Uterus cancer treatment consists mainly of two local therapies: surgical therapy and radiotherapy, and two systematic therapies that affect your entire organism: hormone therapy and chemotherapy.
Your doctor will use at least one of the basic treatments (surgery, radiotherapy, hormone therapy and chemotherapy) to combat the cancer. However, treatment used depends on your age, health status, location and stage of the cancer. Your health care provider may use a combination of these treatments to increase your chance of recovery.
Surgery is considered as the essential treatment of uterine cancer; it is fairly the safest method to completely eliminate the cancer. Depending on the stage of the cancer, your surgeon may perform a hysterectomy, removal of part or the entire uterus; or a hysterectomy with bilateral salpingo-oophorectomy, removal of the uterus along with the vagina, cervix, fallopian tubes and ovaries.
This is usually done through an incision in the abdomen, under general anesthesia; the surgery requires hospital stay. Although this method is new and less common, some surgeons have begun using the laparoscope for the detachment of the fallopian tubes and ovaries to complete the hysterectomy vaginally.
Whatever the method used to perform the hysterectomy, you will not be able to get pregnant after your uterus has been removed; talk to your surgeon if you plan to get pregnant in the future.
For a stage I uterine cancer, surgery is sometimes the only treatment necessary. In advanced or metastatic uterine cancer, however, chemotherapy, radiotherapy or hormone therapy can be associated.
Radiation Therapy (radiotherapy)
Treatment of a uterine cancer diagnosed at stage 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 its excision. Whether performed before or after the surgery, internal or external radiotherapy will be used. In some cases, both methods can be practiced.
- External beam radiation therapy – this method involves projecting high-dose of X-rays to the tumor to kill cancer cells. External radiation therapy is usually administered on an outpatient basis, once a day, five days a week for several weeks.
- Internal Radiotherapy – during this procedure, small tube containing radioactive material are inserted into your vagina for several hours to several days. The internal radiation therapy always requires hospitalization.
Chemotherapy involves the use of powerful chemical agents (drugs) to kill cancer cells. Chemotherapy is used to treat uterine cancer if the cancer is very aggressive (a cancer that spreads very quickly) or has spread beyond the uterine. Chemotherapy drugs can be taken by mouth, infusion or injection. In the treatment uterine cancer, however, 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 can cause side effects. Side effects vary from one person to another, from one drug to another. Most common adverse effects of chemotherapy medications used to treat uterine cancer include:
- low blood cells count
- stomach pain
- loss of appetite
- temporary hair loss
- increased vulnerability to infections
Hormone therapy usually involves taking synthetic progestin pills or gonadotropin-releasing hormone agonists (GnRH agonist) to stop the proliferation of the cancer cells. Hormone Therapy is most often used to treat advanced or recurrent uterine cancers.