Treating Endometrial Cancer

The most common treatment for women diagnosed with endometrial cancer is surgery but, depending on the type of cancer and stage, more than one treatment option may be used. Treament options include radiation, chemotherapy, hormone therapy, targeted therapy, and immunotherapy.

Surgery: The main treatment for endometrial cancer is surgery to take out the uterus and cervix. This operation is  called a hysterectomy. Most of the time the the fallopian tubes and ovaries are also removed. In order to determine the stage of the cancer, the lymph nodes are also removed. In some cases the surgeon will also perform a pelvic washing, which is when the abdominal and pelvic cavity are "washed" with salt water to see if there are endometrial cancer cells in the fluid.

Radiation Therapy: Radiation is often used after surgery to treat endometrial cancer. Radiation therapy uses high-energy radiation (like x-rays) to kill cancer cells. Radioactive materials are either put inside a cylinder and the cylinder is then put inside the vagina (internal radiation therapy or brachytherapy) or a machine focuses radiation beams on the tumor (external beam radiation therapy).

Chemotherapy: Chemotherapy is the use of drugs that kill cancer cells. They're given through an IV or by mouth as pills. These drugs go into the bloodstream and reach throughout the body. Because of this, chemo is often part of the treatment when endometrial cancer has  spread beyond the endometrium to other parts of the body and surgery cannot be done. Chemotherapy is often given in cycles: a period of treatment followed by a rest period. Chemo drugs used to treat endometrial cancer may include:

  • ​Paclitaxel (Taxol®)

  • Carboplatin

  • Doxorubicin (adriamycin®) or liposomal doxorubicin (Doxil®)

  • Cisplatin

  • Docetaxel (Taxotere®)

Hormone Therapy: This type of treatment uses hormones or hormone-blocking drugs to treat cancer. It is most often used to treat endometrial cancer that's advanced (stage III or IV) or has come back after treatment (recurred). Hormone therapy is often used along with chemotherapy. Hormone treatment for endometrial cancer may include:

  • Progestins, which is the main hormone treatment that's used

  • Tamoxifen

  • Luteinizing hormone-releasing hormone agonists (LHRH agonists)

  • Aromatase inhibitors (Als)

Targeted Therapy: Uses drugs that are made to target certain changes in the cancer cells. These drugs are mostly used to treat high-risk endometrial cancers and those that have spread (metastasized) or come back (recurred) after treatment. Drugs used in this type of therapy may include:

  • Lenvatinib (Lenvima®)

  • Bevacizumab (Avastin®)

  • mTOR inhibitors

    • Everolimus (Afinitor®)​

    • Temsirolimus (Torisel®)

Immunotherapy: Treatment with drugs that help a person’s own immune system better recognize and kill cancer cells. Immunotherapy can be used to treat certain types of endometrial cancer that has spread or come back (recurred). The main immunotherapy drug used for endometrial cancer is Pembrolizumab (Keytruda®).

References:

1. American Cancer Society. Chemotherapy for Endometrial Cancer. (2019, March 2017). Retrieved March 30, 2021, from https://www.cancer.org/cancer/endometrial-cancer/treating/chemotherapy.html

2. American Cancer Society. Hormone Therapy for Endometrial Cancer. (2019, March 2017). Retrieved March 30, 2021, from https://www.cancer.org/cancer/endometrial-cancer/treating/hormone-therapy.html

3. American Cancer Society. Immunotherapy for Endometrial Cancer. (2019, September 17). Retrieved March 30, 2021, from https://www.cancer.org/cancer/endometrial-cancer/treating/immunotherapy.html

4. American Cancer Society. Radiation Therapy for Endometrial Cancer. (2019, March 2017). Retrieved March 30, 2021, from https://www.cancer.org/cancer/endometrial-cancer/treating/radiation.html

5. American Cancer Society. Surgery for Endometrial Cancer. (2019, March 27). Retrieved March 30, 2021, from https://www.cancer.org/cancer/endometrial-cancer/treating/surgery.html

6. American Cancer Society. Targeted Therapy for Endometrial Cancer. (2019, September 17). Retrieved March 30, 2021, from https://www.cancer.org/cancer/endometrial-cancer/treating/targeted-therapy.html