Oncology >>>> Treatment of uterine cancer with modern methods

Treatment of uterine cancer with modern methods.

Since uterine cancer (has synonyms: endometrial cancer, cancer of the uterine body) occupies one of the most important places among the malignant forms of diseases of the female reproductive system, the methods of treating this disease are of unquenchable interest in patients, and an understanding of these methods is necessary for timely decision-making on this disease.

Methods of treating cancer of the endometrium include:

surgical
ray
drug

Each of these methods has advantages and disadvantages, but it is considered most effective to combine all three methods to improve the treatment rates of uterine cancer . This means that the treatment must be comprehensive.

The choice of treatment tactics involves the analysis of certain factors with which the oncologist has to work:

Condition of regional lymph nodes
Endocrine disorders of the patient
Accompanying illnesses
Age

Since the danger of cancer lies in metastasis, three possible ways of spreading metastases are considered:

Lymphogenous (through the lymphatic system) - the main path
Hematogenous (with blood flow to the lungs, liver, bones)
Implantation (the peritoneum is involved in the process - the fallopian tubes, ovaries, greater omentum are affected)

Surgical treatment of uterine cancer.

When choosing the volume of surgical intervention, they rely on studies of the ways of spreading metastases, and the scale of the operation directly depends on the severity of endocrine processes, the age of the patient, and concomitant somatic diseases.

During surgical intervention, several options for operations are possible:

Subtotal hysterectomy - or uterine amputation (preserving the cervix)
Simple hysterectomy - or simple extirpation (removal of the cervix and uterus) is performed if the patient has concomitant pathologies (diabetes mellitus, hypertension, obesity), a localized tumor of the T1T2N0M0 type, a differentiated tumor of the G1G2 type.
Modified extended hysterectomy according to Bohmann - or modified extirpation is performed if, among other things, it is required to remove the appendages and pelvic lymph nodes, that is, with localized tumors of the T1T2N0M0 type with reduced differentiation of the G2G3 type, or with a locally advanced process of the T3aN1M0 type, regardless of differentiation of a tumor of the type G1G2G3.
Wertheim's operation is performed with a significant local spread of a tumor of the T2T3N1M0 type in case of its transition to the cervical canal.

Today, there are several options for surgical intervention in the treatment of endometrial cancer:

Laparotomy of the uterus (open hysterectomy) is a cavity dissection from the side of the peritoneum.
Vaginal hysterectomy - access to the uterus through the vagina.
Laparoscopic hysterectomy - small incisions are made in the peritoneum and the operation is performed using laparoscopes inserted into them and viewing the manipulations on the display.
Laparoscopic hysterectomy performed with a special operating robot.

Radiation therapy for endometrial cancer.

Ionizing radiation is used as an aggressive therapy in the treatment of uterine cancer. It is performed in combination with the surgical method (before and after surgery), and is also considered as an independent method of treating uterine cancer. It is believed that in most cases, endometrial cancer is highly sensitive to ionizing radiation (approximately 18-20%).

Radiation therapy, as an independent method, is also used in cases with patients with severe concomitant diseases (hypertension, diabetes mellitus, heart failure, and others), a significant spread of the tumor to the vagina, ligamentous apparatus (third stage), or elderly patients.

Recently, brachytherapy has been used - a method of conducting radiation therapy, when a radiation source (microcapsules) is introduced into the organ and implanted into the tumor tissue. Thus, radiation exposure to adjacent tissues and organs is minimized.

Radiation therapy for uterine cancer is carried out in accordance with a certain set of rules:

Intracavitary irradiation and along the contour of the uterus.
Intracavitary and remote irradiation of the uterus, pelvic area, vagina and regional zones, depending on the studies and indications.
Intracavitary irradiation of the vaginal walls for prophylaxis.
The use of electron-acceptor compounds before intracavitary irradiation.
Combination of radiation therapy with hormonal drugs.

Drug therapy for uterine cancer.

Drug therapy is carried out in two directions:

Chemotherapy for uterine cancer.

In the early stages of the disease, chemotherapy is usually not used. Chemotherapy is indicated in cases where endometrial cancer begins to occupy large areas, or in case of recurrent disease.

Standard protocols for such treatment include monotherapy or drug combinations. It is believed that the combined use of chemotherapy drugs is most beneficial. Such combinations are chosen by the oncologist.

Hormone therapy for endometrial cancer.

Hormone therapy is carried out with drugs of progestins, antiestrogens. This therapy is indicated in the presence of progesterone receptors in the tumor. In the absence of these receptors, chemotherapy is considered more favorable. The treatment regimen is prescribed by the doctor.

With the timely detection of uterine cancer and its persistent treatment, today the prognosis is considered favorable. Therefore, do not neglect regular medical examinations, or undergo methodical gynecological examinations yourself.