The stage of the cancer, or how far it has spread, dictates the treatment strategy for Endometrial Cancer.
When detected early, endometrial cancer can often be cured. Treatment is most often surgical and radiation, but chemotherapy is used if the cancer has spread to other parts of the body. Chemotherapy can also reduce the risk of complications.
Common Treatment Options
- Hysterectomy: The most common intervention is a total abdominal hysterectomy, which is removal of the uterus through an incision in the abdomen. Often both fallopian tubes and ovaries are removed in a procedure called a bilateral salpingo-oophorectomy. Often the lymph nodes near the tumor are removed as well. The cancer may have spread to other parts of the body if the lymph nodes contain cancerous cells. Rarely, surgeons remove the omentum, which is an apron-like structure that hangs from the bottom of the stomach and helps circulation in the abdomen.
- Radiation Therapy: Radiation therapy is used in combination with surgery in women for whom the cancer is likely to recur, or when the cancer has spread. Radiation is used before surgery to shrink the tumor and after surgery to kill any cancerous cells that may remain. Either external or internal radiation may be used. The former directs radiation to the endometrium from outside the body, and the latter involves injection of a radioactive compound directly onto the area. Radiation treatment is used alone in women who are not eligible for surgery.
- Hormone Therapy: Hormonal therapy is used for the following: cancer that has affected tissues outside the pelvic region, in women who cannot have surgery or radiation, for tumors that are estrogen-dependent, and to treat recurrent cancer. The hormone is typically progesterone in pill form.
- Chemotherapy: Chemotherapy for recurrent or advanced endometrial cancer usually consists of cisplatin (Platinol). This platinum-containing drug interacts with DNA and interrupts cell growth and division.
Other Treatment Options
The U.S. National Cancer Institute is sponsoring research on new treatment options and strategies against endometrial cancer. For example, the effectiveness of combination treatment is being investigated in clinical trials. In one, the potential benefit of treatment with radiation in combination with three chemotherapeutic agents (cisplatin, paclitaxel, and carboplatin) is being investigated in women with stage I, II, or III cancer.
Less invasive techniques are also being sought. Laparoscopic (with small incisions) and traditional total abdominal hysterectomies are being compared with respect to disease-free survival and quality of life in women with stage I cancer.