[MOL] Re: Sherry/Res/ [00325] Medicine On Line


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[MOL] Re: Sherry/Res/



Sherry, I have included everything I could find to help you in your decision
making process.  Know that we are here for you in anyway possible.  Your friend,
Lillian

What is sarcoma of the uterus?

Sarcoma of the uterus, a very rare kind of cancer in women, is a disease in
which cancer (malignant)
cells start growing in the muscles or other supporting tissues of the uterus.
The uterus is the hollow,
pear-shaped organ where a baby grows. Sarcoma of the uterus is different from
cancer of the
endometrium, a disease in which cancer cells start growing in the lining of the
uterus (see the PDQ
summary on cancer of the endometrium for information on that disease).

Women who have received therapy with high-dose x-rays (external beam radiation
therapy) to their
pelvis are at a higher risk to develop sarcoma of the uterus. These x-rays are
sometimes given to
women to stop bleeding from the uterus.

A doctor should be seen if there is bleeding after menopause (the time when a
woman no longer has
menstrual periods) or bleeding that is not part of menstrual periods. Sarcoma of
the uterus usually
begins after menopause.

If there are signs of cancer, a doctor will do certain tests to check for
cancer, usually beginning with
an internal (pelvic) examination. During the examination, the doctor will feel
for any lumps or changes
in the shapes of the pelvic organs. The doctor may then do a Pap test, using a
piece of cotton, a
small wooden stick, or brush to gently scrape the outside of the cervix (the
opening of the uterus)
and the vagina to pick up cells. Because sarcoma of the uterus begins inside,
this cancer will not
usually show up on the Pap test. The doctor may also do a dilation and curettage
(D & C) by
stretching the cervix and inserting a small, spoon-shaped instrument into the
uterus to remove pieces
of the lining of the uterus. This tissue is then checked under a microscope for
cancer cells.

The prognosis (chance of recovery) and choice of treatment depend on the stage
of the sarcoma
(whether it is just in the uterus or has spread to other places), how fast the
tumor cells are growing,
and the patient's general state of health.



STAGE EXPLANATION


Stages of sarcoma of the uterus

Once sarcoma of the uterus has been found, more tests will be done to find out
if the cancer has
spread from the uterus to other parts of the body (staging). A doctor needs to
know the stage of the
disease to plan treatment. The following stages are used for sarcoma of the
uterus:


Stage I

Cancer is found only in the main part of the uterus (it is not found in the
cervix).


Stage II

Cancer cells have spread to the cervix.


Stage III

Cancer cells have spread outside the uterus but have not spread outside the
pelvis.


Stage IV

Cancer cells have spread beyond the pelvis, to other body parts, or into the
lining of the bladder (the
sac that holds urine) or rectum.


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has
been treated.



TREATMENT OPTION OVERVIEW


How sarcoma of the uterus is treated

There are treatments for all patients with sarcoma of the uterus. Four kinds of
treatment are used:

     surgery (taking out the cancer in an operation)
     radiation therapy (using high-dose x-rays or other high-energy rays to kill
cancer cells and
     shrink tumors)
     chemotherapy (using drugs to kill cancer cells)
     hormone therapy (using female hormones to kill cancer cells)

Surgery is the most common treatment of sarcoma of the uterus. A doctor may take
out the cancer
in an operation to remove the uterus, fallopian tubes and the ovaries, along
with some lymph nodes in
the pelvis and around the aorta (the main vessel in which blood passes away from
the heart). The
operation is called a total abdominal hysterectomy, bilateral
salpingo-oophorectomy, and
lymphadenectomy. (The lymph nodes are small bean-shaped structures that are
found throughout the
body. They produce and store infection-fighting cells, but may contain cancer
cells.)

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and
shrink tumors.
Radiation therapy for sarcoma of the uterus usually comes from a machine outside
the body (external
radiation). Radiation may be used alone or in addition to surgery.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill,
or it may be put
into the body by a needle in a vein or a muscle. Chemotherapy is called a
systemic treatment
because the drugs enter the bloodstream, travel through the body, and can kill
cancer cells outside
the uterus.

Hormone therapy uses female hormones, usually taken by pill, to kill cancer
cells.


Treatment by stage

Treatment of sarcoma of the uterus depends on the stage and cell type of the
disease, and the
patient's age and overall condition.

Standard treatment may be considered because of its effectiveness in patients in
past studies, or
participation in a clinical trial may be considered. Not all patients are cured
with standard therapy
and some standard treatments may have more side effects than are desired. For
these reasons,
clinical trials are designed to find better ways to treat cancer patients and
are based on the most
up-to-date information. Clinical trials are ongoing in most parts of the country
for most stages of
sarcoma of the uterus. To learn more about clinical trials, call the Cancer
Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.



STAGE I UTERINE SARCOMA

Treatment may be one of the following:

     1. Surgery to remove the uterus, fallopian tubes and the ovaries, and some
of the lymph nodes
     in the pelvis and abdomen (total abdominal hysterectomy, bilateral
salpingo-oophorectomy,
     and lymph node dissection).

     2. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph
node
     dissection, followed by radiation therapy to the pelvis.

