Oncology

Endometrial Cancer

Endometrial cancer is the most common gynecologic malignancy treated by the physicians at Pacific Gynecology Specialists. The standard of care for treatment of endometrial cancer is surgery (except in select patients) with removal of the uterus (hysterectomy), removal of the fallopian tubes and ovaries (bilateral salpingo-oophorectomy), and possible removal of the right and left pelvic and para-aortic lymph nodes (pelvic and para-aortic lymphadenectomy). Lymphadenectomy may or may not be indicated or performed on all patients. The surgery can be performed vaginally (excluding lymphadenectomy), abdominally, or with a minimally invasive approach either laparoscopically or robotically. The type of surgery recommended will depend on the patient's preoperative pathology, need for lymphadenectomy, body habitus, clinical pelvic exam, previous surgery or radiation therapy, and other medical problems.

For patients who have a vaginal, laparoscopic, or robotic surgery the typical hospital stay is 1 night. For patients who have an abdominal procedure the typical hospital stay is 2-3 nights. Processing of the surgical specimens by the pathologist takes between 7-14 days. Patients are typically seen by the surgeon for a postoperative visit and discussion of the pathology results approximately 2 weeks following the surgery, which allows ample time for the final pathology report to be reviewed. Any recommendations for additional treatment such as radiation therapy or chemotherapy will be discussed at that initial post-operative visit.

For patients who live in the Seattle area, radiation therapy can be received from the Radiation Oncology group at the Swedish Cancer Institute. Chemotherapy may be administered to local residents in the clinic infusion suite at PGS or at the Swedish Cancer Institute. For patients outside the Seattle area, referral to a local radiation oncologist for radiation therapy or a local medical oncologist for chemotherapy is facilitated through PGS.

Following treatment patients will enter a cancer surveillance program with quarterly history and physical exams, vaginal pap smears, and intermittent body imaging for the first 3 years, then biannual exams for the next 2 years, and then yearly exams after 5 years. This surveillance can be done entirely at PGS or shared with the patient's primary care provider or referring physician.

With the appropriate treatment endometrial cancer is a very curable disease. The providers at PGS have extensive experience and expertise treating endometrial cancer with excellent results.