In most cases, the primary surgical staging procedure will be curative and no further treatment is needed. If the tumor is stage II or greater, additional therapies are often employed. Those additional therapies are typically radiation and/or chemotherapy.
This surgery involves removal of the uterus, cervix, ovaries and lymph nodes. Cancer cells can spread to the lymph nodes without other obvious metastatic disease. In nearly all cases, Dr. Ivy performs this surgery laparoscopically in order to speed recovery and minimize pain and risk of complications.
After surgery, a stage of disease will be established. In stage II and III, adjuvant pelvic radiation may be used to help prevent recurrence. In high risk stage I tumors, the use of vaginal radiation has been shown to reduce the risk of recurrence as well. Currently studies are ongoing to determine whether the use of chemotherapy with radiation has an added benefit.
There are two types of radiation therapy used in the treatment of endometrial cancer. They are not mutually exclusive, and both may be used in your treatment.
External beam radiotherapy originates from an external source and consists of radioactive beams aimed at the tumor. This type of radiation is given in daily treatments five days a week for 5-6 weeks.
Vaginal brachytherapy is only delivered to the vaginal surface. This can be safely performed in an outpatient setting. Most treatments last only a few minutes and are performed 3 to 7 days apart for a total of 3 to 5 treatments.
For more advanced stage tumors (stage IV), chemotherapy will be used in your adjunctive treatment. Response rates are usually 6-9 months in length, although longer response rates have recently been observed with newer combination chemotherapy.