Endometrial (Uterine) Cancer Treatment
Endometrial cancer begins in the inner lining of the uterus, a hollow, pear-shaped organ in the pelvis that supports pregnancy. Known as the endometrium, the uterine lining repeatedly builds up and sheds during the menstrual cycle, playing a key role in a woman’s reproductive health. The cancer arises when cells in the endometrium undergo harmful DNA changes that cause them to grow uncontrollably. In many cases, the changes are driven by hormonal imbalances involving estrogen, although the precise cause is not always clear.
The risk of endometrial cancer increases with prolonged estrogen exposure, which may occur with obesity, early menstruation, late menopause or never having carried a pregnancy to term. Certain inherited genetic syndromes, such as Lynch syndrome, can also significantly raise the risk. Additional contributing factors may include diabetes, high blood pressure and the use of estrogen-only hormone therapy. The cancer most often occurs in postmenopausal women, and it is usually diagnosed after abnormal vaginal bleeding prompts a medical evaluation.
Endometrial cancer is relatively common compared to many other gynecologic cancers, with more than 60,000 new cases diagnosed each year in the United States. When detected and treated early, the outcome is often very favorable. Treatment can vary based on the stage, grade and molecular features of the tumor and the patient’s overall health and preferences. Options may include surgery, chemotherapy, radiation therapy, immunotherapy or participation in a clinical trial.
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Schedule an AppointmentSurgery for endometrial cancer
Surgery is the primary treatment for endometrial cancer, particularly when the tumor is confined to the uterus. The most common procedure is a hysterectomy, which removes the uterus and cervix. In many cases, some nearby lymph nodes are also removed and sent to a pathology lab to check for evidence of cancer spread.
Depending on the extent of the cancer, other surgical treatment options may include:
- Radical hysterectomy with bilateral salpingo-oophorectomy – Removes the uterus, cervix, fallopian tubes and ovaries
- Pelvic extenteration – Removes the uterus, cervix, vagina, ovaries, bladder and rectum, which may be followed by reconstructive procedures and creation of a colostomy and urinary diversion
The surgeon may take a minimally invasive approach or use robotic assistance as appropriate. The goal is to remove all visible cancer while supporting the patient’s long-term health and recovery.
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Potential risks and side effects of endometrial cancer surgery
As with any surgery, endometrial cancer surgery carries potential risks, including infection, bleeding, blood clots and complications related to anesthesia. Additionally, removal of the ovaries may lead to sudden menopause in a premenopausal patient, which can cause symptoms such as hot flashes, mood swings and vaginal dryness. The healthcare team will review these risks in detail and suggest strategies to help manage any side effects both before and after surgery.
Preparing for endometrial cancer surgery and recovery
Surgical preparation typically includes imaging studies, lab work and a thorough medical history review. Before the procedure, the patient will receive specific instructions related to medications, nutrition and physical activity.
The recovery timeline can vary depending on the extent of the surgery. Most patients are encouraged to begin gentle movements soon afterward and gradually resume their normal activities. During follow-up appointments, the healthcare team will monitor healing and determine whether additional treatment may be needed.
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More than 60,000
new cases of endometrial (uterine) cancer are diagnosed each year in the U.S.
Chemotherapy for endometrial cancer
Chemotherapy may be considered for endometrial cancer that has spread beyond the uterus or returned after initial treatment. This powerful systemic treatment works by targeting rapidly dividing cells throughout the body. It is often used in combination with other treatments, such as surgery and radiation therapy, for enhanced effectiveness.
Chemotherapy drugs that may be used to treat endometrial cancer include:
- Paclitaxel
- Carboplatin
- Doxorubicin or liposomal doxorubicin
- Cisplatin
- A combination of drugs, such as carboplatin and paclitaxel or cisplatin and doxorubicin
Typically, chemotherapy is given in cycles, allowing the body time to recover between doses. The specific drugs and schedule will be tailored to the patient and the characteristics of the cancer. The duration of chemotherapy can vary depending on the treatment plan and how the cancer responds.
Potential risks and side effects of chemotherapy for endometrial cancer
The side effects of chemotherapy can vary based on the medications used. Common experiences include fatigue, nausea, hair loss, appetite changes, nerve-related symptoms and increased risk of infection. Most side effects are temporary and can be managed with supportive care. Throughout treatment, the healthcare team will monitor the patient and adjust the care plan as needed to balance effectiveness and quality of life.
Preparing for chemotherapy and recovery between cycles
Before starting chemotherapy, the patient will undergo medical testing to confirm that the treatment plan is safe and appropriate. During therapy, the healthcare team will monitor the patient for side effects and assess the response.
Between chemotherapy cycles, the patient will be encouraged to get sufficient rest, hydration and nutrition, all of which are important for recovery. Many patients are able to maintain their work schedule and daily routines with some slight modifications, depending on how they feel.
"You have pretty much one shot at it to get the best treatment that you can get. To me, Moffitt was my choice, and I would do it all over again."
