For several different types of gynaecological issues and checks, and with a personal touch, be sure to speak with Greenslopes Gynaecology. Our services cover many different areas in the field, one of which being endometrial uterine cancer treatment.
Usually presents as abnormal vaginal bleeding. Often this is post-menopausal in nature but 25% occur in the premenopausal age group and 5% occur before the age of 40. It may present simply as heavy periods. Although most cancers of the uterus present with Post-menopausal bleeding (90%) only 10-20% of patients presenting with Post-menopausal bleeding in fact have endometrial or uterine cancer.
Obesity, Late menopause and nulliparity (no children) are all potential risk factors. Some inherited conditions such as LYNCH syndrome (also known as HNPCC) may have up to 40-50% chance of developing endometrial or uterine cancer and often undergo prophylactic laparoscopic surgery after childbearing is completed to negate this.
Usually requires a biopsy of the endometrium (lining of the uterus), which can sometimes be done in the rooms at your initial visit with Dr Land via a pipelle (specialised uterine lining sampling device) usually with a result within 24-hours. A day surgery curette (cleaning of the uterine lining for pathology assessment) and hysteroscopy (look inside the uterus with a tiny camera through the cervix) may be necessary. This is performed under a short general anaesthetic.
All results are reviewed weekly by expert gynaecological pathologists and Dr Land in a multidisciplinary tumour board review meeting to ensure the highest possible standards of care are maintained.
If a cancer is confirmed usually a CT scan of the Chest / Abdomen and Pelvis is arranged along with a CA125 (tumour marker) to maximise our knowledge of any possible spread of the cancer away from the uterus to allow the best possible treatment to occur.
Frozen Section - what is it?
Dr Land will arrange a frozen section. This a special assessment by a pathologist performed while you are asleep during the procedure on the endometrial or uterine cancer and the result is telephoned through to Dr Land in theatre. This enables a tailor made procedure to be performed immediately (all in the one procedure) pending the intraoperative pathology result and your preoperative counselling with Dr Land i.e. what you and Dr Land have agreed upon that you wish to have done depending on results).
ALL TREATMENT DECISIONS WILL BE INDIVIDUALISED TO SUIT PATIENT NEEDS AND REQUIREMENTS.
How to treat it
Treatment depends on many factors including the type of cancer you have (there are in fact many different subtypes affecting the uterus – all of these behave differently and may require slightly different surgical approaches. Most cancers of the uterus will require removal of the uterus tubes and ovaries (hysterectomy and ovarian removal). Pending intraoperative findings including the frozen section result (assessing how much cancer and how deep it is invading the uterine wall) lymph node dissection and other staging biopsies may be required. Most of these can be successfully treated laparoscopically or robotically. If there is visible tumour spread away from the uterus the goal is to surgically resect all tumour to no residual.
Most patients do not require extra (adjuvant) treatment, but those that have high risk features on review of all pathology in our multidisciplinary tumour board or with spread away from the uterus noted at the time of surgery will generally be advised to have additional treatment which may consist of chemotherapy and or radiotherapy and or hormonal therapy. The majority of patients treated for uterine cancer are cured of their disease.
Dr Land will coordinate follow up after treatment is completed with 3 monthly reviews for 2 years then 6 monthly reviews for a further 3 years then usually annually thereafter. If you come from out of town alternate follow up arrangements can be made in conjunction with your local GP or gynaecologist.
Get in touch with us in Brisbane if you have any questions
If you are in need of any further information about the uterine – endometrial cancer treatment at our office in Brisbane, feel free to phone 07 3847 7879.