Endometrial Cancer Treatment Options
Treatment options for people with uterine cancer are surgery, radiation therapy, chemotherapy, and hormone therapy. You may receive more than one type of treatment.
Surgery for Endometrial Cancer
Surgery is the most common treatment for women with uterine cancer. You and your surgeon can talk about the types of surgery (hysterectomy) and which may be right for you.
The surgeon is typically also the gynecologic oncologist. They will usually remove the uterus, cervix, and nearby tissues. The nearby tissues may include:
- Fallopian tubes
- Nearby lymph nodes
- Part of the vagina
Surgery to remove lymph nodes may cause lymphedema (swelling) in one or both legs. Your health care team can tell you how to prevent or relieve lymphedema.
Endometrial Cancer Radiation Therapy
Radiation therapy is an option for women with all stages of uterine cancer. It may be used before or after surgery. For women who can’t have surgery for other medical reasons, radiation therapy may be used instead to destroy cancer cells in the uterus. Women with cancer that invades tissue beyond the uterus may have radiation therapy and chemotherapy.
Radiation therapy uses high-energy rays to kill cancer cells. It affects cells in the treated area only.
Doctors use two types of radiation therapy to treat uterine cancer. Some women receive both types:
- External radiation therapy: A large machine directs radiation at your pelvis or other areas with cancer. The treatment is usually given in a hospital or clinic. You may receive external radiation 5 days a week for several weeks. Each session takes only a few minutes.
- Internal radiation therapy(also called brachytherapy): A narrow cylinder is placed inside your vagina, and a radioactive substance is loaded into the cylinder. This common method of brachytherapy may be repeated two or more times over several weeks. Once the radioactive substance is removed, no radioactivity is left in the body.
Women with cancer in the lining of the uterus, the endometrium, often have a hysterectomy as part of the endometrial cancer treatment process. After the uterus and cervix are removed, the oncologist may recommend using high dose rate (HDR) brachytherapy on the upper portion of the vagina. HDR for endometrial cancer is given by inserting a cylinder filled with the radioactive material into the vagina and leaving it there for less than an hour at a time. The cylinder is then removed and the patient can go home right away. This process is repeated weekly or more often for at least three doses. The right dose for each patient is determined by her radiation oncologist, often in consultation with her surgeon and medical oncologist.
By using HDR brachytherapy for endometrial cancer, radiation primarily affects only the area that it is directly next to. Side effects from the radiation therapy also tend to be less severe than external beam radiation therapy. The most common side effect is a change in the lining of the vagina.
Chemotherapy for Endometrial Cancer
Chemotherapy uses drugs to kill cancer cells. It may be used after surgery to treat uterine cancer that has an increased risk of returning after treatment. For example, uterine cancer that is a high grade or is Stage II, III, or IV may be more likely to return. Also, chemotherapy may be given to women whose uterine cancer can’t be completely removed by surgery. For advanced cancer, it may be used alone or with radiation therapy.
Chemotherapy for uterine cancer is usually given by vein (intravenous). It’s usually given in cycles. Each cycle has a treatment period followed by a rest period.
Hormone Therapy Use in Endometrial Cancer
Some uterine tumors need hormones to grow. These tumors have hormone receptors for the hormones estrogen, progesterone, or both. If lab tests show that the tumor in your uterus has these receptors, then hormone therapy may be an option.
Hormone therapy may be used for women with advanced uterine cancer. Also, some women with Stage I uterine cancer who want to get pregnant and have children choose hormone therapy instead of surgery. The most common drug used for hormone therapy is progesterone tablets.