Treatment and Prevention
Removal of the uterus (hysterectomy) is essential to treat endometrial cancer. This won't interfere with sexual activity, but the operation leads to infertility and can't be reversed. Only after the uterus, fallopian tubes, and ovaries have been removed can doctors judge the extent of the cancer. If the cancer hasn't invaded deep into the wall of the uterus (early stage) and isn't an aggressive type (low grade), additional treatment may not be necessary.
In more widespread cancer, radiation, chemotherapy, or both may be offered instead of (or after) surgery. Women with tumors that have invaded further into the wall of the uterus or are higher grade may require a course of pelvic radiation, chemotherapy, or both to kill remaining cancer cells. Some women have been cured by radiation alone after deciding against hysterectomy. However, most experts agree that keeping the uterus intact reduces the chances of a cure if there is no evidence of disease outside of the uterus at the time of diagnosis.
Pelvic radiation treatment can have unpleasant side effects, including nausea, abdominal pain, and fatigue. Another common side effect of radiation to the pelvis is narrowing of the vagina (stenosis). This may make sexual intercourse difficult or painful. Correcting this side effect may require regular stretching of the vagina with vaginal dilators to allow for sexual activity. This can be done at home.
If the cancer is very advanced, chemotherapy may be used alone or in combination with radiation. Chemotherapy can cause many side effects. These side effects vary depending on what chemotherapy medications your doctor decides to give you.
Synthetic progestins, a form of the hormone progesterone, are sometimes used to treat endometrial cancer when it is advanced or when it recurs. Synthetic progestins have only mild side effects compared to typical cancer medications; however, the chance of cure when treated by chemotherapy or progestins alone is very low.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Ed Tanner, MD, Gynecologic Oncology Fellow at Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.