Uterus Tumors
Conventional open surgery for uterine tumors involves a large incision (wound) to do this surgery. Laparoscopic Radical Hysterectomy is performed via small wounds which are tolerated much well by the patients. Laparoscopic or Laparoscopic cancer surgery has several advantages over conventional open surgery with the same cure rate. Only surgery is curative in most of the cancers. Additional therapies (chemotherapy & radiotherapy) are mostly supportive. However, many patients and their relatives try to avoid surgery for fear of the immense trauma for their loved ones, resulting in patients getting wrong or less effective treatment. With laparoscopy, the trauma is much less and makes the treatment more acceptable. The Team MACS, consisting of leading oncologists in India, addresses all these concerns precisely and works relentlessly for a better life.
Dr. Sandeep Nayak
MBBS, MRCSEd, DNB (Gen Surg),
MNAMS (Gen Surg), DNB (Surgical Oncology),
Fellowship in Laparoscopic and Robotic Onco-Surgery.
Dr Nayak is one of the leading senior Surgical Oncologists (cancer surgeon) of Bangalore. He is one of the pioneers of Laproscopic (laparoscopic) cancer treatment (surgery).
The Advantages Of Robotic & Laparoscopic Cancer Surgery Include
Least Pain and Discomfort
Less Blood Loss
Least Pain and Discomfort
Avoid Unnecessary Major Surgery
Quick Return to Normal Life and Work
Get All the Advantages of Robotic Surgery
Better Vision Quality for the Surgeon
Better Preservation of Pelivic Nerves maintaining the Sexual & Urinary Functions
Cosmetically better (Smallest Wound and Scars)
Least Wound Complications, Less Risk of Wound Infections After Colostomy.
What Is Cancer Of Uterus ?
The uterus or womb is muscular organ located in the lower part of women’s abdomen (tummy). Uterus has three parts; roof (fundus), body and lower part (cervix). Inner lining of uterus is called endometrium and this is surrounded by muscle layers.
Fibroids are the most common tumors of uterus. These are non-cancerous tumors arising from muscle layer and need surgery only is there are symptoms.
Cancer can arise from any layer of the uterus (endometrium or muscle). Cancers of endometrium (inner lining) occur in the fundus and body of uterus. These are usually low grade cancers with very good cure rate (low grade endometroid carcinoma). Higher grade cancers can occur in some cases. Rarely cancer can arise from the muscle of body of womb (sarcoma).
Symptoms And Diagnosis
Fibroid can cause irregular bleeding, pain, etc. Endometrial cancers is more common among the women who have gone through their menopause. The patients usually come with bleeding from vagina, particularly if through the menopause. If they haven’t yet been through the menopause, heavy bleeding during period or bleeding between periods would be suspicious. As bleeding is seen early in endometrial cancer, most of the cases are diagnosed early. Symptoms like weight loss, urinary symptoms, etc are seen only when the disease is advanced. Endometrial cancer is diagnosed by an endometrial biopsy.
The cancer of muscles of body of womb (sarcomas) can produce the above symptoms. Added to this the uterus usually grows large and produces pain in the lower part of belly. This can also lead to constipation.
Ultrasound and other scans can give an idea about the origin of the disease and can guide in performing biopsy when needed.
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Staging & Treatment
Stage I, II & III
Stage I endometrial cancer is contained within the womb or uterus. Stage II cancer is when it has involved the cervix of the uterus. In stage III cancer has spread to the tubes or ovary or to the tissue besides uterus (parametrium) or to the lymph nodes, but has not spread to distant organs.
Only treatment that can cure endometrial cancer is surgery. Total hysterectomy with lymph node dissection [removes the uterus along with the tubes and ovary, along with removal of pelvic (and some para-aortic) lymph nodes.] In high grade cases omentum (large apron-like fold of visceral peritoneum that hangs down from the stomach) is also removed to give better cure. Conventional open surgery involves a large incision (wound) to do this surgery. Laparoscopic Radical Hysterectomy is performed via small wounds which are tolerated much well by the patients. Sarcomas of uterus are also treated the same way. Further treatment like chemotherapy or radiotherapy is planned based on the results of microscopic examination of the tissues removed.
Stage II
Stage II cancer is larger than 7 centimeters and is within the kidney. Surgery to remove the entire affected kidney along with its covering tissue and lymph nodes (radical nephrectomy) are the treatment at this stage. Radical Nephrectomy can be performed by conventional open method or by laparoscopy. No further treatment (chemotherapy or radiation) is recommended. Five year survival in this group is about 70%.Stage III
Stage III cancer is when the cancer is spread to one or more of nearby lymph nodes or extends into the vein that drains the kidney or into the fat that surrounds the kidney. The size of the tumor has no relevance. Surgery to remove the entire affected kidney along with its covering tissue and lymph nodes are the treatment at this stage (Laparoscopic Radical nephrectomy).
When cancer extends in to vein, the major vein draining the lower half of the body (inferior vena cava) may have to be opened in order to clear the cancer from the vein. This surgery needs open surgery as blood vessel needs to be opened.
No further treatment (chemotherapy or radiation) is recommended after surgery. Five year survival in this group is about 50%.
Stage IV
Stage IV cancer has spread beyond the layer of fatty tissue around the kidney or to other organs, such as the lungs, liver, bones, or brain, and may have spread to far away lymph nodes. This stage is not curable. The most effective way to treat these patients is to remove the affected kidney in order to reduce the tumor load (cytoreductive nephrectomy) and followed by targeted therapy (chemotherapy tablets that act against specific receptors). This is only to reduce the symptoms due to disease. Five year survival in this group is about 8%. These tumors can be treated using laparoscopic surgery if the size of the tumor permits this.
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