Understanding endometrial cancer treatment options

Cancer

Jun 11, 2020

There are several ways to treat endometrial cancer depending on the stage and type. Gynecologic Oncologist Dr. Sarah Gill explains. Learn more about:

Surgery
Chemotherapy Therapy
Radiation Therapy
Other Treatment Options

If you or a loved one are among the more than 65,000 women diagnosed with endometrial cancer each year, there are several treatment options to help you get back on your feet sooner.

Endometrial cancer develops when the cells that form the lining (or endometrium) of the uterus change and start to grow out of control, explains Dr. Sarah Gill, gynecologic oncologist with St. Joseph’s/Candler Gynecologic Oncology & Surgical Specialists. These cells have the ability to grow unchecked, invading the wall of the uterus and could potentially spread to other organs.

Most endometrial cancers grow slowly and are identified early when the cancer is still confined to the uterus, Dr. Gill says. Depending on the stage and type, your doctor will go over all your treatment options.

There are several treatments for endometrial cancer, but for the majority of patients, surgery is the first line of defense, Dr. Gill says. Other treatment options may include radiation therapy, chemotherapy or hormone or immunotherapy.

At the Nancy N. and J.C. Lewis Cancer & Research Pavilion, we have a team of physicians, nurses, dietitians and others that work together to plan the best course of treatment for each of our individual cancer patients.

While each patient’s case is individualized, it’s important to have a good understanding of endometrial cancer treatment options.

Surgery

Surgery is the main treatment for most women with endometrial cancer. Exceptions may include: the disease is so advanced that it cannot be removed surgically or the patient has other medical conditions that put them at high risk of complications of surgery, Dr. Gill says.

But in most cases, surgery is the best option. The majority of endometrial cancer surgeries are performed robotically through the da Vinci Robotic Surgical System.

“A robotic approach allows patients to have a very thorough but minimally-invasive surgery,” Dr. Gill says.

Some of the benefits of robotic surgery include:

Less postoperative pain
Less time in the hospital after surgery
The option for sentinel lymph node sampling, which decreases the risk of chronic leg swelling after surgery
Improved 3-D visualization for the surgeon, which allows a more accurate sampling of potentially cancerous tissue

The recovery time is typically about six weeks. Dr. Gill says patients may feel better after just one to two weeks, but are still sore and tired until about six weeks after surgery.

If the patient has other complicating factors that require a larger incision, your physician may opt for laparoscopic or even open surgery, which may require a longer recovery time.

The good news is that for most patients with cancer that is only found in the uterus, surgery is curative, Dr. Gill says. However, if the cancer has spread to the lymph nodes, other areas of the pelvic or anywhere outside the pelvis, your physician may recommend other sources of treatment.

Chemotherapy

Chemotherapy is the use of drugs that kill cancer cells. They are administered typically by mouth as pills or through a vein with an IV.

If the cancer has spread outside the uterus, chemotherapy (often in combination with radiation therapy) can help kill cancer cells that were not removed during surgery. If chemotherapy is required, patients usually get a total of six treatments over 18 weeks, Dr. Gill says.

Radiation therapy

Radiation therapy is sometimes required. Most commonly, vaginal brachytherapy is prescribed, Dr. Gill says.

Vaginal brachytherapy gives a small dose of radiation to the top of the vagina to decrease the risk of recurrence there, as the top of the vagina is a very common place for the cancer to come back, Dr. Gill says. Vaginal brachytherapy consists of three to six treatments that typically last around 15 to 20 minutes.

Another option your medical team may consider is whole pelvic radiation. This also functions to decrease the risk of recurrence in the pelvis. Whole pelvic radiation is given daily, Monday through Friday, for about five weeks through external beam radiation therapy such as the TrueBeam device.

Other treatment options

Other treatment options your medical team may recommend include:

Hormone therapy, which is the use of hormones or hormone-blocking drugs to treat cancer. It’s most often used to treat advanced stages of endometrial cancer or cancer that has recurred. Hormone therapy is often used along with chemotherapy.
Immunotherapy is treatment with drugs that help a person’s own immune system better recognize and kill cancer cells. Immunotherapy may be recommended in certain types of endometrial cancer that has spread or recurred.
Clinical trial participation to study advances in treating endometrial cancer. For example, a clinical trial may study the use of targeted therapy for endometrial cancer. Targeted therapy is treatment with drugs that target certain changes in cancer cells. They are different than standard chemotherapy drugs and sometimes have less severe side effects.

Advice for women going through endometrial cancer treatment

However your medical team decides to treat your endometrial cancer, Dr. Gill offers some advice for women going through endometrial cancer:

Stay positive and continue living your life
Join support groups or contact someone who has been through a similar treatment to get advice and comfort
Stay away from sick people
Wash your hands often
Consult your doctor for any unpleasant side effects that you experience because there are supportive treatments available most of the time

Also in this series:

St. Joseph's Hospital Campus

Candler Hospital Campus

Pooler Campus