Gynecologic Oncology Program

Endometrial Cancer

Treatment Options

There are four primary treatment options for patients with endometrial cancer:

surgery
radiation therapy
chemotherapy
hormone therapy

Surgery
Surgery is the most common treatment for endometrial cancer. Typically, a doctor will remove the uterus (hysterectomy) and the pelvic lymph nodes (lymph node dissection). The uterus can be removed through an incision in the abdomen or through the vagina. If the hysterectomy includes removal of surrounding tissues and the top portion of the vagina, the procedure is called a radical hysterectomy. If the cancer has spread to the ovaries and fallopian tubes, they may also be removed during the hysterectomy (bilateral salpingo-oophorectomy).

Side effects of surgery:

Recovery from a hysterectomy may take from two to six weeks (with a three- to seven-day hospitalization), depending on the type of hysterectomy performed. After a hysterectomy, a woman is no longer able to have children. If her ovaries have also been removed, she will enter menopause if she has not already done so.

Radiation Therapy
Radiation is the use of high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation therapy or brachytherapy). Radiation can be used alone or in addition to surgery and/or chemotherapy.

Brachytherapy is typically used after a hysterectomy in cases where only the upper third of the vagina needs to be treated. Radioactive seeds are inserted into an applicator in the vagina. The cancerous area can be treated without affecting nearby organs and structures.

In more advanced cancers, external beam radiation is often used before or after surgery. A series of treatments are usually given over a period of several weeks.

Side effects of radiation:

The side effects of external beam radiation include fatigue; skin irritation, infection, and discoloration; and diarrhea. Radiation to the pelvic area can also cause irritation to the bladder, narrowing of the vagina due to scar tissue, and premature menopause.

Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Most anticancer drugs are injected into a vein (IV) or a muscle; some are given by mouth. Chemotherapy is a systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body to kill cancerous cells. This makes it a useful treatment for cancers that have spread beyond the endometrium. It is generally given in cycles: a treatment period is followed by a recovery period, then another treatment period, and so on.

Side effects of chemotherapy:

Chemotherapy drugs generally target rapidly dividing cancer cells. However, other cells that also divide rapidly include blood cells, cells that line the digestive tract, and cells in hair follicles. Unfortunately, these healthy cells may also be impacted by the chemotherapy drugs, resulting in side effects such as infections, tiredness, temporary hair loss, mouth or vaginal sores, changes in the menstrual cycle, and infertility. Not all chemotherapy patients develop all of these symptoms, and they usually go away during the recovery period or after treatment stops. Medicines and other treatments are available to control or minimize many of these symptoms.

Hormone Therapy
Hormone therapy is the use of hormones, usually taken by pill, to kill cancer cells. It is used to change the way hormones in the body help cancers grow. For the treatment of endometrial cancer, progesterone may be given to slow the growth of the cancer cells.

This page was last updated on: March 3, 2008.