Most of the times, treatment of endometrial cancer consists of surgery, radiotherapy, hormone therapy and chemotherapy. However, the treatment varies depending on your age and general health, the stage and/or the location of the metastasis. Your doctor can use a combination of these therapies to increase your chance of recovery.
Surgery is considered the essential treatment of endometrial cancer; it is fairly the safest medical procedure to eliminate the tumor. Depending on the stage of the cancer, your surgeon may perform a hysterectomy, removal of all or part of the uterus; or a hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO), removal of the uterus along with the vagina, cervix, fallopian tubes and ovaries.
TAH-BSO is usually done under general anesthesia and requires a hospital stay. Although this method is new and less common, your surgeon can perform a laparoscopic surgery to remove the tumor.
Laparoscopic surgery – also called minimally invasive surgery (MIS), a laparoscopic surgery is a recent surgical technique consists of operating an organ of the abdomen through small incisions. This method allows quicker recovery than other abdominal surgeries that involve large cuts.
However, any surgical method performed involving removal of your uterus will make you unable to conceive. Talk to your surgeon if you plan to get pregnant in the future.
For a stage I endometrial cancer, surgery is sometimes the only treatment necessary. In advanced or metastatic cancer, however, chemotherapy, radiotherapy or hormone therapy may be associated with the surgery.
Radiotherapy (radiation therapy)
In case of endometrial cancer stages II, III or IV, surgery must be followed by radiation therapy to destroy locally the cancerous cells and reduce the risk of recurrence or metastasis. In rare cases, however, radiotherapy can be administered before surgery in order to reduce the size of the tumor to facilitate the removal. In general, your physician will recommend internal radiotherapy or external radiation therapy; sometimes, both methods are used.
External beam radiation therapy – this form of radiotherapy involves projecting high-dose of X-rays to the tumor and a small surrounding healthy to kill cancer cells or slow their multiplication. External radiation therapy is usually administered five days a week for several weeks or months.
Internal radiation therapy – in this form of radiotherapy, the radiation is placed very close to or inside the tumor. During an endometrial cancer internal radiation therapy, the radioactive materials (wires, plastic tubes, ribbons, capsules, or seeds) are inserted into the vagina for several hours to several days. The internal radiation therapy always requires hospitalization.
Chemotherapy involves use of a combination of powerful chemical substances (drugs) to kill cancer cells. Chemotherapy is recommended in the treatment of endometrial cancer, if the cancer is very aggressive -a cancer that spreads very quickly or has spread beyond the endometrium. In the treatment of endometrial cancer, chemotherapy drugs are usually administered intravenously to navigate the bloodstream to reach all parts of the body. Your doctor may administer several medications (polychemotherapy) at the same time to facilitate the destruction of the cancerous cells.
However, the chemotherapy drugs attack both the tumor cells and normal cells which multiply rapidly causing side effects. Side effects vary from one person to another, from one drug to another. Adverse effects most commonly associated with endometrial cancer drugs include:
- low blood cells count
- stomach pain and vomiting
- loss of appetite
- temporary hair loss
- increased vulnerability to infections.
In case the cancer has spread into your body, you can be recommended to take hormone drugs to stop the tumor from growing. Like chemotherapy, hormonetherapy is a systemic therapy that affects your entire body. Hormone therapy in the treatment of endometrial cancer usually involves taking synthetic progestin to stop the proliferation of cancer cells. If your doctor thinks it will be helpful, he can prescribe you gonadotropin-releasing hormone agonists to lower your estrogen levels.
Hormone Therapy is most often used to treat advanced or recurrent cancers of the endometrium. Some of their side effects include:
- increased risk of heart disease and breast cancer
- weight gain
- fluid retention and edema
- increased risk of blood clots
- anxiety and nervousness
- hair loss
- skin disorders
- Thyroid problems.