The primary treatment for uterine and endometrial cancer is surgery. The Surgeon may be a gynecologist or more appropriately, a gynecologic oncologist, who is trained specifically in the surgical and medical aspects of treating gynecologic cancers.
The primary surgery is typically removal of the uterus and both ovaries, known as a total abdominal hysterectomy and bilateral salpingo-oopherectomy, or TAH-BSO. In order to determine the stage of the cancer, the surgeon may also perform several other maneuvers to help determine the extent or non-extent of the cancer, including sampling of any fluid in the abdominal or pelvic cavity, as well as total or partial removal of lymph nodes within the pelvic or abdominal area.
The staging system for uterine cancer is
- Stage IA: tumor limited to the endometrium
- Stage IB: invasion of less than half the myometrium
- Stage IC: invasion of more than half the myometrium
- Stage IIA: endocervical glandular involvement only
- Stage IIB: cervical stromal invasion
- Stage IIIA: tumor invades serosa or adnexa, or malignant peritoneal cytology
- Stage IIIB: vaginal metastasis
- Stage IIIC: metastasis to pelvic or para-aortic lymph nodes
- Stage IVA: invasion of the bladder or bowel
- Stage IVB: distant metastasis, including intraabdominal or inguinal lymph nodes
The next steps depend on the type of uterine cancer, and its extent:
Women with low grade disease confined to the uterus may need no further treatment. Women with disease confined to the uterus with an increased risk of recurrence or if the disease extends to the cervix should undergo radiation therapy. If the cancer has spread beyond the uterus and cervix, chemotherapy may be warranted as well.
To discuss radiation therapy options, or to make an appointment for a consultation with one of the expert Radiation Oncologists at Advanced Radiation Centers of New York, call the center's toll free number at 866.955.4-ARC.
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