The stage of your cancer is the primary factor your doctor considers in recommending the best treatment options. However, your medical team also considers your age, overall health, personal preferences and chance for recurrence before making suggestions. You may need more than one kind of treatment. Depending on your needs, you may work with many types of doctors:
- Gynecologists treat diseases of the female reproductive system.
- Gynecologic oncologists specialize in treating cancers of the female reproductive system with surgery, chemotherapy and radiation therapy.
- Medical oncologists use medicine (including chemotherapy) to treat cancer.
- Radiation oncologists use radiation therapy to treat cancer.
It is important for everyone with cancer to feel comfortable with their doctors, and that can be especially true for women with gynecologic cancers. You should feel free to seek a second opinion (asking another doctor to confirm your diagnosis and recommend treatment options).
Surgery is the most common treatment for endometrial cancer, but radiation therapy, hormone therapy and chemotherapy are widely used, too.
Surgery for endometrial cancer typically involves removing the uterus and cervix, a procedure known as a hysterectomy. The ovaries and fallopian tubes are also often removed in a procedure known as a bilateral salpingo-oophorectomy (BSO). Removing both ovaries will cause menopause in premenopausal women.
If cancer has spread to the cervix or the area around it, your doctor may suggest a radical hysterectomy. In a radical hysterectomy, the entire uterus, the tissues next to the uterus and the upper part of the vagina are removed. A BSO is done at the same time.
During surgery, the surgeon may also extract lymph to help determine the exact stage of cancer. If the cancer has spread throughout the abdomen, surgeons try to remove as much of the tumor as possible.
In radiation therapy, high-energy X-rays or other types of radiation are used to kill cancer cells or stop them from growing. Radiation therapy is given in two different ways: external-beam radiation therapy and internal radiation therapy.
In external-beam radiation therapy, a machine outside the body sends radiation to the cancer. Internal radiation is also called brachytherapy. For brachytherapy, a source of radiation is placed in or near the tumor. If brachytherapy is used to treat endometrial cancer, the radioactive material is often placed in a tube, which is then inserted in the vagina.
Chemotherapy uses systemic drugs, which travel throughout the entire body, to fight cancer. They can be administered in multiple ways, most commonly orally, intravenously or as an injection. Two or more chemotherapy drugs are often given together, which can work better than one chemotherapy drug alone.
Chemotherapy may be given for a few cycles, followed by radiation therapy and then more chemotherapy. Chemotherapy may also be given with radiation therapy, which is called chemoradiation.
Hormone therapy uses hormones or drugs that block hormones to stop cancer cells from growing. Progestins are the main hormone therapy drugs used for endometrial cancer, but selective estrogen receptor modulators (SERMs), luteinizing hormone-releasing hormone (LHRH) agonists and aromatase inhibitors may also be used to treat endometrial cancer.
Progestins slow the growth of endometrial cancer cells. SERMs are anti-estrogen drugs that prevent estrogen in the body from helping cancer cells grow.
Many women with endometrial cancer have surgery to remove their ovaries or have radiation therapy that makes their ovaries stop working. Removing the ovaries or decreasing their functionality reduces estrogen in the body, which can slow the growth of endometrial cancer. In women who still have functioning ovaries, LHRH agonists can lower estrogen levels. These drugs are also referred to as gonadotropin-releasing hormone (GnRH) agonists.
Aromatase inhibitors work by blocking enzymes that produce estrogen in women who have already been through menopause.
Clinical trials are research studies that determine whether new treatments are effective. Talk to your doctor about any clinical trials for which you might qualify. Participating in these studies may give you access to treatments that aren’t yet available. For more about clinical trials, click here.