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Pelvic Exenteration for Endometrial (Uterine) Cancer
Endometrial cancer grows in the cells lining the uterus. There are two main layers of the uterus: the myometrium, which is the outer layer of muscle that helps with the birthing process, and the endometrium, which is the inner layer that thickens each month to prepare a woman’s body for pregnancy. (If pregnancy does not occur, the endometrium lining sheds, becoming menstrual flow.) Endometrial cancer, also known as uterine cancer, occurs when cells in the endometrium grow at an accelerated rate and become cancerous.
Treating endometrial cancer
There are many treatment options available to patients with uterine cancer, including surgery, chemotherapy and radiation therapy. Patients with early-stage uterine cancer may undergo a radical hysterectomy with a bilateral salpingo-oophorectomy, which removes the uterus, fallopian tubes and ovaries. Those with later-stage cancers or recurrent endometrial cancer may benefit from a more extensive procedure called pelvic exenteration.
What is pelvic exenteration surgery?
An exenteration involves the complete surgical removal of one or more bodily organs. A pelvic exenteration for endometrial cancer, therefore, involves removing the uterus, cervix, fallopian tubes, vagina, ovaries, bladder and rectum. Afterward, the gynecologic oncologist will create permanent diversion systems for the urinary system and stool as well as reconstruct the vagina:
- Urinary diversion. With the bladder and urethra removed, there must be a new place for urine to leave the body. After completing a pelvic exenteration for endometrial cancer, the surgeon will create a stoma, which is an opening in the midsection that allows urine to drain from the body. The stoma is created by connecting the ureters to a piece of the large intestine, then bringing the large intestine through the muscle wall. The stoma looks like a small, circular piece of flesh.
- Colostomy. With the rectum removed, stool needs a new place to leave the body. Much like a urinary diversion, a stoma creates a pathway for stool to empty.
- Vaginal reconstruction. A new vaginal canal can be created by the surgeon, using tissue from other parts of the body. In some cases, the vagina may simply be closed.
Moffitt Cancer Center offers a wide range of treatment options for endometrial cancer, including pelvic exenteration performed by fellowship-trained surgeons. If you’re exploring your treatment options and would like to consult with the specialists in our gynecological clinic, connect with us at 1-888-663-3488 or complete a new patient registration form online. Your cancer treatment is our top priority, so you’ll be connected with a cancer expert in one day.