Information for the patients:
The uterus is part of the reproductive system of women. It’s where a fetus develops during pregnancy.
The top part of your uterus is called the body or corpus. At the end of your uterus is your cervix, which connects your uterus to your vagina. Uterine cancer refers to cancer in the body of your uterus. Cancer in your cervix — cervical cancer — is a different type of cancer.
Endometrial cancer occurs when healthy uterine cells mutate or change. The abnormal cells multiply, grow and do not die like normal cells. If enough of them grow, they may form a tumor and spread to other tissues or other parts of the body around the uterus.
Uterine cancer can refer to either endometrial cancer or uterine sarcoma. But people often consider the terms “endometrial cancer” and “uterine cancer” the same. That’s because endometrial cancer makes up about 95% of all cases of uterine cancer. A diagnosis of uterine sarcoma is rare.
Endometrial cancer is the most common cancer affecting the reproductive system of women. Endometrial cancer mainly develops after menopause. About 3% of women will receive a diagnosis of uterine cancer at some point during their lives.
Endometrial cancer is often found at an early stage because it causes symptoms. Often the first symptom is irregular vaginal bleeding. If endometrial cancer is found early, surgically removing the uterus often cures it.
Symptoms of endometrial cancer may include:
Factors that increase the risk of endometrial cancer include:
If you develop any of the symptoms listed above, such as post-menopausal bleeding or abnormal vaginal discharge, a gynecologist may use one or more of these tests to establish the diagnosis:
If uterine cancer is diagnosed, your doctor will order additional tests to learn more about the type of cancer involved and to determine whether the cancer has spread beyond the uterus. This is known as staging, and may involve imaging studies such as:
Your health care team uses information from these tests and procedures to assign your cancer stage. Staging helps doctors make a prognosis and put together a personalized treatment plan.
Doctors develop a plan to treat endometrial cancer based on several factors, including your :
Most people with endometrial cancer need surgery. Other treatments you may have include:
Surgery:
Surgery is the most common first step in treating endometrial cancer. Your oncologist may recommend surgery to remove cancer cells or to determine the stage of the cancer and potential need for additional treatment, such as chemotherapy and/or radiation after surgery.
You’ll most likely have a hysterectomy, with the surgeon removing your uterus and cervix. There are four types of hysterectomy procedures:
During a hysterectomy, surgeons often perform two other procedures, as well:
During surgery, your surgeon also will inspect the areas around your uterus to look for signs that cancer has spread. Your surgeon also may remove lymph nodes for testing. This helps determine your cancer's stage.
Radiation therapy:
Radiation therapy uses high-energy radiation (like x-rays) to kill cancer cells. It can be given in 2 ways to treat endometrial cancer:
In brachytherapy, a doctor inserts a small, radiation-containing cylinder into the vagina, close to the uterus. While the cylinder remains in place (for ten or twenty minutes to several days), it emits radiation that destroys cancer cells. Multiple doses of brachytherapy may be necessary.
In some cases, both brachytherapy and external beam radiation therapy are used. When that's done, the external beam radiation is usually given first, followed by the brachytherapy. The stage and grade of the cancer are used to help decide what areas need to be treated with radiation therapy and which types of radiation are used.
Radiation is most often used after surgery to treat endometrial cancer. It can kill any cancer cells that may still be in the treated area. If your treatment plan includes radiation after surgery, you will be given time to heal before starting radiation.
Less often, radiation might be given before surgery to help shrink a tumor so it's easier to remove.
Women who are not healthy enough for surgery may get radiation as their main treatment.
Chemotherapy:
In chemotherapy, drugs are used to destroy or damage cancer cells. These drugs may be administered by mouth or injection.
These drugs go into the bloodstream and reach throughout the body. Because of this, chemo is often part of the treatment when endometrial cancer has spread beyond the endometrium to other parts of the body and surgery can't be done.
In most cases, a combination of chemo drugs is used. Combination chemotherapy tends to work better than one drug alone.
Chemo is often given in cycles: a period of treatment, followed by a rest period. The chemo drugs may be given on one or more days in each cycle.
Chemotherapy is sometimes used after surgery to lower the risk that the cancer might return. Chemotherapy also can be used before surgery to shrink the cancer. This makes it more likely that the cancer is removed completely during surgery.
