Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Nell Suby

Nell Suby, MD

Gyn Oncology

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Sacramento Medical Center
Appt/Advice: 916-614-4055

See all office information »

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Uterine sarcoma is a rare form of cancer. The term “uterine sarcoma” includes a group of cancers that grow in the uterine wall muscles and other tissues. The uterus is the pear-shaped organ located in the middle of a woman’s pelvis.

We can usually treat uterine sarcoma successfully when we catch it early. Your treatment plan will be based on the type of uterine sarcoma you have and its stage (spread).

Treatment options include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy

Uterine sarcoma usually occurs in women who are past menopause. If you are younger and may want to become pregnant, let us know. We’ll talk about how to protect your fertility before we start treatment.

Uterine sarcoma is different from the more common type of uterine cancer, called endometrial cancer. That cancer develops in the lining of the uterus (endometrium).

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We usually treat uterine sarcoma with surgery. Depending on your cancer’s stage (spread), options include:

  • Total hysterectomy. Removal of your uterus.
  • Bilateral salpingo-oophorectomy. Removal of both ovaries and fallopian tubes, usually along with a hysterectomy.

We may also remove nearby lymph glands to check them for cancer. Depending on the surgery you have, recovery time will be 2 to 6 weeks.

Surgery Side Effects

We’ll talk with you about how to prevent or manage side effects. 

After a hysterectomy, you will:

  • Be unable to get pregnant.
  • Stop having menstrual periods.
  • Enter menopause if you have not done so already, if your ovaries are removed.

If you enter menopause you may have symptoms such as hot flashes, night sweats, and vaginal dryness.

Other side effects may include:

  • Difficulty urinating
  • Constipation
  • Infection
  • Leg swelling (lymphedema) if lymph nodes were removed
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Radiation Therapy

Some women benefit from radiation after surgery. High-energy waves, such as X-rays, are used to kill any cancer cells that remain in the body.

There are 2 main types of radiation therapy for uterine sarcoma.

Vaginal brachytherapy

  • Radiation is delivered by a device that we place inside your vagina.
  • Radiation is released for a few minutes.
  • Treatment is usually given once a week.
  • Three to 5 treatments are given, in total.

External-beam radiation therapy

  • A machine outside your body aims radiation at the exact location of the cancer.
  • Treatment is given 5 times a week for up to 6 weeks.

We decide which type of radiation therapy is right for you based on the stage and aggressiveness of your cancer.


If there’s a high risk of your cancer coming back after surgery, we’ll recommend chemotherapy treatment. Chemotherapy, or “chemo,” uses medications to kill cancer cells. 

Chemotherapy for uterine sarcoma:

  • Includes several drugs given in combination.
  • Is given either into a woman’s vein (intravenously, or IV) or in pills.
  • Is given once every few weeks.
  • Includes 4 to 8 treatments, in total.

If cancer has spread outside your uterus, we may recommend both chemotherapy and radiation therapy.

Radiation Therapy and Chemotherapy Side Effects

Both chemotherapy and radiation therapy kill cancer cells but can also damage normal tissues. Side effects range from mild to serious. We can help you manage any side effects.

Either radiation or chemotherapy may cause side effects that include:

  • Tiredness.
  • Nausea and vomiting.
  • Menopause-like symptoms such as vaginal dryness, hot flashes, and night sweats.

Other possible radiation therapy side effects include:

  • Skin tenderness or redness.
  • Frequent urination or blood in urine.
  • Loss of pubic hair.
  • Diarrhea.
  • Loss of the ability to become pregnant (infertility).
  • End of menstruation. Periods return over time in some younger women.

Other possible chemotherapy side effects include:

  • Anemia (low level of red blood cells).
  • Increased risk of infection (low level of white blood cells).
  • Bruising and bleeding easily (low level of blood platelets).
  • Hair loss.
  • Numbness, tingling, or pain in hands and feet.
  • Reduced kidney function.
  • Hearing loss.

Hormone Therapy

Sometimes the growth of uterine sarcoma is affected by the hormones estrogen or progesterone, or both. We can use hormone therapy to stop this growth.

Hormone treatment works by either removing the hormones or blocking their action. This type of hormone therapy is different from the type used to treat symptoms of menopause.

Side effects

Progestin, a synthetic form of progesterone, is most commonly used to treat uterine sarcoma. Progestin therapy may cause:

  • Fluid retention
  • Increased appetite
  • Breast tenderness
  • Weight gain

If you receive another kind of hormone therapy, your side effects may be different.

We will help you manage any side effects.

Clinical Trials

We may suggest that you join a clinical trial. Clinical trials are designed to study how to improve cancer treatment for patients.

Some clinical trials research new treatments. Others compare new treatments to those already in use.

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Follow-up Care

After treatment we’ll make a follow-up care plan. We want to keep close watch with you, to quickly catch any sign of cancer returning and help you with any ongoing treatment side effects.

For the next few years, your follow-up visits will:

  • Occur every 6 months.
  • Be with your regular gynecologist, a doctor who specializes in women’s cancers, or another cancer specialist.
  • Include a physical exam and possibly blood tests and X-rays.
  • Give you time to talk with us about any side effects of treatment that bother you. We can help you manage this important part of your recovery.

Contact us immediately if you develop:

  • Vaginal bleeding.
  • A cough that doesn’t go away.
  • Pain in your belly or pelvis.
  • Unexplained weight loss.

What You Can Do

Taking care of yourself during and after your treatment is very important.

Be sure to:

  • Choose healthy foods.
  • Stop smoking.
  • Be active every day, when you feel well enough.
  • Keep your follow-up appointments.
  • Join a support group to talk with people who have experiences similar to yours.
  • Talk with your partner or a therapist about any intimacy issues.
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Getting Your Care at Kaiser Permanente

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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