Treatment and care of people with cancer is usually provided by a team of health professionals, both medical and allied health, called a multidisciplinary team.
Treatment for uterine sarcoma depends on:
- the type of uterine sarcoma
- where it is in the body
- whether the cancer has spread, and where it has spread to
- your general health
- your personal preferences.
Treatment options can include surgery, chemotherapy, radiation therapy and hormone therapy.
Surgery
Uterine sarcoma is usually treated with surgery to remove the uterus, cervix, fallopian tubes or ovaries, and sometimes lymph nodes as well. Your doctor will discuss what type of surgery might be best for you.
Uterine sarcoma may be diagnosed, staged and treated in the same surgery. During this surgery, the doctor removes as much of the cancer as possible.
Hysterectomy and bilateral salpingo-oophorectomy
A hysterectomy is the surgical removal of the uterus and cervix. Your doctor may also remove part of your vagina, called a radical hysterectomy.
In most cases, the fallopian tubes and ovaries are also removed – this is called a bilateral salpingooophorectomy. The ovaries are removed either because the cancer may have spread to the ovaries, or because the ovaries produce oestrogen, a hormone that may cause the cancer to grow.
The operation can be either:
- open surgery, where a large cut is made in your belly
- laparoscopic surgery (also called keyhole surgery), where several small cuts are made in your belly and a thin telescope is used to see inside. Your uterus and any other organs will be taken out through your vagina.
Surgery can affect your ability to have children (see Effects of treatment on fertility).
Lymph node removal
Lymph nodes (also called lymph glands) are small, bean-shaped organs that are part of the lymphatic system in your body. There are major lymph nodes in the neck, armpits, groin and abdomen. The lymphatic system is an important part of the immune system.
Your doctor may discuss the need to remove some of the lymph nodes in your pelvic region, to make sure the cancer doesn’t spread further. Surgically removing your lymph nodes is called a lymphadenectomy.
Lymph node removal is not recommended for all women. If cancer is found in the lymph nodes, your doctor may advise more therapy, called adjuvant therapy.
Chemotherapy
Chemotherapy uses drugs to destroy cancer cells or slow their growth, and may involve a number of treatments (‘cycles’) over several months.
If you are premenopausal and have not had a hysterectomy or bilateral salpingo-oophorectomy, you should avoid getting pregnant during your chemotherapy because it can harm your unborn baby. If you become pregnant during treatment, talk to your doctor urgently.
Radiation therapy
Radiation therapy uses high-energy X-rays to kill cancer cells. It is often used after surgery to destroy any remaining cancer cells and reduce the risk of the cancer coming back.
You might have radiation therapy to your pelvic area to treat uterine sarcoma. Radiation therapy may also be recommended if the cancer has come back or spread, or, very rarely, if you are not well enough for a major operation.
If you are premenopausal and have not had a hysterectomy or bilateral salpingo-oophorectomy, you should avoid getting pregnant during your during your radiation therapy because it can harm your unborn baby. If you become pregnant during treatment, talk to your doctor urgently.
Hormone therapy
Hormones are produced by glands in the body and circulate in the bloodstream. Some cancers of the uterus depend on hormones (such as oestrogen) for their growth. Progesterone is a common hormone therapy used to treat uterine sarcoma.
Recurrent or advanced disease
Recurrent uterine sarcoma is cancer that has recurred (come back) after it has been treated. It grows back from the cells of the original primary cancer that have not responded to treatment. Secondary cancer, or metastasis, is cancer that has spread from the original site to another part of the body.
Uterine sarcoma may come back in the uterus or in other parts of the body.
The treatment options for recurrent uterine sarcoma are the same as for primary uterine sarcoma.
