Uterine & Gynecologic Cancers

Uterine cancer originates in either the muscular layer of the uterus (myometrium) or the lining (endometrium).

• Endometrial adenocarcinoma is the most common form, also referred to as endometrial cancer
• Other types include uterine sarcomas, papillary serous carcinomas, clear-cell carcinomas, and mixed Müllerian tumors

Endometrial cancer is the most common gynecologic cancer in the U.S., with over 66,000 new cases in 2023. It typically affects women aged 50 to 70, most often postmenopausal, and is more deadly in African American women, despite being more common in Caucasian women.

Symptoms:

• Abnormal vaginal bleeding (especially postmenopausal)
• Pelvic pain or cramping
• Unusual discharge

Cervical cancer forms in the cervix, the lower part of the uterus connecting to the vagina. It is most often caused by persistent infection with high-risk human papillomavirus (HPV).

Types include:

• Squamous cell carcinoma (most common)
• Adenocarcinoma (less common but increasing in frequency)

Prevention through HPV vaccination, Pap tests, and HPV testing has dramatically reduced rates in the U.S., though over 13,900 new cases and 4,300 deaths were still projected in 2023.

Symptoms:

• Abnormal bleeding
• Pelvic pain
• Pain during intercourse
• Often no symptoms until later stages

Ovarian cancer begins in the ovaries and is notoriously difficult to detect early.

• Epithelial tumors are the most common
• Risk factors include BRCA1/2 mutations, family history, and age

Only 20% of cases are detected early, contributing to a poorer prognosis. In 2023, about 19,700 women were diagnosed in the U.S.

Symptoms (often vague):

• Bloating
• Abdominal discomfort
• Frequent urination
• Early satiety

These rare cancers occur in the external and internal parts of the reproductive tract:

• Vulvar cancer often affects the inner edges of the labia
• Vaginal cancer typically forms in the lining of the vagina

HPV infection, age, smoking, and a history of cervical dysplasia increase risk.

Symptoms:

• Itching, pain, or tenderness in the vulva
• Skin changes (rash, discoloration, warts)
• Abnormal bleeding or discharge

Diagnosis typically begins with:

• Pelvic exam
• Pap smear or HPV test
• Transvaginal ultrasound
• Biopsy (can often be performed without anesthesia)

To assess cancer spread, your care team may order:

• Chest X-ray, CT scan, or MRI

PET scan, depending on findings

Treatment depends on the cancer type, stage, and overall health of the patient. It may include:

Surgery

• Hysterectomy (removal of the uterus)
• Oophorectomy (removal of the ovaries)
• Lymph node dissection

Chemotherapy & Targeted Therapy

Used either before, after, or instead of surgery depending on disease stage and aggressiveness.

Radiation Therapy

Radiation plays a critical role when:

• Surgery is not an option
• Used post-operatively to reduce recurrence risk
• Aims to preserve anatomy in cervical or vulvar cancer

External Beam Radiation Therapy (EBRT)

• Delivered using VMAT, IMRT, and IGRT
• Allows precise targeting of the tumor while protecting nearby organs (e.g., bladder, rectum, bowel)

High-Dose Rate (HDR) Brachytherapy

• Internal radiation placed temporarily in or near the tumor
• Uses robotic-like delivery guided by sophisticated imaging
• Especially effective for endometrial and cervical cancers

Managing Side Effects

Radiation therapy to the pelvic region may cause:

• Fatigue
• Gastrointestinal discomfort
• Bladder or bowel changes
• Vaginal dryness or discomfort
• Changes in urinary or sexual function.

Most side effects are temporary and manageable. At ARC, we offer comprehensive support services to address both physical symptoms and emotional well-being.

Consultation

Your care at ARC begins with a comprehensive consultation. During this initial visit, you and your family will meet with one of our experienced radiation oncologists to review your diagnosis and medical history. Together, you’ll explore the most appropriate and effective radiation treatment options tailored to your individual needs. The discussion will also include treatment expectations, potential side effects, and available alternatives to ensure you are fully informed and confident in your care plan.

Simulation (Your Treatment Planning Session)

Once radiation is recommended, you’ll begin with a session called a simulation—a detailed planning appointment that lasts about 45–60 minutes.

During this session:

• We help you get into the best position for your treatment, sometimes using a custom mold to ensure you’re positioned the same way every day.
• Tiny, freckle-sized tattoos may be placed on your skin to help us align your body accurately before each treatment.
• A special imaging scan is performed to pinpoint exactly where the cancer is, so we can target it while protecting nearby healthy tissues.

The Planning process (Behind the Scenes)

After your simulation, your care team—which includes your radiation oncologist, medical physicists, and dosimetrists—will work together to create a custom radiation plan just for you. Using advanced 3D computer software, they map out how to deliver the exact amount of radiation to the right place, while minimizing exposure to healthy areas.

This planning process usually takes 1 to 2 weeks, and it results in a detailed “blueprint” that guides your daily treatments.

Daily Radiation Treatments

Radiation is typically given once a day, five days a week for several weeks. Treatments are done using a machine called a linear accelerator, which delivers invisible, high-energy radiation beams to the cancer.

Here’s what you can expect:

• Each visit takes about 10–15 minutes, with most of the time spent getting you into position. The actual treatment only lasts a few minutes.
• You won’t see or feel the radiation, and there’s no pain during treatment.
• The treatment room is spacious and not claustrophobic.
• In some cases (such as prostate treatment), you may be asked to drink water before your appointment to help move the bladder away from the treatment area.
• Most patients feel well enough to drive themselves, go to work, exercise, and continue their daily routines.

Your radiation oncologist will let you know if there are any specific precautions or changes you should make during treatment.

Weekly On-Treatment Physician Review

During your treatment course, you’ll have weekly visits with your radiation oncologist. These short check-ins help us:

• Monitor how you’re feeling
• Check for any side effects
• Adjust medications if needed
• Answer any questions you have

These visits are an important part of your care and help us support you every step of the way.

Completion of Therapy and Follow-Ups

At the end of your treatment, you’ll meet with your radiation oncologist to talk about:

• What to expect in the coming weeks
• How side effects should improve
• Whether any additional treatment or follow-up is needed

Regular follow-up appointments are essential after radiation to monitor your recovery and watch for any signs of recurrence. We’ll be here to support you long after your final treatment.

If you ever have questions or need guidance along the way, don’t hesitate to reach out. Our team is here to help you feel informed, confident, and cared for throughout your journey.