically consists of a predetermined number of treatments administered over a predetermined time period. Radiation therapy can be administered both externally and inside. External-beam radiation therapy employs the utilisation of a machine located outside the body to administer radiation to the pelvic region or another location specified by your radiation oncologist. Internal radiation can also be administered.

Brachytherapy

Brachytherapy is a type of radiation therapy. External-beam radiation therapy may be administered alone or in conjunction with brachytherapy. Brachytherapy alone may be appropriate for some patients. External-beam radiation therapy is the most prevalent method of radiation treatment. Some women with uterine cancer require surgery (as mentioned above) as well as radiation therapy. Radiation therapy is typically used following surgery to kill any leftover cancer cells.

Radiation therapy is sometimes used prior to surgery to shrink the tumour. If a woman is unable to have surgery, her doctor may suggest radiation therapy instead.

Radiation therapy directed at the entire pelvis and/or delivered solely to the vaginal canal, known as vaginal brachytherapy, are two options for treating uterine cancer. If a woman has a grade 1 or 2 cancer that has gone through half or more of her myometrium, or a grade 3 cancer that has spread through less than half of her myometrium, she may be able to have vaginal brachytherapy instead of pelvic radiation.

Chemotherapy

Chemotherapy is the use of medications to eradicate cancer cells, typically by preventing the cancer cells from growing, dividing, and proliferating. Chemotherapy is generally used following surgery for endometrial cancer. If the endometrial cancer returns after the person’s initial treatment, chemotherapy is also recommended.

A chemotherapy regimen, or schedule, typically consists of a predetermined number of cycles administered over a predetermined time period. A patient may be administered one medicine at a time or a mixture of drugs at the same time.

Chemotherapy’s purpose is to either eradicate any cancer that remains after surgery or to reduce the disease and slow its growth if it returns or has spread to other places of the body. Although chemotherapy can be administered orally, the majority of medications used to treat uterine cancer are administered intravenously. IV chemotherapy is administered either directly into a vein or via a catheter, which is a thin tube placed into a vein.

To know more about Cancer prevention Book your appointment with DR. ANSHUMALA SHUKLA KULKARNI, at KDAH