Wellstar offers innovative advances in the fight against uterine cancer, including:
- Advanced gynecologic oncologists who specialize in uterine cancer and who practice state-of-the-art care in a collegial atmosphere.
- Expert surgical teams offering experience in complex hysterectomies, including da Vinci Robot surgery.
- The entire spectrum of diagnostic and interventional treatments - including ultrasounds and magnetic resonance imaging (MRI).
- Intensity Modulated Radiation Therapy (IMRT), a treatment that allows for the radiation to be tailored to the size and placement of the tumor, while sparing healthy tissue.
- A Tumor Board, which meets weekly to present patient cases and craft a personalized treatment plan. The conference is attended by medical oncology, radiation oncology, radiology, pathology, and a team of surgeons specializing in minimally invasive surgery.
- Clinical trials - making novel therapies available to patients.
Uterine cancer is one of the most common cancers in American women, but this type of cancer is often found at its earliest—and treatable—stage. About 43,470 new cases of uterine cancer are diagnosed annually, with almost 8,000 women dying from the disease, according to the American Cancer Society.
Uterine cancer is rare in women under the age of 40—with most cases found in women 50 and over and the majority of patients are diagnosed between those 50 and 69 years of age.
Typically, uterine cancer starts in the cells of the endometrium, the lining of the uterus. Uterine cancer is often detected at an early stage because it frequently produces vaginal bleeding between menstrual periods or after menopause. If uterine cancer is discovered early, removing the uterus surgically often eliminates all of the cancer.
- Bleeding after menopause
- Prolonged periods or bleeding between periods
- A non-bloody discharge from the vagina.
- Pelvic pain.
- Pain during sexual intercourse
- Unexplained weight loss
- Obesity. Being obese can increase the level of estrogen, putting a woman at a higher risk of uterine cancer and other cancers. Obese women have three times the risk of uterine cancer and overweight women have twice the risk, according to the American Cancer Society.
- Never having been pregnant. Pregnancy seems to decrease the risk of endometrial cancer.
- Many years of menstruation. If a woman started menstruating at an early age - before age 12 - or began menopause late, she is at higher risk.
- Irregular ovulation. Ovulation, the monthly release of an egg from an ovary in menstruating women, is regulated by estrogen. Irregular ovulation or failure to ovulate increases a woman’s lifetime exposure to estrogen, tied to uterine cancer.
- A high-fat diet. This type of diet may add to the risk of uterine cancer by promoting obesity. High fat foods may directly affect estrogen metabolism, further increasing a woman's risk of endometrial cancer.
- Diabetes. Uterine cancer is more common in women with diabetes.
- Estrogen-only replacement therapy (ERT). Estrogen stimulates growth of the endometrium. Replacing estrogen alone after menopause may increase the risk of uterine cancer.
- Ovarian tumors. Some tumors of the ovaries may themselves be a source of estrogen, increasing estrogen levels.
Other factors that can increase your risk of endometrial cancer include:
- Age. The majority of endometrial cancer occurs in women older than 55.
- Personal history of breast cancer or ovarian cancer. If you've had breast or ovarian cancer, you may have an increased risk of endometrial cancer because all of these cancers share some of the same risk factors. However, the vast majority of women who have either breast or ovarian cancer never develop endometrial cancer.
- Tamoxifen treatment. One in every 500 women whose breast cancer was treated with Tamoxifen will develop endometrial cancer. Although Tamoxifen acts mostly as an estrogen blocker, it does have some estrogen-like effects and can cause the uterine lining to grow. If you're being treated with this hormone, see your doctor for an annual pelvic examination and be sure to report any unusual vaginal bleeding.
- Hereditary nonpolyposis colorectal cancer (HNPCC). This inherited disease is caused by an abnormality in a gene important for DNA repair. Women with HNPCC have a significantly higher risk of endometrial cancer as well as colon and other cancers.
- Race. Black women have an increased risk of death from endometrial cancer, although white women are more likely to develop endometrial cancer.
Uterine Cancer Prevention
Wellstar supports scientific research that shows certain lifestyle choices can lower a person’s risk.
Reduce your risk
If you smoke, please consider getting help to quit through one of Wellstar’s tobacco cessation programs. Avoid excess body fat by limiting caloric intake and/or balance caloric intake with ample moderate-to-vigorous exercise.
Uterine Cancer Diagnosis
If Wellstar physicians are concerned about abnormal uterine bleeding, they might suggest more testing:
- Endometrial biopsy, which involves removing tissue from the uterine lining for laboratory analysis. This may be done in your physician's office and usually doesn't require anesthesia.
