Treatment of endometrial cancer of the uterus: chemotherapy, recommendations after surgery

Methods for treating endometrial cancer, as well as the results of therapy, depend on the stage at which the disease was detected. Even during the diagnosis, physicians study all the information about the problem: determine the location of the pathological focus, its type, prevalence and degree of aggression. After that, several doctors (a consultation) constitute an individual regimen of therapy.

If endometrial cancer is detected at an early stage of development, it is most often resorted to a surgical stopping of the disease process, with the further appointment of radiation treatment (sometimes in combination with brachytherapy). Radiotherapy can reduce the risk of oncology re-development. The term "brachytherapy" refers to a type of radiotherapy, in which radiation is delivered directly to the affected tissues of an organ - to a tumor focus.

If at the time of diagnosis the cancer process has already spread to nearby tissues and organs, then it is necessary to resort to resection of the uterus and appendages, with the further prescription of chemotherapy drugs and radiation treatment.

With the intensive spread of a cancer (for example, in vital organs, bones), when the operation is extremely difficult or impossible, supportive treatment is prescribed, the purpose of which is to stop the development of the disease process and prolong the life of the woman. Most often in such situations chemotherapy, hormones, immunotherapy are prescribed. Conservative treatment can be supplemented by radiation exposure.

Clinical guidelines

There are a number of clinical guidelines that are relevant for the treatment of endometrial cancer.

Chemotherapy.

Due to the relatively weak overall effect of the use of chemotherapy in endometrial cancer, it is impossible to determine the optimal scheme for this type of treatment. Most often, these drugs are used in the form of mono or polytherapy.

Monotherapy provides such appointments:

• intravenous drip of gemcitabine in the amount of 1250 mg / m² for half an hour (first, eighth and fifteenth days, repeat administration after a week);
• intravenous drip of doxorubicin in the amount of 60 mg / m² once in 21 days (from four to six courses);
• intravenous drip cisplatin in the amount of 100 mg / m² once in 21 days (from four to six courses);
• intravenous drip of epirubicin in the amount of 75-100 mg / m² once in 21 days (from four to six courses).
• The number of courses of polytherapy is assigned individually:
• intravenous drip of doxorubicin 50 mg / m² once every 28 days;
• 500 mg / m² cyclophosphamide intravenous drip once every 28 days, 500 mg / m² fluorouracil once every 28 days, or 50 mg / m² cisplatin, 30 mg / m² doxorubicin (first and eighth days), fluorouracil 400 mg / m² (first and eighth days), cyclophosphamide 400 mg / m² (first and eighth days - the course is repeated every 28 days), or doxorubicin 50 mg / m² once every 21 days;
• drip cisplatin 100 mg / m² once every 21 days.

Hormone Therapy for Endometrial Cancer

The appointment of hormonal drugs to avoid recurrence and metastasis is not practiced in all cases of endometrial cancer. The generalized process may require the following assignments:

• intramuscular injections of gestonoron caproate, 200 mg weekly, for a long time, or oral megestrol from 160 to 320 mg per day for at least two months, or medroxyprogesterone orally, 200-800 mg per day for ten weeks (after which, intake of 200-800 mg twice a week for a long time).

The dynamics of the effects of chemotherapy are determined by the following criteria:

• the degree of reduction of the diameters of the primary or recurrent focus;
• disappearance or reduction of diameters of metastatic foci.

The basic criterion is also the relief of the general well-being of patients, the disappearance of symptoms, the improvement of the quality of life and the increase in its duration.

Modern anti-cancer drugs can act in several directions at once, so they are usually used in a complex way. The usual treatment regimen may combine drugs that destroy cancer cells, as well as agents that inhibit tumor growth and prevent the formation of new malignant structures.

In the later stages of the disease, analgesics are almost always necessary, as well as various symptomatic drugs.

The basic chemotherapeutic drugs are those groups of drugs:

• Alkylating agents that destroy proteins involved in the formation of the DNA of malignant structures (a typical representative is cyclophosphamide).
• Platinum drugs are toxic cytostatic drugs that also destroy the DNA of malignant cells.
• Antimetabolite drugs - alter the cellular genetic mechanism, making cell division impossible (a typical representative is gemcitabine).
• Anthracyclines - form substances that can damage the DNA of the affected structures (a typical representative is daunorubicin).
• Taxane preparations - alter the mechanisms of malignant cell division (for example, paclitaxel).
• Vincalcaloid drugs - cause the destruction of the cancerous cytoskeleton (for example, the known vincristine and vinblastine).

