Cancer of the cervix or uterus

Understanding the disease Treatment options Side effects of treatment

Cross section anatomy of the female pelvis

Cross section anatomy of the female pelvis

rectum

CT Scans may be useful in showing cancer

1. Ovary, 2. Endometrial Cancer, 3. Uterus, 4. Urinary Bladder, 5.

Rectum, 6. Vagina

Endometrial cancer – adenocarcinoma of the lining of the uterus

Uterine cancer can spread to lymph nodes

Lymph Nodes

Guidelines for the use of radiation after a hysterectomy

Treatment of Endometrial cancer

For most stages surgery (hysterectomy) is performed and postOp radiation is indicated for high risk features:

•Deep muscle invasion (stage T1b or T1c)

•Involvement of cervix (stage T2)

•Spread to nodes, ovaries or tubes (Stage T3)

•High risk pathology: high grade, vascular invasion, serous or clear cell

Cancer of the cervix – squamous carcinoma (occasionally adenocarcinoma)

uterus

Cervix cancer

Cervix cancer stages

Treatment of cervix cancer

•Early stages: surgery (hysterectomy) with postOp radiation if high risk features (deep invasion, spread to nodes or other organs)

•More advanced cases: radiation +/- chemotherapy (cisplatin) then possibly surgery

CT scan is obtained at the time of simulation

CT images are then imported into the treatment planning computer

In the simulation process the CT and PET scan images are used to create a computer plan

In the treatment the lasers are used to line up the beam and the patient receives the radiation treatment

Radiation for advanced cervix cancer

Tomotherapy for Advanced Cervix Cancer

Radiation for gynecologic cancers

•External beam irradiation (daily for 5 weeks)

•Low dose radiation (LDR) Internal radiation (cesium implants, in hospital for 2-3 days

•High dose rate radiation (HDR) with Nucletron (Iridium) once a week for 3-5 weeks as an outpatient

Internal radiation devices

Radiation Fields and Side Effects

Pelvic field

Para-aortic

Node field

Side Effects of Pelvic RadiationRadiation fields

Radiation may hit the bowel causing some more bowel frequency, cramps, diarrhea and fatigue

Side Effects of Pelvic Radiation

Radiation fields

Radiation may hit the bladder and rectum causing urinary burning or frequency and rectal irritation

Patients may benefit from Imodium, cranberry juice, skin creams and rectal ointments

Radiation prescription for #

Diagnosis: #

External radiation: #

Internal radiation: #