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diagnosis and radiation treatment of cancers of the cervix and uterus
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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: #
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