Endometrial cancer is the most frequently diagnosed gynecologic cancer. It is the fourth most common neoplasm in women and is often associated with the exposure of the endometrium to estrogen.
Transvaginal ultrasound – which women should undergo as part of their annual check-up – provides information on possible thickening of the endometrium and contributes to the early diagnosis of cancer. Also early symptoms are manifested that should not be ignored, such as bleeding after menopause.
Early diagnosis and the appropriate combination of treatments achieve high cure rates. Depending on the stage of endometrial cancer as well as the oncology center, the five-year survival rates are over 90%, in early, low risk stages.
The treatment of choice in endometrial cancer is radical hysterectomy.
Radiotherapy and chemotherapy are adjuvant treatments in uterine cancer and are applied after hysterectomy, that is after the removal of the uterus, fallopian tubes and ovaries.
Radiotherapy is necessary when the final histological examination warns of a high risk of recurrence. To treat this type of cancer, we apply either intravaginal brachytherapy, with the newest method of afterloading, or a combination of radiotherapy and brachytherapy, depending on the degree of infiltration of the endometrial cancer into the uterus and its aggressiveness.
Radiotherapy begins 4 to 6 weeks after surgery. We apply advanced external radiotherapy techniques in the pelvic area with high-energy linear accelerators such as intensity modulated radiotherapy (IMRT) imaged guided brachytherapy (IGBR), which are guided to the anatomical particularities of the woman. We precisely irradiate the affected area – thanks to its 3D imaging – and at the same time protect neighboring healthy tissues from radiation. It is the most important development in recent years as it has increased local control of the disease and reduced adverse effects, thus improving survival. We apply intravaginal brachytherapy, in women who have undergone surgery for endometrial cancer 4 to 6 weeks after surgery. Intravaginal brachytherapy is applied to the vaginal stump. No anesthesia or sedation and no hospitalization are required. 5 to 10% of the patients with endometrial cancer cannot undergo surgery due to comorbidity, age, obesity, diabetes, heart disease as well as due to the high risk they run during the anesthesia of the surgery.
In inoperable stages of endometrial cancer, the combination of radiotherapy and chemotherapy can control uterine cancer locally.
The therapeutic outcome depends on the total dose of radiotherapy, therefore the escalation of the radiation dose by an experienced radiotherapist is important.
To reduce the total time of radiotherapy we safely increase the radiation dose of the targeted tumor, by administering an additional radiation dose to the targeted endometrial tumor or to possibly enlarged lymph nodes, that were positive in the PET-CT scan.
We apply intratissue brachytherapy in women with endometrial cancer who undergo radical radiotherapy.
Brachytherapy for inoperable endometrial cancer is applied directly to the tissues of the tumor: three sessions, once a week.
It is an invasive radiotherapy and is performed under light anesthesia or sedation. High doses of radiation are applied locally to the targeted uterine tumor while the maximum protection of the healthy tissues surrounding the uterine tumor is ensured.
Radiotherapy initially harms the cancer cells so that they cannot multiply and subsequently the cancer cells die and are naturally removed by the human body itself. The total treatment time is 6 to 8 weeks.
Moreover, the SBRT stereotactic radiotherapy technique can be applied locally to residual disease in case of locoregional recurrence of endometrial cancer.
We have modern machines, know-how, and we provide safe treatments with low side effects.
I am fortunate to operate state-of-the-art equipment, that offers my patients the best results with the lowest possible side effects. Cancer is no longer an incurable disease.
Since the 1970s, the patients who recovered from cancer have increased sixfold globally. Radiotherapy is the most personalized treatment because it is designed and carried out according to the needs of each patient. We are here to offer treatment and care, individually for each patient.