Chemotherapy may be recommended for treating advanced endometrial cancer that has spread beyond the uterus or to treat cancer that has come back.
Hormone therapy:
Hormone therapy involves taking medicines to lower the hormone levels in the body. In response, cancer cells that rely on hormones to help them grow might die. Hormone therapy may be an option if you have advanced endometrial cancer that has spread beyond the uterus.
Targeted therapy:
Targeted therapy uses medicines that attack specific proteins or other components of cancer cells that are not found in noncancerous cells. By blocking these chemicals, targeted treatments can cause cancer cells to die. Targeted therapy is usually combined with chemotherapy for treating advanced endometrial cancer.
Immunotherapy:
Immunotherapy uses medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. For endometrial cancer, immunotherapy may be an option for women with advanced cancer that has come back after treatment.
The program includes:
Required documents
Price from: On request
Type of program: Outpatient
Expected duration of the program: 5 days
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The program includes:
How program is carried out
During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including complete blood count, laboratory assessment of liver and kidney function. Based on the received results, the physician will elaborate the chemotherapy regimen, conduct radiotherapy planning with the help of CT or MRI, make the permanent tattoo marks on the skin and conduct CT simulation in order to assess the accuracy of the rays and the radiation dose. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).
Chemotherapy and radiation therapy are carried out as the day hospital procedure, without mandatory admission to the hospital. At each visit, the physician will assess your general condition and the marks on the skin. After that, you will be placed in a shielded radiation therapy room, on a special table.
Each radiation therapy session lasts less than half an hour (including preparation). All this time, doctors and nurses are monitoring your condition, you can communicate with them through a loudspeaker. The procedure is completely painless. Depending on the planned course of treatment, you will visit the hospital from 1 to 3-5 times a week.
During the chemotherapy session, after the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.
After the completion of the chemotherapy and radiation therapy course, you will undergo control examinations aimed at assessing your condition and efficacy of treatment. After that you will receive the medical report with detailed recommendations regarding further follow-up and treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of treatment, if necessary.
The use of brachytherapy with types of implants may be called , wires, needles, capsules, balloons, or tubes. No matter which type of implant is used, it is placed in your body (transvaginal) , very close to or inside the tumor. This way the radiation harms as few normal cells as possible. The implant procedure is usually done in a hospital operating room designed to keep the radiation inside the room. You’ll get anesthesia, which may be either general (where drugs are used to put you into a deep sleep so that you don’t feel pain) or local (where part of your body is numbed). Imaging tests (an x-ray, ultrasound, MRI, or CT scan) are usually used during the procedure to find the exact place the implant needs to go. High-dose-rate (HDR) brachytherapy allows a person to be treated for several minutes at a time with a powerful radioactive source that’s put in the applicator. The source is removed after 10 to 20 minutes. This may be repeated twice a day over a few days, or once a day over the course of a few weeks. The radioactive material is not left in your body. The applicator might be left in place between treatments, or it might be put in before each treatment. If your implant is held in place by an applicator, you may have some discomfort in that area.
Required documents
Price from: on request
Type of program: Outpatient
Expected duration of the program: 39 days
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The program includes:
Required documents
Price from: on request
Type of program: Inpatient
Expected duration of the program: 8-10 days
___________________________________________________________________________
4- chemotherapy or immunotherapy:
The program includes:
How program is carried out
During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests. After that, you will undergo an additional examination, including laboratory assessment of liver and kidney function. Based on the received results, the doctor will elaborate the chemotherapy regimen. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).
Chemotherapy is carried out as outpatient according to chemotherapy protocol type. After the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.
After the course of chemotherapy, you will stay under medical supervision in the ward for a few more hours. After the completion of the chemotherapy course and control examinations you will receive the medical report with detailed recommendations regarding further treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of chemotherapy, if necessary.
Required documents
Price from: On request (regarding chemotherapy protocol)
Type of program: outpatient
Expected duration of the program: from 1 to 4 days per cycle (regarding chemotherapy protocol)
مؤسسة شفا الأورمان المُشهره بوزارة التضامن الاجتماعي برقم 5859 لسنة 2016
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