Cancer Education Slides

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Cancer Education Slides

• Uterine Cancer

2009
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What is Cancer?

• A group of 100 different diseases
• The uncontrolled, abnormal growth of cells
• Cancer may spread to other parts of the body

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What is Uterine Cancer?

• Most common cancer of the female reproductive
  system
• Fourth most common cancer and eighth most common
  cause of cancer death in women
• A disease in which cells in the uterus begin to
  change, grow uncontrollably, and form a malignant
  (cancerous) tumor
• Two major types adenocarcinoma (95 of cases)
  and sarcoma (2 to 4 of cases)
• Other, less common types include carcinosarcoma
  and endometrial stromal sarcoma

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What is the Function of the Uterus?

• Pear-shaped, hollow, and located in a womans
  pelvis between the bladder and rectum
• Also known as the womb, where a baby grows during
  pregnancy
• Made up of three sections cervix (lower), corpus
  (middle), and fundus (top)
• The inside of the uterus has two tissue layers
  endometrium (inner) and myometrium (outer

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What are the Risk Factors for Uterine Cancer?

• Age (most often occurs in women over age 50 after
  menopause)
• Obesity
• Race
• Genetics
• Other health conditions and cancers
• Tamoxifen (Nolvadex) use (drug used to prevent
  and treat breast cancer)
• Radiation therapy to the pelvis
• Estrogen exposure and/or imbalance
• Diet

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Uterine Cancer Prevention

• Birth control pills
• Assessing uterine cancer risk before considering
  hormone replacement therapy (HRT)
• Maintaining a healthy weight
• If diabetic, maintaining good self-care

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What are the Symptoms of Uterine Cancer?

• Unusual vaginal bleeding, spotting, or discharge,
  particularly during or after menopause
• Difficulty or pain when urinating
• Pain during sexual intercourse
• Pain in pelvic area

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How is Uterine Cancer Diagnosed?

• Pelvic exam
• Transvaginal ultrasound a test that uses sound
  waves to produce images of the uterus
• Endometrial biopsy or a dilation curettage
  (DC) removes tissue samples from the uterus to
  check for cancerous cells
• Imaging tests to find out if cancer has spread

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Uterine Cancer Staging

• Staging is a way of describing a cancer, such as
  the size of a tumor and if or where it has spread
• Staging is the most important tool doctors have
  to determine a patients prognosis
• Staging is described by the TNM system the size
  and location of the Tumor, whether cancer has
  spread to nearby lymph Nodes, and whether the
  cancer has Metastasized (spread to other areas of
  the body)
• Some stages are divided into smaller groups that
  help describe the tumor in even more detail
• Treatment depends on the stage of the cancer
• Recurrent cancer is cancer that comes back after
  treatment

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Stage 0 Uterine Cancer

• Known as cancer in situ, meaning the cancer is
  in only one layer of cells and has not spread

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Stage I Uterine Cancer

• The cancer is found only in the uterus and has
  not spread to other parts of the body
• Treatment options include surgery, surgery and
  radiation therapy, and hormone therapy

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Stage II Uterine Cancer

• The tumor has spread from the uterus to the
  cervix
• Treatment options include surgery and radiation
  therapy

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Stage III Uterine Cancer

• The cancer has spread beyond the uterus, but it
  is still only in the pelvic area
• Treatment options include surgery followed by
  radiation therapy and/or chemotherapy, or a
  clinical trial

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Stage IV Uterine Cancer

• The cancer has spread to the mucosa (inner
  surface) of the bladder or rectum, and/or to the
  lymph nodes in the groin, and/or to distant
  organs
• Treatment options include surgery, radiation
  therapy, hormone therapy, and chemotherapy, or a
  clinical trial

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Recurrent Uterine Cancer

• May return in the uterus, pelvis, abdominal lymph
  nodes, or other parts of the body
• Approximately 70 of recurrent uterine cancers
  take place within three years of initial therapy
• Symptoms include vaginal bleeding and discharge
  pain in pelvis, abdomen, or back of legs
  difficulty or pain when urinating weight loss a
  chronic cough
• Treatment options are hormone therapy and
  chemotherapy

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How is Uterine Cancer Treated?