     3. Surgery followed by chemotherapy.

     4. Surgery followed by radiation therapy.



STAGE II UTERINE SARCOMA

Treatment may be one of the following:

     1. Surgery to remove the uterus, fallopian tubes and the ovaries, and some
of the lymph nodes
     in the pelvis and abdomen (total abdominal hysterectomy, bilateral
salpingo-oophorectomy,
     and lymph node dissection).

     2. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph
node
     dissection, followed by radiation therapy to the pelvis.

     3. Surgery followed by chemotherapy.

     4. Surgery followed by radiation therapy.



STAGE III UTERINE SARCOMA

Treatment may be one of the following:

     1. Surgery to remove the uterus, fallopian tubes and the ovaries, and some
of the lymph nodes
     in the pelvis and abdomen (total abdominal hysterectomy bilateral
salpingo-oophorectomy,
     and lymph node dissection). Doctors will also try to remove as much of the
cancer that has
     spread to nearby tissues as possible.

     2. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph
node
     dissection, followed by radiation therapy to the pelvis.

     3. Surgery followed by chemotherapy.



STAGE IV UTERINE SARCOMA
Treatment will usually be a clinical trial using chemotherapy.



RECURRENT UTERINE SARCOMA

If the cancer has come back (recurred), treatment may be one of the following:

     1. Clinical trials of chemotherapy or hormone therapy.

     2. External radiation therapy to relieve symptoms such as pain, nausea, or
     abnormal bowel functions.



TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER
What is cancer of the vagina?

Cancer of the vagina, a rare kind of cancer in women, is a disease in which
cancer (malignant) cells
are found in the tissues of the vagina. The vagina is the passageway through
which fluid passes out of
the body during menstrual periods and through which a woman has babies. It is
also called the "birth
canal." The vagina connects the cervix (the opening of the womb or uterus) and
the vulva (the folds
of skin around the opening to the vagina).

There are two types of cancer of the vagina: squamous cell cancer (squamous
carcinoma) and
adenocarcinoma. Squamous carcinoma is usually found in women between the ages of
60 and 80.
Adenocarcinoma is more often found in women between the ages of 12 and 30.

Young women whose mothers took DES (diethylstilbestrol) are at risk for getting
tumors in their
vaginas. Some of them get a rare form of cancer called clear cell
adenocarcinoma. The drug DES
was given to pregnant women between 1945 and 1970 to keep them from losing their
babies
(miscarriage).

A doctor should be seen if there are any of the following: bleeding or discharge
not related to
menstrual periods, difficult or painful urination, and pain during intercourse
or in the pelvic area. Also,
there is still a chance of developing vaginal cancer in women who have had a
hysterectomy.

A doctor may use several tests to see if there is cancer. The doctor will
usually begin by giving the
patient an internal (pelvic) examination. The doctor will feel for lumps and
will then do a Pap smear.
Using a piece of cotton, a brush, or a small wooden stick, the doctor will
gently scrape the outside of
the cervix and vagina in order to pick up cells. Some pressure may be felt, but
usually with no pain.

If cells that are not normal are found, the doctor will need to cut a small
sample of tissue (called a
biopsy) out of the vagina and look at it under a microscope to see if there are
any cancer cells. The
doctor should look not only at the vagina, but also at the other organs in the
pelvis to see where the
cancer started and where it may have spread. The doctor may take an x-ray of the
chest to make
sure the cancer has not spread to the lungs.

The chance of recovery (prognosis) and choice of treatment depend on the stage
of the cancer
(whether it is just in the vagina or has spread to other places) and the
patient's general state of health.



STAGE EXPLANATION


Stages of cancer of the vagina

Once cancer of the vagina has been found (diagnosed), more tests will be done to
find out if the
cancer has spread from the vagina to other parts of the body (staging). A doctor
needs to know the
stage of the disease to plan treatment. The following stages are used for cancer
of the vagina:


Stage 0 or carcinoma in situ

Stage 0 cancer of the vagina is a very early cancer. The cancer is found inside
the vagina only and is
in only a few layers of cells.


Stage I

Cancer is found in the vagina, but has not spread outside of it.


Stage II

Cancer has spread to the tissues just outside the vagina, but has not gone to
the bones of the pelvis.


Stage III

Cancer has spread to the bones of the pelvis. Cancer cells may also have spread
to other organs and
the lymph nodes in the pelvis. (Lymph nodes are small bean-shaped structures
that are found
throughout the body. They produce and store cells that fight infection.)


Stage IVA

Cancer has spread into the bladder or rectum.


Stage IVB

Cancer has spread to other parts of the body, such as the lungs.


Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may
come back in the vagina or in another place.



