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Treatments and drugs
By Mayo Clinic staffSurgery is the most common treatment for endometrial cancer. Most doctors recommend either the surgical removal of the uterus alone (hysterectomy) or, more likely, the surgical removal of the uterus, fallopian tubes and ovaries (hysterectomy with bilateral salpingo-oophorectomy). Lymph nodes in the area should also be removed during surgery along with other tissue samples.
A hysterectomy is a major operation, and because you can't get pregnant after your uterus has been removed, it can be a difficult decision for some women. However, surgery is usually the only way to eliminate the cancer or the need for further treatment.
If you have an aggressive form of endometrial cancer or the cancer has spread to other parts of your body, you may need additional treatments. These may include:
- Radiation. If your doctor believes you're at high risk of cancer recurrence, he or she may suggest that you have radiation therapy after a hysterectomy. Your doctor may also recommend radiation therapy if the cancerous tumor is fast growing, invades deeply into the muscle of the uterus or involves blood vessels. Radiation therapy involves the use of high-dose X-rays to kill cancer cells. When done from outside the body, it's called external beam radiation therapy. Brachytherapy is another form of radiation that involves the internal application of radiation, usually to the inner lining of the uterus. Brachytherapy has fewer side effects than conventional radiation therapy does. However, brachytherapy treats only a small area of the body.
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Hormone therapy. If the cancer has spread to other parts of your body, synthetic progestin, a form of the hormone progesterone, may stop it from growing. The progestin used in treating endometrial cancer is administered in higher doses than is used in hormone replacement therapy for menopausal women. Other medications may be used as well. Treatment with progestin may be an option for women with early endometrial cancer who want to have children and, therefore, don't want to have a hysterectomy. However, this approach is not without the risk that the cancer will return. Carefully discuss this treatment with an expert in this field.
Another hormone therapy option is gonadotropin-releasing hormone agonists. These drugs can lower estrogen levels in premenopausal women.
- Chemotherapy. Chemotherapy is the use of drugs to kill cancer cells. Often, chemotherapy drugs are used in combination to increase their efficacy. Generally, women with stage III or stage IV endometrial cancer will be offered chemotherapy as part of their treatment regimen. You may receive chemotherapy drugs by pill (orally) or through your veins (intravenously). These drugs enter your bloodstream and then travel through your body, killing cancer cells outside the uterus.
Each type of treatment for endometrial cancer can have side effects. Ask your doctor what side effects you can expect and what can be done to manage them.
If you have late-stage or recurrent endometrial cancer, you may benefit from participating in clinical trials that provide new experimental treatment options. For more information on clinical trials, contact the National Cancer Institute at 800-4-CANCER (800-422-6237) or visit its Web site.
After treatment for endometrial cancer, your doctor will likely recommend regular follow-up examinations to determine whether the cancer has returned. Checkups may include a physical exam, a pelvic exam, a Pap test, a chest X-ray and laboratory tests.
- Detailed guide: Endometrial cancer. American Cancer Society. http://documents.cancer.org/140.00/140.00.pdf. Accessed Sept. 9, 2008.
- Endometrial cancer treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/patient/allpages/print. Accessed Sept. 16, 2008.
- Bakkum-Gamez JN, et al. Current issues in the management of endometrial cancer. Mayo Clinic Proceedings. 2008;83(1):97-112.
- Sorosky JI. Endometrial cancer. Obstetrics and Gynecology. 2008;111(2, Part 1):436-447.
- Moynihan T (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 21, 2008.
