After being diagnosed with uterine (endometrial) cancer, you will need to make decisions about treatment. You may meet with a number of doctors, such as a gynecological cancer surgeon and a medical oncologist. This can be a stressful and challenging time. This brief overview of treatment options may help you think of questions to ask your doctors.
The main treatments for uterine cancer are surgery, radiation therapy, chemotherapy and hormone therapy. Your doctors will recommend treatment based on the stage of your cancer (how much the cancer has spread, if at all). Surgery is usually offered first. Other treatments may be included in your treatment plan if the cancer has or could spread. Your doctor can explain the possible side effects of each type of treatment and suggest ways to manage them.
Surgery is the most common treatment for uterine cancer. Surgery to remove the uterus is called a hysterectomy. The uterus may be removed either through the vagina or through an incision in the abdomen. If a vaginal hysterectomy is done, the surgeon may make small incisions in the abdomen to insert a lighted instrument called a laparascope. This lets the surgeon see and remove the correct tissues.
Types of surgery include:
- Total hysterectomy to remove the uterus and cervix. This surgery is an option if the cancer is confined to the uterus.
- Radical hysterectomy to remove the uterus, the cervix, part of the vagina and nearby tissues. This must be done if the cancer has spread to the cervix or nearby tissues.
In most cases, the ovaries and fallopian tubes are also taken out. This procedure is called a bilateral salpingo-oophorectomy. It is done because women with uterine cancer are at increased risk of ovarian cancer. The surgeon may also take some lymph nodes and other tissues to check them for cancer cells.
After surgery, other treatments may be used to kill any remaining cancer cells or treat cancer that has spread beyond the uterus.
Radiation therapy is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation may be used:
- Before surgery to shrink the tumor before removing it
- After surgery to destroy any remaining cancer cells and help prevent the cancer from coming back
- In combination with other treatments when cancer has spread
- Instead of surgery when surgery is not possible
Radiation therapy can be delivered in two ways:
- Internally, which is called brachytherapy. For brachytherapy, a doctor inserts a small applicator that contains radioactive pellets. The pellets may be left in for an hour or up to a day at a time, depending on the dose.
- Externally, which is called external beam radiation. A large machine, similar to an x-ray machine, delivers radiation to a specific site on the body. This treatment is usually done five days a week for four to six weeks.
Chemotherapy is the use of medications to kill cancer cells. These drugs can be taken as pills or injected into a vein or muscle. They get into the bloodstream and travel throughout the body. As a result, they are useful for treating cancer that has spread from the uterus to other parts of the body.
Hormone therapy is the use of hormones that can prevent cancer cells from growing. The most common hormone therapy is progestin, a synthetic form of progesterone. Hormone therapy may be used if uterine cancer has spread to other parts of the body. It may also be an option for women who are not good candidates for surgery.
Clinical trials are studies of new treatments. They are being done at research centers across the U.S. Taking part in a clinical trial is a way to get access to the latest treatment for uterine cancer. You can ask your doctor if a clinical trial might be a good idea for you.
Created on 11/16/1999
Updated on 09/22/2010
- American College of Obstetricians and Gynecologists. Cancer of the uterus.
- National Cancer Institute. Endometrial cancer treatment: Stage I endometrial cancer.
- American Cancer Society. Endometrial cancer detailed guide.
- Bakkum-Gamez JN, Gonzalez-Bosquet J, Laack NN, Mariani A, Dowdy SC. Current issues in the management of endometrial cancer. Mayo Clinic Proceedings. 2008;83(1):97-112.