TREATMENT OPTION OVERVIEW


How cancer of the vagina is treated

Treatments are available for all patients with cancer of the vagina. There are
three kinds of treatment:

     surgery (taking out the cancer in an operation)
     radiation therapy (using high-dose x-rays or other high-energy rays to kill
cancer cells and
     shrink tumors)
     chemotherapy (using drugs to kill cancer cells)

Surgery is the most common treatment of all stages of cancer of the vagina. A
doctor may take out
the cancer using one of the following:

     Laser surgery uses a narrow beam of light to kill cancer cells and is
useful for stage 0 cancer.
     Wide local excision takes out the cancer and some of the tissue around it.
A patient may need
     to have skin taken from another part of the body (grafted) to repair the
vagina after the cancer
     has been taken out.
     An operation in which the vagina is removed (vaginectomy) is sometimes
done. When the
     cancer has spread outside the vagina, vaginectomy may be combined with
surgery to take out
     the uterus, ovaries, and fallopian tubes (radical hysterectomy). During
these operations, lymph
     nodes in the pelvis may also be removed (lymph node dissection).
     If the cancer has spread outside the vagina and the other female organs,
the doctor may take
     out the lower colon, rectum, or bladder (depending on where the cancer has
spread) along
     with the cervix, uterus, and vagina (exenteration).
     A patient may need skin grafts and plastic surgery to make an artificial
vagina after these
     operations.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and
shrink tumors.
Radiation may come from a machine outside the body (external radiation) or from
putting materials
that produce radiation (radioisotopes) through thin plastic tubes into the area
where the cancer cells
are found (internal radiation). Radiation may be used alone or after surgery.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill,
or it may be put
into the body by a needle in a vein. Chemotherapy is called a systemic treatment
because the drugs
enter the bloodstream, travel through the body, and can kill cancer cells
outside the vagina. In
treating vaginal cancer, chemotherapy may also be put directly into the vagina
itself, which is called
intravaginal chemotherapy.


Treatment by stage

Treatment of cancer of the vagina depends on the stage of the disease, the type
of disease, and the
patient's age and overall condition.

Standard treatment may be considered because of its effectiveness in patients in
past studies, or
participation in a clinical trial may be considered. Not all patients are cured
with standard therapy
and some standard treatments may have more side effects than are desired. For
these reasons,
clinical trials are designed to find better ways to treat cancer patients and
are based on the most
up-to-date information. Clinical trials are ongoing in most parts of the country
for most stages of
cancer of the vagina. To learn more about clinical trials, call the Cancer
Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.



STAGE 0 VAGINAL CANCER

Treatment may be one of the following:

     1. Surgery to remove all or part of the vagina (vaginectomy). This may be
followed by skin
     grafting to repair damage done to the vagina.

     2. Internal radiation therapy.

     3. Laser surgery.

     4. Intravaginal chemotherapy.



STAGE I VAGINAL CANCER

Treatment of stage I cancer of the vagina depends on whether a patient has
squamous cell cancer or
adenocarcinoma.

If squamous cancer is found, treatment may be one of the following:

     1. Internal radiation therapy with or without external beam radiation
therapy.

     2. Wide local excision. This may be followed by the rebuilding of the
vagina. Radiation
     therapy following surgery may also be performed in some cases.

     3. Surgery to remove the vagina with or without lymph nodes in the pelvic
area (vaginectomy
     and lymph node dissection).

If adenocarcinoma is found, treatment may be one of the following:

     1. Surgery to remove the vagina (vaginectomy) and the uterus, ovaries, and
fallopian tubes
     (hysterectomy). The lymph nodes in the pelvis are also removed (lymph node
dissection). This
     may be followed by the rebuilding of the vagina. Radiation therapy
following surgery may also
     be performed in some cases.

     2. Internal radiation therapy with or without external beam radiation
therapy.

     3. In selected patients, wide local excision and removal of some of the
lymph nodes in the
     pelvis followed by internal radiation.



STAGE II VAGINAL CANCER

Treatment of stage II cancer of the vagina is the same whether a patient has
squamous cell cancer or
adenocarcinoma.

Treatment may be one of the following:

     1. Combined internal and external radiation therapy.

     2. Surgery, which may be followed by radiation therapy.



STAGE III VAGINAL CANCER

Treatment of stage III cancer of the vagina is the same whether a patient has
squamous cell cancer
or adenocarcinoma.

Treatment may be one of the following:

     1. Combined internal and external radiation therapy.

     2. Surgery may sometimes be combined with radiation therapy.



STAGE IVA VAGINAL CANCER

Treatment of stage IVA cancer of the vagina is the same whether a patient has
squamous cell cancer
or adenocarcinoma.





pink wrote:

> I WOULD LIKE TO SPEAK TO ANY PATIENTS WHO HAVE HAD UTERINE CANCER WHICH HAS
> SPREAD TO THE VAGINAL APEX REGION AND THE TREATMENTS THEY HAVE
> RECEIVED.....I HAD MY UTERUS REMOVED...HAD 25 RADIATION TREATMENTS AND 7
> MOS. LATER FOUND OUT I HAD ANOTHER TUMOR IN THE VAGINAL APEX...THEY ARE
> RECOMMENDING A EXENTERATION AND WOULD LIKE TO KNOW IF THERE ARE ANY
> SURGEONS OUT THERE WHO HAVE EVER REMOVED THE TUMOR WITH OUT REMOVING THE
> BLADDER AND INTESTINES, ETC....MRS. GARCIA
>
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