• Treatment depends on stage of cancer
• More than one treatment may be used
• Surgery
• Radiation therapy
• Chemotherapy
• Hormone therapy

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Cancer Treatment Surgery

• First line of treatment
• Type of surgery depends on the extent of the
  cancer
• Simple hysterectomy removal of the body of the
  uterus and cervix
• Radical hysterectomy removal of the uterus,
  cervix, upper vagina, and nearby tissue
• Bilateral salpingo-oophorectomy removal of
  fallopian tubes and ovaries
• May be performed as traditional surgery or by
  laparoscopy
• After a hysterectomy, a woman cannot have
  children
• Removal of the ovaries results in premature
  menopause

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Cancer Treatment Radiation Therapy

• The use of high-energy x-rays to destroy cancer
  cells
• Usually given after surgery
• External-beam outside the body
• Brachytherapy delivers radiation directly to
  the tumor
• Side effects may include fatigue, mild skin
  reactions, upset stomach, and loose bowel
  movements

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Cancer Treatment Chemotherapy

• Drugs used to kill cancer cells (options may
  include a combination of drugs)
• Used to destroy remaining cancer after surgery,
  slow tumor growth, or reduce side effects
• Potential side effects include fatigue, hair
  loss, risk of infection, neuropathy, and others

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Cancer Treatment Hormone Therapy

• Slows the growth of uterine cancer cells
• Primary treatment is progesterone, a sex hormone
• May be used for women who cannot have surgery or
  radiation therapy
• Side effects include fluid retention, appetite
  increase, weight gain, and changes in the
  menstrual cycle

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Current Research

• Genetics
• Targeted therapy treatment targeting faulty
  genes or proteins that contribute to cancer
  growth
• Radiation therapy after chemotherapy
• Multiple drug combinations
• Hyperthermia kills cancer cells by increasing
  body temperature
• Improved drug delivery
• Fertility preservation

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The Role of Clinical Trials for the Treatment of
Uterine Cancer

• Clinical trials are research studies involving
  people
• They test new treatment and prevention methods to
  determine whether they are safe, effective, and
  better than the standard treatment
• The purpose of a clinical trial is to answer a
  specific medical question in a highly structured,
  controlled process
• Clinical trials can evaluate methods of cancer
  prevention, screening, diagnosis, treatment,
  and/or quality of life

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Clinical Trials Patient Safety

• Informed consent participants should understand
  why they are being offered entry into a clinical
  trial and the potential benefits and risks
  informed consent is an ongoing process
• Participation is always voluntary, and patients
  can leave the trial at any time
• Other safeguards exist to ensure ongoing patient
  safety

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Clinical Trials Phases

• Phase I trials determine the appropriate dose of
  a new treatment in a small group of people and
  provide preliminary information about the drugs
  safety
• Phase II trials provide information about the
  safety of the new treatment and provide the first
  evidence as to whether or not the new treatment
  is effective in treating the cancer that is being
  studied
• Phase III trials compare two or more different
  treatments. Most commonly, they test whether a
  new treatment is better than the standard
  treatment. Patients are typically divided
  randomly into two or more different groups. Each
  group gets a different treatment, and the
  researchers evaluate which group has had the best
  results. This is the best way to measure whether
  a new treatment results in longer life or better
  quality of life for patients

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Clinical Trials Resources

• Coalition of Cancer Cooperative Groups
  (www.CancerTrialsHelp.org)
• CenterWatch (www.centerwatch.com)
• National Cancer Institute (www.cancer.gov/clinical
  _trials)
• EmergingMed (www.emergingmed.com)

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Coping with Side Effects

• Side effects are treatable talk with the doctor
  or nurse
• Fatigue is a common, treatable side effect
• Pain is treatable non-narcotic pain-relievers
  are available
• Antiemetic drugs can reduce or prevent nausea and
  vomiting
• For more information, visit www.cancer.net/sideeff
  ects

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After Treatment

• Talk with the doctor about developing a follow-up
  care plan
• Regular physical examinations and/or medical
  tests may be required
• Pelvic examinations
• Blood tests
• Yearly Pap test
• X-rays
• Fear of recurrence is common talk with your
  doctor about ways to cope

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Where to Find More InformationCancer.Net Guide
to Uterine Cancer(www.cancer.net/uterine)

• Overview
• Medical Illustrations
• Risk Factors
• Symptoms
• Diagnosis
• Staging With Illustrations
• Treatment

• Clinical Trials
• Side Effects
• After Treatment
• Current Research
• Questions to Ask the Doctor
• Patient Information Resources

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Cancer.Net (www.cancer.net)

• Comprehensive, oncologist-approved cancer
  information
• Guides to more than 120 types of cancer and
  cancer-related syndromes
• Coping resources
• Survivorship information
• Cancer information in Spanish
• Weekly feature articles
• The latest cancer news
• For patient information resources, please call
  888-651-3038