Uterine Cancer

Treatment

Surgery is the most common approach to treating uterine cancer. Additional therapy to destroy uterine cancer cells may include radiation, chemotherapy and hormone therapy. After the treatment has been completed, physicians provide follow-up care that includes physical exams, pelvic exams, Pap smears, chest X-rays and laboratory tests.

Surgery

The most common initial treatment for uterine cancer involves surgery to remove the uterus. In almost all cases of uterine cancer, a gynecologic oncologist will recommend a hysterectomy (removal of the uterus) or a complete hysterectomy (removal of the uterus, fallopian tubes and ovaries). At Mayo Clinic, highly trained pathologists examine the tissue removed during the operation so the surgeon can make informed decisions about how much tissue to remove. This approach also helps the team determine if follow-up therapy is needed and can help predict long-term outcome. To find out whether cancer cells have spread to other parts of the body, the surgeon also removes lymph nodes that drain the uterus and performs biopsies of other abdominal sites. The need for these additional biopsies depends upon the type and extent of cancer found in the uterus. These procedures reflect the value of receiving treatment from a gynecologist with special training in oncology.

Radiation Therapy

Radiation (high-level X-rays) kills microscopic cancer cells that may remain after surgery. Patients with aggressive forms of uterine cancer or who are considered to be at high risk for recurrence may need radiation therapy after surgery. Radiation is occasionally used instead of surgery when the tumor cannot be safely removed surgically because of the cancer's stage or the patient's health.

Radiation may be given in the form of external beam irradiation and/or brachytherapy. External beam may utilize intensity modulated radiation therapy (IMRT) to decrease toxicity while treating the areas of concern.

Hormone Therapy

Progestin (synthetic progesterone) may be used to help stop the cancer from spreading to other parts of the body. Specific doses are prescribed in conjunction with other medications.

Chemotherapy

In chemotherapy, drugs are used to destroy cancer cells. Patients may receive drugs orally (pills) or intravenously (through their veins). Chemotherapy drugs travel through the body to kill cancer cells. Recent data suggest that chemotherapy can improve the outcome in some patients with advanced endometrial cancer after surgical removal of their tumor.