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- The treatment of gynecological cancers is based on the stage of the disease, specifically, the extent to which the cancer has spread to other parts of the body. Treatments include surgery, chemotherapy, radiation, and biological therapy.
- Chemotherapy: Chemotherapy uses a combination of drugs to slow tumor growth and destroy cancer cells. Chemotherapy may be used in addition to surgery to treat gynecological cancer and to prevent recurrent disease. Drugs may be administered by mouth or intravenously (IV, or into the veins). Side effects of chemotherapy may be severe and include: fatigue; fever; hair loss (alopecia); infection; low blood cell count (such as anemia, neutropenia, thrombocytopenia); and nausea.
- Hormone therapy: Some gynecological tumors, such as uterine tumors, contain certain proteins, called hormone receptors, which attract and bind to estrogen and use this hormone to grow. Hormone therapy is a treatment that uses progesterone to balance the effect of estrogen and slow tumor growth.
- Hormone therapy usually involves a synthetic type of progesterone (progestin) in pill form. Side effects include increased appetite, fluid retention, weight gain, and, in premenopausal women, changes in the menstrual cycle.
- Radiation therapy: Radiation uses high-energy X-rays to destroy cancer cells and shrink tumors. This treatment may be used prior to surgery (called neoadjuvant therapy) or after surgery to destroy remaining cancer cells. Radiation also may be used in patients who are unable to undergo surgery.
- External beam radiation is an outpatient treatment delivered by a machine outside the body. This treatment usually is administered five days a week for several weeks. Most individuals refrain from sexual intercourse during and for several weeks following radiation therapy because contact with the genitals and vagina may be painful.
- Internal beam radiation may be administered for four to six weeks after surgery. In this procedure, which is usually performed in the radiation department of a hospital, a special applicator is used to insert pellets of radioactive material into the upper vagina. In some cases, both external and internal radiation therapies are used.
- Side effects of radiation include: diarrhea; dryness, itching, tightening, and burning in the skin of the vagina; fatigue; frequent, painful urination; hair loss; and changes in tastes and loss of appetite.
- Surgery: Treatment for many gynecological cancers usually involves removal of the uterus, including the cervix (called total hysterectomy), and removal of the fallopian tubes and ovaries (called bilateral salpingo-oophorectomy). Surgery may be performed through an incision in the abdomen or through the vagina (called transvaginal hysterectomy).
- Postoperative pain, nausea, vomiting, and fatigue are common side effects of surgery. Individuals may remain hospitalized for a few days to one week and usually can resume normal activities in four to eight weeks. Complications include the following: adverse reaction to anesthesia; hemorrhage (bleeding) caused by injury to surrounding blood vessels; injury to surrounding organs (such as the large intestine); and thromboembolism (blockage of an artery or vein by a blood clot).
- Other therapies: Biological therapies involve treatments to help improve the immune system. It uses such agents as interleukin-2 (IL-2), vaccine therapy, and anti-HER-2. Anti-angiogenesis (the growth of new blood vessels to tumors) therapy decreases the amount of blood a tumor can get, thereby possibly killing or decreasing the tumor.
- Some drugs treat the side effects of chemotherapy. Anemia (low number of red blood cells) is a frequent side effect of chemotherapy and may cause symptoms such as extreme tiredness, dizziness, or shortness of breath. Epoetin alfa (Procrit ®, Epogen ®) is a synthetic hormone that is used for the treatment of chemotherapy-related anemia by stimulating red blood cell production. Immune system problems caused by chemotherapy may be treated with filgrastim (Neupogen ®), a human granulocyte colony-stimulating factor (G-CSF). G-CSF helps stimulate the production of cells of the immune system, including granulocytes, macrophages, and stem cells.
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