Endometrial cancer is a condition where cancer cells form layers in the endometrial linings of the female uterus which is why it is sometimes referred to as Uterine Cancer. But endometrial cancer is not the only cancer concerning the uterus. There are many cancers starting from the uterine area, but endometrial is the most common. Aside from being one of the most common types of cancer, endometrial cancer is also one of the easiest to detect due to its obvious symptom of irregular vaginal bleeding. Treatment of endometrial cancer often involves surgical removal of the uterus or hysterectomy.
Endometrial cancer is treated by one or a combination of treatments, including surgery, radiation therapy, chemotherapy, and hormone therapy. Combinations of treatments are often recommended. Treatment options depend on several factors, including the type and stage of cancer, possible side effects, and the woman’s overall health, and her age and her personal preferences, including whether or how treatment will affect the ability to have children. Women with endometrial cancer may have concerns about if or how their treatment may affect their sexual function and fertility.
Surgery is the removal of the tumour and surrounding tissue during an operation. It is typically the first treatment used for endometrial cancer. A surgical oncologist
is a doctor who specializes in treating cancer
using surgery. Common surgical procedures for endometrial cancer include:
- Hysterectomy: Depending on the extent of the cancer, the surgeon will perform either a simple hysterectomy (removal of the uterus and cervix) or a radical hysterectomy (removal of the uterus, cervix, the upper part of the vagina, and nearby tissues). For patients who have been through menopause, the surgeon will also perform a bilateral salpingo-oophorectomy, which is the removal of both fallopian tubes and ovaries.
- Lymph node dissection: At the same time as a hysterectomy, the surgeon may remove lymph nodes near the tumour to determine if the cancer has spread beyond the uterus.
- Sentinel lymph node biopsy: Sometimes a sentinel lymph node biopsy is performed. A sentinel lymph node biopsy is a procedure that helps the doctor to find out whether cancer has spread to the lymph nodes. This procedure is proven to be useful for breast and other cancers, and doctors are researching its usefulness in endometrial cancer.
Radiation therapy is the use of high-energy X-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist
. A radiation therapy schedule usually consists of a specific number of treatments given over a set period of time. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body.
Some women with endometrial cancer need both radiation therapy and surgery. The radiation therapy is most often given after surgery to destroy any cancer cells
remaining in the area. Radiation therapy is rarely given before surgery to shrink the tumour. If a woman cannot have surgery, the doctor may recommend radiation therapy as another option.
Radiation therapy options for endometrial cancer may include radiation directed towards the whole pelvis
, or applied only to the vaginal cavity often called intra-vaginal radiotherapy or IVRT.
Side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, and loose bowel movements and will depend on the extent of radiation therapy given. Most side effects usually go away soon after treatment is finished but long term side effects causing bowel or vaginal symptoms are possible.
Chemotherapy is the use of drugs
to destroy cancer cells, usually by stopping the cancer cell's’ ability to grow and divide. Chemotherapy is given by a medical oncologist
or gynaecologic oncologist
, a doctor who specializes in treating women’s reproductive cancer with medication. For patients with endometrial cancer, chemotherapy is given usually after surgery, either with or instead of radiation therapy. Chemotherapy is also used if the endometrial cancer returns after initial treatment.
The goal of chemotherapy can be to destroy cancer remaining after surgery, slow the tumour growth
, or reduce side effects. Although chemotherapy can be given orally (by mouth), most drugs used to treat endometrial cancer are given intravenously (IV). IV chemotherapy is either injected directly into a vein or through a catheter, which is a thin tube inserted into a vein.
The side effects of chemotherapy depend on the individual, the type of chemotherapy, and the dose used, but they can include fatigue
, risk of infection, nausea and vomiting, hair loss, loss of appetite
, and diarrhoea. These side effects usually go away once treatment is finished.
HORMONE THERAPY Hormone therapy
is used to slow the growth of certain types of endometrial cancer cells that have receptors to the hormones on them. These tumours are generally adenocarcinomas and are grade 1 or 2 tumours. Hormone therapy for endometrial cancer often involves the sex hormone progesterone
, given in a pill form. Other hormone therapies include the aromatase inhibitors (AIs) often used for the treatment of women with breast cancer
, such as anastrozole
(Femara), and exemestane
(Aromasin). An aromatase inhibitor is a drug that reduces the amount of the hormone oestrogen in a woman's body by stopping tissues and organs other than the ovaries from producing it. Hormone therapy may also be used for women who cannot have surgery or radiation therapy or in combination with other types of treatment.
Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.