Surgery to relieve symptoms of advanced womb cancer

Not everyone with advanced womb cancer can have surgery. You might not be well enough for an operation. Or your doctor might recommend another treatment that is more suitable for your situation. 

Your doctor will only recommend surgery if they think it will help control the cancer and help you feel better. You also need to be fit enough to make a good recovery afterwards. They will also discuss with you whether the benefits outweigh the discomfort you may go through.

You may need time to consider your treatment options. Talk to your doctor and specialist nurse, and discuss your options with your family and friends. 

Types of surgery

Advanced womb cancer is more difficult to treat with surgery. The cancer has spread to another part of the body, so surgery to remove the womb will not cure it. But you might have an operation if it can help your situation.

Removing as much of the cancer as possible

Your specialist might recommend an operation to remove as much of the cancer as possible, also called debulking. This can slow down the growth of the cancer and help relieve any symptoms you are having. Treatment to help with symptoms is called palliative treatment, so your doctor might describe this as palliative surgery.

Treating a blocked bowel

There is a risk that your bowel could become blocked if your cancer begins to grow into your bowel. This means the waste that normally passes through the bowel cannot get through.

This may not happen to you. But if it does, you might:

• feel bloated

• be constipated

• feel sick

• have griping pains in your abdomen

• vomit large amounts

If you are well enough, it may be possible to have an operation to remove the blockage or bypass it by doing a colostomy. A colostomy is an opening of the bowel onto the surface of the tummy (abdomen). You wear a bag over the opening to collect the poo (faeces) from the bowel.

It's sometimes possible to unblock the bowel to relieve symptoms by putting in a tube called a stent. The surgeon puts a flexible tube with a light at the end (called an endoscope) into the bowel through your back passage. This is called a colonoscopy.

The surgeon uses the endoscope to see where the blockage is and pushes the stent through it. The stent expands and holds the bowel open so that bowel motions can pass through again. The surgeon leaves the stent in the bowel to keep it open. As well as relieving symptoms, this procedure gives doctors time to plan an operation to remove the blocked part of the bowel.

If you can't have an operation, your specialist might suggest a drug called somatostatin (Octreotide). The drug works by reducing the amount of fluid that builds up in your stomach and digestive system. Unfortunately, this treatment usually only works for a few weeks or months.

Treating a waterlogged kidney (hydronephrosis)

Doctors call a waterlogged kidney hydronephrosis. Sometimes womb cancer can spread and block one of the tubes from the kidney to the bladder (the ureters).

This means that the urine made by that kidney can't drain away and the kidney becomes overloaded with it. To treat this your doctor might put in a tube to drain the urine from the kidney.

The drainage tube is called a nephrostomy tube. It is attached to a bag outside the body. The urine collects in the bag which has a tap for easy emptying. After this type of surgery, you have a district nurse visit you at home to help you manage the tube and drainage bag.

Sometimes it is possible to pass a tube (a stent) through the blockage so that the kidney can drain inside you and you don’t need a drainage bag.