Mary Beth, Endometrial Cancer Survivor
Request an AppointmentRadiation therapy for endometrial cancer
Radiation therapy is a well-established cancer treatment that uses targeted high-energy beams to destroy cancer cells. It may be used after endometrial cancer surgery to help reduce the risk of recurrence or as a primary treatment if surgery is not an option.
The two main types of radiation treatment for endometrial cancer are:
- Brachytherapy – A small amount of radioactive material is placed in a special applicator device and inserted into the vagina. Low-dose rate (LDR) brachytherapy requires that the device remain in place for one to four days, while high-dose rate (HDR) brachytherapy treatments are shorter in duration (typically less than one hour). HDR brachytherapy is usually administered in at least three doses scheduled several days or weeks apart.
- External beam radiation therapy (EBRT) – Before treatment begins, a mold of the patient’s lower back and pelvis will be created to help ensure proper positioning during each session. To help ensure accurate treatment delivery, the care team may place temporary skin markings or other positioning references during treatment planning. The radiation beams will be delivered via an external machine (linear accelerator). Treatments are usually scheduled five days a week over four to six weeks, with each session lasting approximately 30 minutes.
In some cases, radiation therapy is combined with chemotherapy for enhanced effectiveness.
Potential risks and side effects of radiation therapy for endometrial cancer
Common side effects of radiation therapy for endometrial cancer include fatigue, skin irritation in the treated area, vaginal discomfort and changes in bladder or bowel habits. These symptoms are usually temporary and improve after treatment ends. With careful planning, the healthcare team can minimize any exposure to the surrounding healthy tissues and help prevent or reduce side effects.
Preparing for radiation therapy and what to expect
Before beginning radiation therapy, the patient will attend a planning session (simulation) to map the tumor and treatment site. Usually, radiation is delivered over several weeks in a series of short outpatient sessions. Most patients are able to continue their normal activities during treatment, and supportive care will be available to minimize any discomfort.
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Schedule an AppointmentImmunotherapy for endometrial cancer
Immunotherapy is an emerging treatment option for certain types of endometrial cancer, particularly advanced or recurrent disease. This treatment approach works by helping the body’s immune system recognize and attack cancer cells more effectively.
The immune system uses checkpoints to distinguish healthy cells from abnormal or foreign cells. Some cancers exploit these checkpoints to avoid detection. Immune checkpoint inhibitors block this process, helping the immune system recognize and attack cancer cells more effectively.
Some endometrial cancers have specific molecular features, such as mismatch repair deficiency (dMMR), a genetic abnormality that prevents cells from correcting mistakes that arise when DNA copies itself, or microsatellite instability-high (MSI-H) status, which indicates that these DNA errors have accumulated within the tumor. These features make the cancer more likely to respond to immune checkpoint inhibitors.
In some cases, immunotherapy for endometrial cancer may be used alone or in combination with other treatments to improve the outcome.
Potential risks and side effects of immunotherapy for endometrial cancer
The side effects of immunotherapy differ from those of chemotherapy. Because immunotherapy activates the body’s immune system, it can sometimes cause inflammation in healthy tissues. Possible symptoms include fatigue, skin rash, diarrhea, thyroid changes or inflammation in the lungs, liver or other organs.
When identified early, most immunotherapy side effects are manageable. The healthcare team will closely monitor the patient throughout treatment so the care plan can be adjusted if needed.
Preparing for immunotherapy and what to expect
Before starting immunotherapy, the patient may undergo specialized testing to determine whether the cancer is likely to respond. Treatment is typically given through an IV infusion on a scheduled basis.
Many patients tolerate immunotherapy well and can maintain their daily routines. Ongoing communication with the healthcare team will be important to address new or unusual symptoms promptly.
Clinical trials for endometrial cancer
Clinical trials are an important option for some patients with endometrial cancer, particularly those with advanced or recurrent tumors. These research studies may be designed to evaluate the effectiveness of new chemotherapy drugs, hormone therapies, immunotherapies or targeted treatments based on tumor genetics. Participation in a clinical trial may allow the patient to be among the first to benefit from a promising new therapy while contributing to advances in endometrial cancer care.
Frequently asked questions (FAQs) about endometrial cancer treatment
A diagnosis of endometrial cancer often brings many questions. Understanding the treatment options can help the patient feel informed and supported. FAQs include:
- What are the endometrial cancer treatment options by stage?
- How soon after my diagnosis should I be treated for endometrial cancer?
- Will I need a hysterectomy to treat endometrial cancer?
- What can I expect after a hysterectomy?
- What are my chances of having children after endometrial cancer?
Benefit from world-class care at Moffitt Cancer Center
At Moffitt, patients with endometrial cancer receive comprehensive care from a multispecialty team with expertise in gynecologic oncology. We take an individualized, evidence-based approach supported by advanced diagnostics, innovative treatments and a strong focus on patient well-being from diagnosis through survivorship.
If you would like to learn more about endometrial cancer treatment, you can request an appointment with a specialist in the gynecologic clinic at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.
