top of page

Treatments and Side Effects

Talk to your gynecologic oncologist about the treatment options available for your type and stage of uterine / endometrial cancer. Your doctor can explain the risks and benefits of each treatment and their side effects. Side effects are how your body reacts to drugs or other treatments.

 

Uterine cancer is treated in several ways. It depends on the kind of uterine cancer and how far it has spread. Treatments include surgery, chemotherapy, and/or radiation.

 

Understanding the goals of treatment

As you begin your treatment, make sure that you understand what to expect. Is this for a cure? What are the chances of a cure? If there is no cure, will the treatment make me live better or longer? It is very important to understand the truth about what to expect from the treatment—and what are the potential costs of side effects, expenses, etc.—so that you can make the best decisions for yourself and the life you want to lead.

Side Effects of treatment

All treatments for uterine cancer have side effects, but most side effects can be managed or avoided. Treatment may affect various aspects of your life, including your function at work, home, intimate relationships, and deeply personal thoughts and feelings.

 

Before beginning treatment, it is important to learn about the possible side effects and talk with your treatment team members about your feelings or concerns. They can prepare you for what to expect and tell you which side effects should be reported to them immediately. They can also help you find ways to manage the side effects that you experience.

The National Comprehensive Cancer Network (NCCN) establishes guidelines for treatment of many cancers, including uterine cancer. You can find a patient guide to standardized treatment of uterine cancer HERE.

 

Learn more about NCCN HERE.  

Surgery: The most common treatment for endometrial cancer is surgery. Several types of surgery can be performed.

Hysterectomy (total) involves removal of the uterus, cervix, fallopian tubes, and ovaries and is the standard procedure for treating endometrial cancer. The uterus, cervix, fallopian tubes, and ovaries can be removed in one of two ways:

  • Total abdominal hysterectomy: The uterus, cervix, fallopian tubes, and ovaries are taken out through an incision in the abdomen.

  • Minimally invasive hysterectomy (laparoscopic-assisted vaginal hysterectomy and robotic-assisted laparoscopic hysterectomy): The uterus, cervix, fallopian tubes and ovaries are taken out through the vagina with the assistance of a laparoscope or robotic device (with a camera attached) that is placed through the abdomen via a small incision.

 

For patients with multiple medical problems who are not healthy enough to undergo an extensive surgical procedure, a vaginal hysterectomy is another option, although some patients are not surgical candidates. In most cases, both ovaries and both fallopian tubes must also be removed. This procedure is called a bilateral salpingo-oophorectomy.

In addition to these procedures, lymph nodes in the abdomen and pelvis may also be removed to see whether they contain cancer.

 

Chemotherapy: Using special medicines to shrink or kill the cancer. The drugs can be pills you take, or medicines given in your veins (IV or intravenous), or sometimes both. Chemotherapy drugs travel through the bloodstream to reach all parts of the body. This is why chemotherapy can be effective in treating endometrial cancer that has spread beyond the uterus (Stage III or IV). However, the same drugs that kill cancer cells may also affect healthy cells.

 

Another method of delivering chemotherapy drugs is intraperitoneal (IP) therapy, which is the delivery of anti-cancer drugs directly into the peritoneal space (abdominal cavity), the space that lies between the abdominal muscles and abdominal organs. To limit the damage to healthy cells, chemotherapy is usually given in cycles. Periods of chemotherapy are alternated with rest periods, during which no chemotherapy is given.

 

Most people with endometrial cancer receive intravenous chemotherapy that is usually given after surgery, but in some cases, it may be given prior to hysterectomy surgery.

 

Commonly used chemotherapy drugs for gynecologic cancers include: carboplatin, cisplatin, paclitaxel, docetaxel, doxorubicin, and others. These medications can be given alone or in combination. The combination of carboplatin and paclitaxel is the most commonly used therapy for patients requiring chemotherapy for endometrial cancer.

Managing Chemo Side Effects

Each person responds to chemotherapy differently. Some people may have very few side effects, while others experience several. Most side effects are temporary. They include:

  • Nausea

  • Loss of appetite

  • Mouth sores

  • Increased chance of infection

  • Bleeding or bruising easily

  • Hair loss

  • Fatigue

 

Radiation: Radiation therapy (also called radiotherapy) uses high-energy x-rays, or other types of radiation, to kill cancer cells or stop them from growing.

 

Radiation therapy can be used:

  • Instead of surgery to treat early-stage endometrial cancer, although this is uncommon.

  • Before surgery, to shrink the cancer (called neoadjuvant therapy).

  • After surgery, to kill any cancer cells that may have spread to other tissues within the pelvis (called adjuvant therapy).

 

Two types of radiation therapy are used to treat endometrial cancer:

  • External radiation therapy uses a machine that directs the x-rays toward a precise area of the body. The therapy is usually given every day for about 6 weeks. It does not hurt and only takes a few minutes each day. You can be treated at a clinic, hospital or radiation oncology office.

  • Internal radiation therapy (also called brachytherapy) involves placing a small capsule of radioactive material inside the vagina. This procedure can be performed either on an inpatient or outpatient basis, depending on your treatment team’s recommendation.

 

Side effects of radiation

The side effects of radiation therapy depend on the dose used and the part of the body being treated. Common side effects include:

Dry, reddened skin in the treated area

Fatigue

Diarrhea

Discomfort when urinating

Narrowing of the vagina

Anemia

 

Most of these side effects are temporary. Be sure to talk with your treatment team members about any side effects that you experience. They can help you find ways to manage them.

 

Refer to the article linked below to learn more about radiation therapy for uterine and endometrial cancers:

https://www.cancer.org/cancer/types/endometrial-cancer/treating/radiation.html

 

Hormone Therapy: Some types of endometrial cancer have hormone receptors that can be targeted to prevent their growth. In such cases, hormone therapy is a treatment option. Hormone therapy can block these receptors and inhibit female hormones as a way of preventing endometrial cancer cells from getting or using the hormones they may need to grow. It is usually taken as a pill but can be given as a shot.

 

Side effects of hormone therapy

The side effects of hormone therapy depend on the type of hormones being used. Some people retain fluid and have a change in appetite or have hot flashes. Other hormones can sometimes cause blood clots.

Targeted therapies are a type of cancer treatment that targets cancer cells to stop or slow the growth or spread of cancer cells. These drugs can be pills you take or medicines given in your veins. Your doctor may recommend genetic testing to find out which targeted therapy is right for you.

New treatment options are continually being developed. You can learn about the most up to date options for Uterine and Endometrial cancer on the Foundation for Women’s Cancer website: https://foundationforwomenscancer.org/gynecological-cancers/gynecologic-cancer-types/uterine-endometrial-cancer-gtd/

 

You may find it helpful to track any side effects you experience and then talk to your doctor about the ones that cause you concern. Often, your doctor will have a solution or suggestions for helping combat side effects. They won’t know unless you tell them!

Resources:

Foundation for Women's Cancer

American Cancer Society

Centers for Disease Control

bottom of page