Hormonal treatment is appropriate for many types of hormone-dependent tumor processes. Estrogen-containing drugs are used to inhibit androgenic activity, and androgen-containing drugs - to inhibit the production of estrogen.

Why the use of such funds causes a lot of controversy among medical professionals? First of all, hormonal drugs can suppress the effect of chemotherapy drugs. Secondly, with prolonged hormonal treatment, resistance of the organism can be produced.

Can a norkolut be prescribed for endometrial cancer? This medicine is used in such cases:

• if it is a small size myoma;
• if there is endometriosis, endometrial hyperplasia.

Cancer processes of the reproductive organs are considered a contraindication to the use of norcolute, therefore, in this situation it is not prescribed.

Not prescribed for the treatment of endometrial cancer and such a well-known drug like tamoxifen, which is actively used in cancer processes in the mammary glands. Moreover, for a long time, tamoxifen and endometrial cancer were associated with each other: it was believed that prolonged use of the drug can cause malignant degeneration of mucous tissues in the uterus. Despite the fact that scientists subsequently could not provide all the necessary evidence for such information, the use of tamoxifen in endometrial cancer is considered inappropriate.

[1], [2], [3], [4], [5], [6]

Alternative treatment

Is it worth trying to cure endometrial cancer with alternative prescriptions? An unequivocal answer to this question is impossible. Some women claim that alternative medicine has helped them get rid of a terrible disease, while for others this treatment was just a waste of precious time, which only aggravated the problem.

We can say one thing with precision: it is allowed to start such treatment only after a frank conversation with the attending doctor. Perhaps appropriate recommendations will be given, and alternative methods will be able to successfully enhance the effect of traditional therapy.

• Crushed 150 g of aloe leaves, mixed with 250 g of honey and 200 ml of high-quality red wine. The resulting mixture is placed in a refrigerator for aging for five days. Take the tool for 1 tsp. Three times a day before meals.
• Brew 1 tbsp. L Thistle plants in 1 liter of boiling water, infused for five hours, filtered. Drink 100 ml three times a day, before meals. Store the tool in the refrigerator for no more than three days.
• Water is filled with fresh or dried birch buds, based on a 5: 1 ratio. Put on the fire, bring to a boil, turn off, cover with a lid and incubated for two hours. Next, the tool is filtered and used for douching (daily, morning and evening).
• Soak cotton or gauze tampons sea buckthorn oil or celandine. Such tampons are put on overnight daily.

[7], [8], [9], [10], [11], [12], [13], [14]

Herbal medicine

• Daily do douching infusions of plants such as celandine, kolanhoe, the mountaineer bird.
• Regularly drink tea with the addition of ginseng, pink radio, barberry ordinary.
• Drink tea from lemon balm, 4-5 times a day between meals.
• Insist in a thermos rhizome of white lily (1 tablespoon per 1 liter of boiling water), drink 200 ml twice a day.
• Take warm teas with the addition of chamomile decoction, thistle, calendula, several times a day.
• Take an infusion of wormwood daily for 30 drops with a small amount of water.

Homeopathy

Of course, oncology is not a reason to experiment. But if we consider that endometrial cancer is a complex disease in which several painful processes occur at once, then it is necessary to influence the problem in combination. Otherwise, signs of pathology can return again in the form of relapse.

Many experts believe that the use of homeopathic treatment on the background of traditional therapy leads to a more stable and pronounced result. Homeopathy preparations are prescribed in stages:

• taking means to inhibit the growth of tumors;
• blocking tumor growth;
• directional effect on the tumor for the purpose of destruction;
• recovery of the body, prevention of re-illness.

Selection of drugs is carried out by a homeopath during an individual consultation with a patient with endometrial cancer. The advantage is given to such means:

• Argentum Metallicum;
• Asaphette;
• Argentum Jodatum.

Dosages are set individually: not only the stage and symptoms of the disease, but also the age, as well as the mental and constitutional features of the patient are taken into account.

Surgery

For most patients, surgical intervention becomes the basic way of getting rid of endometrial cancer. Most often, the uterus is removed completely: this operation is called a total hysterectomy. Removal of the uterus and appendages is shown in the menopausal period.