- Dilation and curettage (D&C), a common diagnostic procedure used by gynecologists to obtain tissue from the wall of the uterus. During a D&C, the opening of the cervix is gradually stretched. One after the other, a series of increasingly thick rods (dilators) are inserted into the cervical opening. The thickest dilator may be the width of a fountain pen. As an alternative, absorbent dilators can be used to stretch the cervical opening. Scraping (curetting) the lining of the uterus yields tissue, which can then be looked at under the microscope to determine if cancer is present. Rarely, if ever, is curettage used for the treatment of uterine cancer since only a superficial layer of the uterus is removed.
- Transvaginal sonography, which involves an ultrasound apparatus passed through the vagina in order to examine the uterus.
- Sonohysterography, which improves the accuracy of sonography by first infusing salt solution into the uterus through the cervix.
- Magnetic Resonance Imaging (MRI), which is useful in determining whether the lymph nodes are involved with cancer and may prevent the need for lymph node dissection.
Uterine Cancer Stages
When uterine cancer is diagnosed, your Wellstar physician will categorize it by the current stage. Each stage describes the progression of the disease and whether the cancer has spread to other parts of the body. You should talk to your Wellstar physician to understand each stage, and what it means for your treatment plan.
Uterine Cancer Treatment
Once cancer has been detected, biopsied and “staged,” your team of specialists in gynecological oncology, surgery, radiation oncology, radiology and pathology will work together to assess your best course of uterine cancer treatment. This will include formulating a coordinated plan of personalized treatment consistent with the highest standards of care. Your treatment will be tailored to your specific type of uterine cancer, and it may involve a combination of surgery, radiation, chemotherapy or hormonal drugs and targeted therapies.
Uterine cancer surgery
Surgery is the primary treatment for uterine cancer, with more than 90 percent being done with the da Vinci robotic surgery, which reduces pain, length of hospital stay and recovery time. Wellstar physicians are some of the most highly trained in the nation with the da Vinci robotic surgery and approximately 82 percent of women survive five years after diagnosis.
Surgical approaches for uterine cancer at Wellstar include:
- Da Vinci robotic surgery, which allows hysterectomies through small surgical holes. The entire procedure, including hysterectomy as well as removal of pelvic and para-aortic lymph nodes can be performed through this technique, eliminating the need for abdominal incision.
- Total Hysterectomy. The standard surgery for treatment of uterine cancer is a total abdominal hysterectomy (removal of the uterus) and bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries). In addition to removing the uterus and ovaries, the surgeon will often sample or remove the pelvic and para-aortic lymph nodes to determine if cancer has spread.
Medical oncology and chemotherapy
Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life.
Hormone therapy is used if the cancer has spread to other parts of the body. Synthetic progestin, a form of the hormone progesterone, is often used to keep the cancer from growing. Other medications may be used as well.
Medical oncologists at Wellstar believe in a personalized approach to uterine cancer therapy—often guided by the genetics of the cancer and the condition of the patient.
Radiation therapy for uterine cancer involves the use of high-energy radiation and/or radioactive substances to destroy cancer cells or prevent the cells from reproducing. Wellstar offers standard radiation and cutting edge techniques, including:
- High-Dose Rate (HDR) brachytherapy, an internal radiation therapy, offers a fast, powerful and precise way to deliver radiation directly to uterine tumors.
Ongoing Care for Uterine Cancer
You’ll be referred after your recovery from uterine cancer surgery to Wellstar’s medical oncology team for treatment, surveillance and survivorship programs. These comprehensive programs focus on diet, exercise and nutrition to help you reduce the risk of recurrence.
Cancer care at Wellstar is more than advanced technology, clinical research, and highly specialized physicians and nurses. It includes an array of supportive care services to improve the patient experience before, during and after treatment. All of these services are available within the Wellstar system, including:
- Counseling services for individuals, couples and families.
- Nutrition services, which allow cancer patients to stay strong through treatment and eat healthier foods that lower cancer risk.
- Physical therapy centers, which allow many rehab options and lymphedema therapy.
- Smoking cessation programs, which offer support to patients who need to come off cigarettes and nicotine. Special services are offered to those who have made prior attempts.
- Retail stores that offer wigs, mastectomy bras and other cancer support products.
- Genetic counseling services, which offer patients and family members who are at high risk to be tested for genetic abnormalities after meeting with a certified genetic counselor.
- Healthplace, which offers programs for cancer patients to regain strength and fight fatigue after chemotherapy or radiation therapy.
Palliative Care and Hospice
Wellstar's certified palliative care physicians and certified registered nurses are dedicated to providing compassionate, quality care in various settings, including home hospice, inpatient hospice nursing homes, assisted living facilities and nursing homes. WellStar offers caring and compassionate hospice care for patients and their families in one of Georgia's oldest hospice programs serving Bartow, Cherokee, Cobb, Douglas and Paulding counties.