Endometrial Cancer Treatment Options

There are several different treatment options for people with endometrial cancer, also referred to as uterine cancer. The best treatment options depend on several factors, including the stage of endometrial cancer, the type of cell causing the cancer, whether the patient has already been through menopause, overall health, the ability to tolerate different treatments, as well as personal preferences. One or more of the following types of treatment may be included in the treatment plan for endometrial cancer: 

• Surgery
• Radiation Therapy
• Chemotherapy
• Hormone Therapy
• Targeted Therapy
• Immunotherapy
• Clinical Trials

An endometrial cancer diagnosis should be discussed with a gynecologic oncologist, a type of doctor who specializes in cancers of the female reproductive system. They will evaluate several factors and make sure to learn about your values and preferences. From there, a personalized cancer treatment plan is created. The oncologist will discuss the side effects of each treatment type and describe the expected timing for each therapy with you. 

Learn more about what to expect after a gynecologic cancer diagnosis.

Surgery to Remove Cancer of the Uterus

Surgery is often the most common method of treatment for women with endometrial cancer. The gynecologic oncologist will also perform the surgery. Surgery is most commonly performed using a minimally invasive laparoscopic procedure that allows the doctor to see the cancer’s exact location and if it has spread. Learn more about da Vinci robotic surgery.

Based on the findings at the time of surgery, removal of the cervix, uterus, fallopian tubes, and ovaries (depending on the patient’s age) may be recommended to remove the cancer and determine more information. However, if the cancer has moved outside of the uterine lining, it may be necessary to remove additional organs. The surgeon may also take lymph node biopsies at the time of the surgery.  

If tumors are found throughout the abdomen, a debulking procedure is performed to remove as much of the cancer as possible.

The extent of surgery needed will impact the recovery time, but in the event minimally invasive surgery is appropriate, patients may go home the same day and recover comfortably.  

Radiation Therapy for Endometrial Cancer

Radiation therapy is an option for women with all stages of uterine cancer. It may be used before or after surgery. For women who can’t have surgery for other medical reasons, radiation therapy may be used instead to destroy cancer cells in the uterus. Women with cancer that invade tissue beyond the uterus may have radiation therapy and chemotherapy.

Radiation therapy uses high-energy rays to kill cancer cells. It affects cells in the treated area only.

Doctors use two types of radiation therapy to treat uterine cancer. Some women receive both types.

• External radiation therapy: A large machine directs radiation at your pelvis or other areas with cancer. The treatment is usually performed in a hospital or clinic. You may receive external radiation 5 days a week for several weeks. Each session takes only a few minutes.
• Internal radiation therapy (also called brachytherapy): A narrow cylinder is placed inside your vagina, and a radioactive substance is loaded into the cylinder. This common method of brachytherapy may be repeated two or more times over several weeks. Once the radioactive substance is removed, no radioactive material is left in the body.

Chemotherapy for Endometrial Cancer

Chemotherapy uses medications to kill cancer cells. It may be used after surgery to treat uterine cancer that has an increased risk of returning after treatment. For example, uterine cancer that is a higher stage (Stage III or IV) or a more aggressive type of cancer, may be more likely to return. Also, chemotherapy may be given to women whose uterine cancer can’t be completely removed by surgery. For advanced cancer, it may be used alone or with radiation therapy.

Usually, a combination of chemotherapies is most effective for treating endometrial cancer.

Hormone Therapy to Treat Endometrial Cancer

Some uterine tumors use hormones to grow. These tumors have hormone receptors for the hormones estrogen, progesterone, or both. If lab tests show the tumor in your uterus has these receptors, then hormone therapy may be an option.

Hormone therapy may be used for women with advanced uterine cancer. Hormone therapy may be a good alternative for women with Stage I uterine cancer who want to have children. 

The main hormone treatment for endometrial cancer is progestins. These drugs have been found useful for women who would like to get pregnant in the future. 

Some patients might receive other kinds of hormone therapy: 

• Tamoxifen is an anti-estrogen drug sometimes used to treat advanced or recurrent endometrial cancer.
• Luteinizing hormone-releasing hormone agonists (LHRH agonists) lowers estrogen levels in women who still have working ovaries, “turning them off” so they no longer make estrogen. 
• Aromatase inhibitors can stop additional estrogen from being produced in the body’s fat tissue after the ovaries have been removed.

Targeted Therapy for Endometrial Cancer

Targeted therapy uses drugs or other substances to identify and attack specific cancer cells. The precision of this approach usually causes less harm to normal cells than chemotherapy or radiation therapy. 

A common test performed on the endometrial cancer cells removed determines whether there is an overexpression of the HER2 protein causing the cells to grow rapidly. If the protein exists, a HER2-blocking targeted therapy is used to slow production.

Targeted therapies for endometrial cancer: 

• Anti-angiogenesis therapy blocks the growth of blood vessels (angiogenesis) that support tumor growth. 
• Mammalian target of rapamycin (mTOR) inhibitors block mTOR, a protein that helps control cell division. mTOR inhibitors may keep cancer cells from growing and prevent the growth of new blood vessels that tumors need to grow. 

Immunotherapy Drugs for Endometrial Cancer Treatment

The patient’s immune system can be used to fight cancer cells. Some cancers can disguise themselves as healthy cells by turning off cell checkpoints that tell the body whether to attack and kill cells that are not normal. Immunotherapy drugs that target these checkpoints can be used to treat some endometrial cancers. 

Immunotherapy uses substances made by the body or in a laboratory to boost the immune system and help the body better recognize and attack cancer cells. Immunotherapy treatment for endometrial cancer is primarily immune checkpoint inhibitors.

Clinical Trials Can Be Part of the Endometrial Cancer Treatment Plan

Cancer research plays a vital role in making each of these endometrial cancer treatments available to patients everywhere. Our participation in clinical trials allows us to offer our patients access to clinical trials. This opens new treatment options to eligible patients. If your VOA endometrial cancer specialist discusses a specific clinical trial with you, we hope you consider it as an option for your treatment plan as it may benefit you and others as well. Learn more about clinical research trials for gynecologic cancers.

The Latest Endometrial Cancer Treatments at Virginia Oncology Associates

For women diagnosed with a type of gynecologic cancer like uterine cancer, the first step is to meet with a gynecologic oncologist. The first appointment with an oncologist aims to provide you with an individualized treatment plan for your specific diagnosis of endometrial cancer. 

Virginia Oncology Associates offers personalized treatment plans and second opinions on treatment in Chesapeake, Newport News, Norfolk, and Suffolk, Virginia.