What Are The Treatments For Women With Endometrial Cancer?
The initial treatment of endometrial cancer is individualized and depends on the unique situation for each woman. Generally treatment includes surgery primarily with radiation therapy, hormone therapy, and/or chemotherapy used in addition to surgery. Sometimes women are too sick to go to surgery first, and other treatments will be used. When surgery is done first, surgical staging will give more information about if and where the tumor cells have spread and how aggressive the tumor looks within the uterus. This information will allow the doctor to “tailor” treatment specific to the individual situation.
Surgery is the most common treatment for uterine cancer. Often, it is the only treatment needed. A standard surgery for endometrial cancer is the removal of the uterus. This is called a hysterectomy. It’s also standard to remove the attached ovaries and fallopian tubes. In many cases, your doctor will recommend removal of lymph nodes from the abdomen and pelvis. The purpose for removing the nodes is to see if the cancer has spread. The complete surgery of hysterectomy with lymph node removal is called surgical staging. Surgical staging can be done through an incision on your abdomen. This is called a laparotomy or open procedure. It can also be done by laparoscopy. This is a minimally invasive surgery that uses cameras to help with the surgery. Your doctor will discuss which approach is best and why.
Radiation uses high-energy beams directed to an area in the body to kill cancer cells. For endometrial cancer the beams are directed at the pelvis. Radiation is most frequently used after surgery. In some cases, though, it is used before surgery. There are rare patients who have severe medical problems and cannot tolerate surgery safely. In those cases, radiation may be used in place of surgery. Sometimes, certain factors in the uterus or lymph nodes suggest the there is a strong chance cancer will return (recur) if only surgery is used. In those cases, radiation is an option after surgery. Radiation may be given by placing a device into the vagina. The device delivers radiation to the tissues. This treatment is called internal radiation. It may also be given by using a machine to focus the radiation beam into an area of the body. This is called external radiation.
Chemotherapy uses anticancer drugs typically administered by vein to kill cancer cells. It is a systemic therapy. That means it that travels from head to toe and works throughout the body. Radiation only works on the area where the radiation is given. Chemotherapy may be given to patients whose cancer has spread when they are diagnosed. It may also be used to treat a cancer that comes back, or recurs. Hormone therapy is a type of drug therapy. It frequently uses a class of hormones called progestins. The drugs are given by mouth or by injection. They travel through the body in the blood. The drugs work on special targets on cancer cells called hormone receptors. Hormone therapy is used to treat widespread disease. It’s also used for cancers that return (recur).