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Gyn Cancers


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diagnosis and radiation treatment of cancers of the cervix and uterus

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Gyn Cancers

  1. 1. Cancer of the cervix or uterus <ul><li>Understanding the disease </li></ul><ul><li>Treatment options </li></ul><ul><li>Side effects of treatment </li></ul>
  2. 4. Cross section anatomy of the female pelvis
  3. 5. Cross section anatomy of the female pelvis rectum
  4. 6. CT Scans may be useful in showing cancer
  5. 7. 1. Ovary, 2. Endometrial Cancer, 3. Uterus, 4. Urinary Bladder, 5. Rectum, 6. Vagina E ndometrial cancer – adenocarcinoma of the lining of the uterus
  6. 8. Uterine cancer can spread to lymph nodes
  7. 9. Lymph Nodes
  8. 12. Guidelines for the use of radiation after a hysterectomy
  9. 13. Treatment of E ndometrial cancer For most stages surgery (hysterectomy) is performed and postOp radiation is indicated for high risk features: <ul><li>Deep muscle invasion (stage T1b or T1c) </li></ul><ul><li>Involvement of cervix (stage T2) </li></ul><ul><li>Spread to nodes, ovaries or tubes (Stage T3) </li></ul><ul><li>High risk pathology: high grade, vascular invasion, serous or clear cell </li></ul>
  10. 14. Cancer of the cervix – squamous carcinoma (occasionally adenocarcinoma) uterus Cervix cancer
  11. 15. Cervix cancer stages
  12. 18. Treatment of cervix cancer <ul><li>Early stages: surgery (hysterectomy) with postOp radiation if high risk features (deep invasion, spread to nodes or other organs) </li></ul><ul><li>More advanced cases: radiation +/- chemotherapy (cisplatin) then possibly surgery </li></ul>
  13. 19. CT scan is obtained at the time of simulation CT images are then imported into the treatment planning computer
  14. 20. In the simulation process the CT and PET scan images are used to create a computer plan
  15. 21. In the treatment the lasers are used to line up the beam and the patient receives the radiation treatment
  16. 22. Radiation for advanced cervix cancer
  17. 23. Tomotherapy for Advanced Cervix Cancer
  18. 24. Radiation for gynecologic cancers <ul><li>External beam irradiation (daily for 5 weeks) </li></ul><ul><li>Low dose radiation (LDR) Internal radiation (cesium implants, in hospital for 2-3 days </li></ul><ul><li>High dose rate radiation (HDR) with Nucletron (Iridium) once a week for 3-5 weeks as an outpatient </li></ul>
  19. 25. Internal radiation devices
  20. 26. Radiation Fields and Side Effects Pelvic field Para-aortic Node field
  21. 27. Side Effects of Pelvic Radiation Radiation fields Radiation may hit the bowel causing some more bowel frequency, cramps, diarrhea and fatigue
  22. 28. 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
  23. 29. Radiation prescription for # Diagnosis: # External radiation: # Internal radiation: #