Uterine Cancer Treatment

Uterine Cancer Treatment

There are a number of treatment options for endometrial cancer. Patients’ treatment plans will depend in large part on the stage of the cancer – or, whether it has spread beyond the uterus and, if so, how far. Many patients undergo surgery to remove the cancer. Some patients will also receive chemotherapy, immunotherapy, and/or radiation therapy to treat cancer cells that have spread to other organs or to reduce the risk of the cancer coming back.

At Siteman Cancer Center, our team of Washington University gynecologic oncologists understand that every patient is unique. They will design a personalized treatment plan for you, taking into account, not only the type, stage, and even genetic profile of your cancer, but also your age, desires for future fertility, and your overall health.

Many patients at Siteman receive treatment through clinical trials, which are research studies evaluating new drugs and procedures. Trials give patients access to new therapies, some that may even lead to better outcomes than the current standard of care. Siteman offers more clinical trials than any other facility in the region. Your physicians will have a conversation with you if they think a particular trial could be a good fit.

We understand that you probably have many questions and concerns as you embark on treatment for endometrial cancer. There is no question too small or simple to ask. Your care team – your physicians, nurse coordinators, and other support personnel – will be with you every step of the way, ready to help.

Chemotherapy

Chemotherapy is a cancer therapy that is infused through an IV to kill cancer cells wherever they may be found in the body. As with radiation therapy, chemotherapy is used for patients with more advanced endometrial cancer.

Most patients tolerate chemotherapy well. If chemotherapy is recommended for you, your oncologist will go over common side effects. These include fatigue, nausea, vomiting, and low blood counts– or, reduced numbers of red blood cells and white blood cells in the blood stream.  Low blood counts can make you more susceptible to bleeding, bruising, and infections.

At Siteman, we recognize that starting chemotherapy can be overwhelming. To help you through treatment, you will be assigned a dedicated nurse coordinator, who will spend additional one-on-one time with you and any support persons to make sure all of your questions and concerns are addressed. Your nurse coordinator will provide you with:

• Educational material on common chemotherapy side effects
• Prescriptions for medications that help prevent side effects before they occur
• A schedule of all of your treatments

We will guide you through this process. If you have already started your treatments and have questions, or are starting to notice bothersome symptoms, be sure to speak to your care team so that we can optimize your care and better support you.

Hormone therapy

Some patients may receive medications containing the hormone progesterone to treat endometrial cancer. Progesterone can stop endometrial cancer cells from growing and spreading, especially in patients with estrogen receptor positive cancers. Patients may be given progesterone for a number of different reasons. Some patients will receive it to treat cancer that has spread or returned after treatment. Other patients may take progesterone because they hope to have children and wish to avoid a hysterectomy for as long as possible.

Hormone therapy typically is given as an injection or pills. In some cases, it can be given locally with an intrauterine device, when a patient may desire future fertility.

Immunotherapy

Immunotherapy is a new form of cancer treatment that uses the patient’s own immune system to attack cancer cells. It’s most often used in combination with chemotherapy for patients with advanced disease or if the cancer has returned.

The immunotherapies used to treat endometrial cancer are a class of medications known as “checkpoint inhibitors.” Cancer cells can show a signal on their surface that tricks the immune system into thinking that the cancer cells are actually “normal” cells, preventing them from being attacked. Checkpoint inhibitors block the signal, allowing the white blood cells to recognize the cancer cells as foreign and eliminate them.

Like chemotherapy, immunotherapy for endometrial cancer is administered as an IV infusion.

Radiation therapy

Radiation therapy uses beams of particles to damage cancer cells, preventing them from spreading or multiplying. Patients with endometrial cancer may receive radiation therapy to eliminate malignant cells and keep the cancer from recurring. Radiation therapy can be administered as a follow-up treatment to a hysterectomy, or as a primary treatment if a patient cannot safely undergo surgery.

There are two basic ways of delivering radiation therapy to cervical cancer patients: external and internal. Most patients will receive both forms of radiation as part of their treatment. External radiation therapy uses large machines to transmit radiation beams to the tumor. During internal radiation therapy, a radioactive source passes by the tumor staying a short distance away for a few minutes. This process is called brachytherapy.

Learn more about radiation therapy at Siteman.

Surgery

Surgery to remove the uterus is often the first course of treatment for patients with endometrial cancer. This procedure is called a hysterectomy with removal of sentinel lymph nodes typically via minimally invasive techniques. In the operating room, your surgeon will inject a special dye to find the first draining lymph node of the uterus in order to effectively stage the cancer. This technology helps with minimizing lymphedema which is permanent swelling and discomfort of the legs. At Siteman, our gynecologic oncologists use advanced tools and techniques to operate safely and effectively.

Click here to read more about surgery for endometrial cancer at Siteman. 

Targeted therapy

Targeted therapies are medications that attack the mechanisms inside cancer cells that allow them to grow and multiply. They are not yet widely used in the initial treatment of endometrial cancer but can be helpful for patients with more advanced or recurrent disease.

There are several targeted therapy drugs used to treat endometrial cancer. Some of them work by preventing the tumor from growing new blood vessels. Others make it more difficult for the cancer cells to multiply.

Patients may receive targeted therapy drugs as either pills or intravenous infusions (IVs).

Weight management

Losing weight can help reverse uterine cancer. This is because adipose cells, or fat cells, make a protein that change testosterone to estrogen. The added amount of estrogen can cause the lining of the uterus to grow. Getting rid of or reducing this fat takes away an additional source of estrogen, allowing the body’s hormone levels to return to normal.

Your Washington University oncologists will carefully evaluate your cancer and discuss whether weight loss could improve your recovery.

Learn more about how Siteman helps endometrial cancer patients manage their weight.

Fertility preservation

Many younger women with endometrial cancer worry about how the disease will impact their ability to bear children. Depending on the type and stage of your cancer, the Washington University gynecologic oncologists at Siteman will work with you whenever possible to choose therapies that could effectively treat the cancer while extending your fertility.

In addition, we offer patients consultations with fertility preservation specialists who can provide a wide range of additional techniques, including egg banking.