Uterine Cancer (cont.)
Staging
If uterine cancer is diagnosed, the doctor needs to know the stage, or
extent, of the disease to plan the best treatment. Staging is a careful attempt
to find out whether the cancer has spread, and if so, to what parts of the body.
The doctor may order blood and urine tests and chest x-rays. The woman also
may have other x-rays, CT scans, an ultrasound test, magnetic resonance imaging
(MRI), sigmoidoscopy, or colonoscopy.
In most cases, the most reliable way to stage this disease is to remove the
uterus (hysterectomy). (The description of surgery in the "Methods of Treatment" section has more information.) After the uterus has been removed, the surgeon
can look for obvious signs that the cancer has invaded the muscle of the uterus.
The surgeon also can check the lymph nodes and other organs in the pelvic area
for signs of cancer. A pathologist uses a microscope to examine the uterus and
other tissues removed by the surgeon.
These are the main features of each stage of the disease:
- Stage I -- The cancer is only in the body of the uterus. It is not in the
cervix.
- Stage II -- The cancer has spread from the body of the uterus to the cervix.
- Stage III -- The cancer has spread outside the uterus, but not outside the
pelvis (and not to the bladder or rectum). Lymph nodes in the pelvis may contain
cancer cells.
- Stage IV -- The cancer has spread into the bladder or rectum. Or it has
spread beyond the pelvis to other body parts.
Treatment
Many women want to take an active part in making decisions about their
medical care. They want to learn all they can about their disease and their
treatment choices. However, the shock and stress that people may feel after a
diagnosis of cancer can make it hard for them to think of everything they want
to ask the doctor. It often helps to make a list of questions before an
appointment. To help remember what the doctor says, patients may take notes or
ask whether they may use a tape recorder. Some women also want to have a family
member or friend with them when they talk to the doctor -- to take part in the
discussion, to take notes, or just to listen.
The patient's doctor may refer her to doctors who specialize in treating
cancer, or she may ask for a referral. Treatment generally begins within a few
weeks after the diagnosis. There will be time for the woman to talk with the
doctor about her treatment choices, get a second opinion, and learn more about
uterine cancer.
Getting a second opinion
Before starting treatment, a woman might want a second opinion about the
diagnosis, the stage of cancer, and the treatment plan. Some insurance companies
require a second opinion; others may cover a second opinion if the woman
requests it. Gathering medical records and arranging to see another doctor may
take a little time. In most cases, a brief delay does not make treatment less
effective.
There are a number of ways to find a doctor for a second opinion:
- The patient's doctor may refer her to one or more specialists. Specialists
who treat women with uterine cancer include surgeons, gynecologic oncologists,
medical oncologists, and radiation oncologists. At cancer centers, these doctors
often work together as a team.
- The Cancer Information Service, at 1-800-4-CANCER, can tell callers about
treatment facilities, including cancer centers and other programs supported by
the National Cancer Institute.
- People can get the names of specialists from their local medical society, a
nearby hospital, or a medical school.
- The American Board of Medical Specialties (ABMS) has a list of doctors who
have met certain education and training requirements and have passed specialty
examinations. The Official ABMS Directory of Board Certified Medical Specialists
lists doctors' names along with their specialty and their educational
background. The directory is available in most public libraries. Also, ABMS
offers this information on the Internet at http://www.abms.org. (Click on "Who's
Certified.")
Preparing for treatment
The choice of treatment depends on the size of the tumor, the stage of the
disease, whether female hormones affect tumor growth, and the tumor grade. (The
grade tells how closely the cancer cells resemble normal cells and suggests how
fast the cancer is likely to grow. Low-grade cancers are likely to grow and
spread more slowly than high-grade cancers.) The doctor also considers other
factors, including the woman's age and general health.
These are some questions a woman may want to ask the doctor:
- What kind of
uterine cancer do I have?
- Has the cancer spread? What is the stage of the disease?
- Do I need any more tests to check for spread of the disease?
- What is the grade of the tumor?
- What are my treatment choices? Which do you recommend for me? Why?
- What are the expected benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment?
- What is the treatment likely to cost?
- How will treatment affect my normal activities?
- How often should I have checkups?
- Would a clinical trial (research study) be appropriate for me?
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Women do not need to ask all their questions or understand all the answers at
once. They will have other chances to ask the doctor to explain things that are
not clear and to ask for more information.
Next: Methods of treatment »
- medroxyprogesterone, Provera, Depo-Provera, Depo-Sub Q Provera 104 - Explains the medication medroxyprogesterone (Provera, Cycrin, Depo-Provera, Deop-Sub Q Provera 104), a drug used used to treat abnormal uterine bleeding, contraception, and for treating endometrial or renal cancer.
- CT Scan (Computerized Axial Tomography) - CT Scan (Computerized Axial Tomography, CAT scan) is a procedure that assists in diagnosing tumors, fractures, bony structures, and infections in the organs and tissues of the body.
- Endometriosis - Lern about endometriosis symptoms like pelvic pain, infertility, diarrhea, constipation, lower back pain, abdominal pain, irregular or heavy menstrual bleeding, and even blood in the urine.
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