When choosing a treatment strategy, the prevalence of the tumor process is necessarily taken into account. There are two types of surgical removal of the uterus:

• amputation, when the uterus is separated from the cervix;
• extirpation, when the organ is removed along with the neck.

According to clinical observations, the first option of removal is perceived by patients less painful, and the likelihood of complications during amputation is lower than during extirpation. Therefore, the second option is resorted to only when there are suspicions of the spread of pathology to the neck area.

Most often during the intervention, the appendages are removed. Of course, as a result of this, the hormonal balance in the woman’s body is somewhat reduced, but not critical: other glands, for example, the adrenal glands, take on the production of hormones.

The operation of hysterectomy can be carried out by such methods:

• abdominal, with access through an incision in the abdomen;
• vaginal, with access through an incision in the posterior vaginal wall.

Only in some cases, removal of the organ can be avoided: if the tumor does not exceed the size of 3 mm. In a similar situation, the endometrial layer is ablated. As a result, the uterus is preserved, but the woman still becomes infertile.

Endometrial Cancer Radiotherapy

Radiation treatment involves the use of high-energy rays to destroy malignant cells. Irradiation can be external or internal (the so-called brachytherapy).

Radiation treatment is carried out after surgery, to reduce the likelihood of recurrence. In addition, the conduct of such therapy is appropriate if the operation for any reason is contraindicated.

With the re-development of the tumor, irradiation can be applied as the main therapeutic procedure.

In the overwhelming majority of patients with the second or third stage of endometrial cancer, radiation therapy is used as a prophylactic anti-relapse method.

This type of treatment may be accompanied by a number of adverse events that usually stop on their own several months after the end of exposure. So, there may be increased dryness of the skin, hair loss, vaginal discharge, diarrhea, nausea, discomfort during urination, a constant feeling of fatigue. In addition, there may be long-term consequences in the form of lymphatic edema of the lower extremities.

[15], [16], [17], [18], [19], [20], [21], [22]

Treatment of endometrial cancer in Israel

Israeli experts in the field of oncology and surgery treat endometrial cancer using gentle and at the same time effective techniques. Resection of the tumor focus and damaged tissue is performed through small punctures in the abdominal wall, or through an intravaginal incision. This approach eliminates damage to healthy tissues, speeds up the regeneration period and prevents the formation of gross cicatricial changes.

During surgery, a biopsy is performed according to the new Frozen Section method. This is the taking of material from all lymph nodes located near the uterus, with further analysis. This method allows you to determine which nodes should be removed in order to further avoid the recurrence of the disease.

For comparison: in most domestic clinics, basic cancer treatment is carried out by open surgery, and hysterectomy is never accompanied by a study of lymph nodes. As a result, according to statistics, 60% of patients develop a second pathology over the course of two years.

In order to choose the best Israeli clinic for treatment, you need to take into account the following points:

• qualification of specialized specialists;
• the presence in the clinic of modern equipment to remove tumors with extreme precision, in order to avoid recurrence of the disease;
• level of service and pricing policy of the treatment center.

As a rule, choosing a good clinic in Israel for the treatment of endometrial cancer does not pose any particular problems. The main thing is to contact the institution in advance and discuss all possible nuances.

Nutrition for endometrial cancer

A cancerous tumor in the active growth stage absorbs most of the energy, which leads to a weakening of the body. Therefore, the nutritional ration for endometrial cancer should be made so that the patient replenishes vitamins daily and is able to maintain and maintain the necessary energy potential. Strengthening the body's capabilities will lead to strengthening the immune system and enhancing the response to the aggression of the malignant process.

In the later stages of the disease, a woman, as a rule, is rapidly losing weight, depleting. This moment also needs to be taken into account when drawing up the menu for the patient: the food must retain the maximum possible percentage of useful components.

It is believed that some products are able to have a peculiar antitumor effect. These products include:

• all kinds of cabbage;
• onions, garlic;
• asparagus, peas, soybeans, beans;
• carrots, beets;
• cereals;
• vegetables and fruits that have not undergone heat treatment;
• greens, berries.

Nutritionists advise to refuse meat in general, having replaced it with sea fish.

What should be absolutely refused:

• from alcohol, strong black tea, cocoa, chocolate;
• from sweets, sugar;
• from white bread, sweet pastries;
• from spicy and salty foods, smoked products;
• from convenience foods, fast food.

The use of tea or decoction based on medicinal plants, as well as plain non-carbonated water is welcomed.