Cancer of Uterus

Cancer of uterus

A hysterectomy is a surgical removal of a woman's uterus. In endometrial cancer, the surgery usually involves the removal of the ovaries and fallopian tubes (bilateral salpingo-oophorectomy). A pelvic and para-aortic lymph node biopsy may also be done to assess the stage and grade of the cancer. Luckily, the majority of endometrial cancer cases are diagnosed early when the condition is still localized in the uterus and can be treated successfully.

Types of Hysterectomy for Endometrial Cancer

The degree of surgery varies with the extent of the cancer and its effect on the reproductive system:

• Total Hysterectomy – Uterus and cervix removal.
• Total Hysterectomy with Bilateral Salpingo-Oophorectomy – Uterus, cervix, fallopian tubes, and ovaries are removed. It is the most used operation to treat endometrial cancer.
• Radical Hysterectomy – Uterus, cervix, surrounding tissues, upper vagina, and often the pelvic lymph nodes are removed. Depending on the spread of the cancer, lymph nodes removed may vary.

Surgical Methods

Hysterectomy to treat endometrial cancer may be done by various surgical methods:

Abdominal Hysterectomy

• The uterus, ovaries, and fallopian tubes are removed via an abdominal incision (laparotomy).
• It gives a good view of the organs, making it easy to check for cancer spread.
• It leaves a visible abdominal scar (usually about five inches long).
• The average hospital stay is about three days.

Laparoscopic Hysterectomy

• It is a minimally invasive procedure, which involves small cuts in the abdominal area, through which a small camera and specific instruments are placed.
• The extent of cancer can be evaluated by the surgeon with reduced tissue disruption, if any.
• It causes minimal scarring and generally facilitates a faster recovery.
• Hospital stay can range from one to two days, and some patients can be discharged on the day of the procedure.
• In some instances, robotic-assisted laparoscopy is employed, whereby the surgeon manipulates robotic arms for better accuracy.

Post-Surgical Expectations

Patients are observed in a recovery area after the procedure for one to four hours before being taken to a hospital room. Hospital stay is usually one to four days. Instructions for post-operative care will be given by nurses to support recovery.

A follow-up visit is typically booked four to six weeks after surgery. Most patients can also go back to regular activities, such as sexual intercourse, within six to eight weeks. Spotting or early light bleeding for a period of six weeks is normal, but heavy or strange bleeding must be reported to a medical professional.

When to Call a doctor

Call a doctor immediately if you notice any of the following:

• Pain in the chest, cough that lasts, or shortness of breath
• Red vaginal bleeding that soaks over two pads an hour or the presence of large clots
• Leg swelling, pain, or redness
• Temperature greater than 100.4°F (38°C)
• Persistent pain despite medication
• Pus or abnormal discharge from the incision site
• Bowel movement difficulty lasting over three to five days
• Pain or burning when urinating, blood in urine, or cloudy urine
• Painful, uncomfortable, or bleeding intercourse
• Hot flashes, flushing, sweating, or fast heartbeat

Purpose of Hysterectomy for Endometrial Cancer

Endometrial cancer begins in the inner lining of the uterus and frequently remains within the uterus in its early form. Removal of the uterus by surgery drastically lowers the chances of cancer occurring again or spreading. Because the ovaries are an usual location for metastases, the ovaries are usually also taken out as a means of stopping cancer cells from spreading.

Hysterectomy is a serious procedure for the treatment of endometrial cancer, and the surgical method is determined by several factors such as the stage of the disease, general health, and the skill of the surgical team. A consultation with a specialist ensures optimal treatment strategy based on personal requirements.

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