At the University of Florida, gynecologic cancer is managed with a team approach involving close interaction between a gynecologic surgical oncologist and a radiation oncologist who specializes in radiation therapy for gynecologic cancer.
Radiation Therapy for Gynecologic Cancers – An Overview in English
Before a treatment plan is recommended, most cases are discussed at a conference by a group of medical specialists with expertise in the diagnosis and management of gynecologic cancer. This type of conference is called a multidisciplinary tumor board. The gynecologic tumor board includes a gynecologic surgical oncologist, a gynecologic radiation oncologist, a specialist in pelvic and abdominal imaging from diagnostic radiology, a gynecologic pathologist, a nurse oncology specialist, and a social worker.
Radiation Therapy for Gynecologic Cancers – An Overview in Spanish
Cervix
The treatment approach for cancer of the uterine cervix usually depends on the size of the tumor, the location of the tumor relative to other pelvic tissues (like bladder, rectum, and pelvic side wall). The size and location of a cervix cancer is often described by a system called the FIGO staging system. Small cervix cancers (small FIGO stage IB) that develop in healthy patients are usually treated surgically with an operation called a radical hysterectomy. After the operation the uterus and other tissues are examined under a microscope by a pathologist. If microscopic examination suggests that the patient is at high risk for cancer recurrence, radiation therapy is usually recommended. Radiation therapy in this setting usually involves 5 weeks of external beam radiation therapy (treatments given 5 days per week).
Moderately advanced cervix cancers (FIGO stage IB, II, or III) are usually treated with a combination of radiation therapy and chemotherapy (medication that helps to cure the cancer). Chemotherapy is usually given as an intravenous injection every week during radiotherapy. In most cases the radiation therapy involves 5 weeks of external beam radiotherapy (treatments given 5 days per week) followed by 5 internal implantation radiation therapy treatments with tandem and ring applicators. The internal radiation treatments are usually scheduled twice a week. Each internal treatment involves getting a pelvic MRI to guide the planning of the internal radiation. The entire internal radiation procedure lasts about 3 hours. Therefore, radiation therapy for this stage of cervix cancer usually takes a total of 8 to 9 weeks to complete both external beam and internal implantation portions of the radiotherapy program.
Uterus
Cancer of the uterus is usually treated with surgery (a hysterectomy). The need for radiotherapy depends on multiple factors such as the health of the patient, the growth pattern of the cancer, the extent of the cancer in the uterus, and the presence of cancer in pelvic lymph nodes. When radiation therapy is necessary after a hysterectomy, most patients are treated with 4 internal radiotherapy implantation treatments to the vagina. Internal implantation treatments are usually done twice a week for 2-3 consecutive weeks. Each internal radiation session takes about 45 minutes. Some patients with stage II or III cancer of the uterus require external beam radiation therapy given over about 5 weeks (treatments given 5 days per week).
Vagina
Very small tumors of the vagina may be treated with either surgery or radiation therapy. In most cases radiation therapy is the best treatment because the surgical procedure that would be needed to cure the cancer would require removal of too much normal tissue. The radiation therapy program for vaginal cancer usually involves 5 weeks of external beam radiation treatments (treatments given 5 days per week) followed a few weeks later by a 3 day radiation treatment with internal implantation. Patients go to the operating room with anesthesia for the internal implantation procedure. The basic implantation technique usually involves inserting multiple needles into the area of the vagina involved with cancer. Radioactive wires are then placed in the needles to deliver radiation treatments. Patients stay in a private hospital room for the 3 days of internal implantation therapy.
