Dr. M.J. Bazos, MD.
Patient Handout
UTERINE MALIGNANT
TUMORS
About Your
Diagnosis
The uterus (womb) is located
between the bladder and rectum. It is made up of the cervix, which connects the
uterus to the vagina, and the body (corpus), from which the fallopian tubes
extend. Cancer of the uterus can start from the cervix or from the inner layer
of the uterus (the endometrium). Malignant tumors of the uterus also can start
from the muscular body of the uterus or from its connecting tissue and are
called uterine sarcoma. Uterine sarcoma is rare, occurring among 1 in 100,000
women. The cause of uterine sarcoma is unknown. Uterine sarcoma can be divided
into one of three types, which can be diagnosed only by means of a biopsy and
tissue examination. Uterine sarcoma is difficult to cure, but if detected early,
the chance for cure is better than if the cancer has
spread.
Living With Your
Diagnosis
Uterine sarcoma usually
becomes apparent with abnormal vaginal bleeding among women who have gone
through menopause. Other symptoms include abdominal fullness, bloating, and
pain. Urinary symptoms of frequency, urgency, and discomfort can occur. Uterine
sarcoma usually spreads local and invades nearby organs, such as the vagina,
ovaries, rectum, and
bladder.
Treatment
To
confirm the diagnosis a D & C is performed to remove tissue for examination
with a microscope. D & C means to dilation (widening) of the cervix for
insertion of a curette (a spoon-shaped instrument with sharp edges) to remove
tissue. Once the diagnosis is made, the physician determines the extent of
disease by staging the cancer. Staging tells whether the disease has spread.
Blood tests, radiographs (x-rays) of the chest, and computed tomography (CT) of
the abdomen and pelvis are performed to look for disease outside the uterus.
Stage I means the sarcoma is confined to the uterus. Stage II means the sarcoma
extends to the cervix. Stage III means the sarcoma extends to structures in the
pelvis. Stage IV means the sarcoma extends beyond the pelvic structures.
Treatment depends on the stage of the disease and can be surgical, radiation,
hormonal, or chemotherapy. A surgical procedure is the main treatment. It
consists of removing the uterus, fallopian tubes, and ovaries (hysterectomy with
bilateral salpingo-oophorectomy). A surgical procedure
is
generally performed for early-stage
disease. The decision to use radiation or chemotherapy depends on the type of
uterine sarcoma and the stage of disease. The type of radiation or combination
of chemotherapy should be discussed with an oncologist (physician specializing
in cancer). Side effects of surgical treatment are pain and soreness in the
pelvic area and problems emptying the bladder or moving the bowels. Side effects
of radiation therapy are dry, red, itchy skin, nausea, vomiting, diarrhea,
vaginal dryness, pain with intercourse, and frequency, urgency and discomfort
with urination. Side effects from chemotherapy are nausea, vomiting, easy
bruising and bleeding, infections, fever, and hair
loss.
The
DOs
• Find a surgeon and
oncologist who have experience in the treatment of uterine sarcoma. This cancer
is so rare you should seek a cancer center with a team of physicians and
healthcare personnel who deal with all aspects of
treatment.
• Keep your appointments
during and after treatment to monitor for side effects and determine whether the
cancer has returned.
• Remember that
you will no longer have periods (menstrual cycles) after your operation. If your
ovaries are removed or if damage is caused by irradiation, menopause occurs, and
you may experience symptoms of menopause such as hot
flashes.
The
DON’Ts
• Do not ignore any
vaginal bleeding after menopause.
•
Do not ignore abnormal vaginal bleeding (excess bleeding or bleeding between
periods) if you have not gone through
menopause.
• Do not believe you will
have no sexual desire or not be able to have sexual intercourse after surgical
treatment. Sexual intercourse and normal activity can be resumed 4 to 8 weeks
after the operation.
When to Call
Your Doctor
• If you have any
vaginal bleeding or abnormal vaginal
bleeding.
• If you have any abnormal
vaginal discharge (smell, quantity,
color).
• If you need emotional
support.
• If you have any side
effects of treatment (surgical, radiation, or chemotherapy).