Endometrial cancer is treated by one or a combination of treatments. Ultimately, treatment for uterine cancer depends on the type of cancer and how extensive it is, as well as whether it is localized or has spread (metastasized). Other factors include overall health, age, and personal preferences, such as whether it is important to preserve fertility.
Surgery
A total hysterectomy is the main surgical treatment for uterine cancer. That procedure removes the entire uterus and the cervix. A bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes) may also be performed to reduce the risk that the cancer will spread. Your doctor may also remove lymph nodes from the pelvic area to test for any cancer that may have spread outside of the uterus.
Hormone Therapy
Hormone therapy blocks or changes the effects of hormones that contribute to cancer growth. It’s sometimes used in patients who want to preserve the uterus and their fertility. It’s also often used to treat stage 3 or 4 cancer or cancer that has recurred after treatment.
Medication is prescribed to lower the body’s hormone levels so that uterine cancer cells, which grow in response to hormones, might die off. Depending on the drug prescribed, it comes in pill or injection form. Hormone treatment options for endometrial cancer can include:
Progestins, which are the primary hormone treatment prescribed
Aromatase inhibitors (AIs)
Tamoxifen
Fulvestrant
CDK 4/6 inhibitors
Chemotherapy
Chemotherapy is a type of cancer treatment that uses powerful medicine to kill cancer cells. It’s an effective way to treat cancer, but it also can cause unpleasant side effects such as nausea, fatigue, hair loss, nerve damage, and a loss of appetite. It can be used alone or in combination with other treatments, like surgery and radiation, to improve the patient’s chance for survival.
Drugs that are used to treat uterine cancer include:
bevacizumab (Avastin)
carboplatin
cisplatin
docetaxel (Taxotere)
doxorubicin (Adriamycin) or liposomal doxorubicin (Doxil)
gemcitabine
paclitaxel (Taxol)
Radiation Therapy
Radiation therapy is often used after surgery to destroy any remaining cancer cells. This is the main treatment for women whose cancer has returned, and for those who have health conditions that won’t allow them to have surgery. It’s often done along with chemotherapy to eliminate large uterine tumors or cancer that’s spread to other parts of the body.
Your doctor may order computerized tomography (CT) scans during treatment to ensure that the radiation avoids nearby healthy organs and tissues and to track the shape and size of the tumor. Radiation therapy can be given two ways:
Internal radiation therapy, which is when radioactive materials are placed inside the body. It’s also known as brachytherapy.
External beam radiation therapy, which is performed with a machine that focuses radiation beams at the tumor.
Targeted Therapy
Targeted drug treatments are designed to attack changes within cancer cells. They are mostly used to treat high-risk endometrial cancers and those that have metastasized. They have different and possibly less severe side effects than chemo drugs, but they are sometimes combined with chemotherapy.
Targeted drugs include:
bevacizumab (Avastin), Trastuzamab (Herceptin)
cabozantinib (Cabometx)
entrectinib (Rozlytrek)
everolimus (Afinitor)
fam-trastuzumab deruxtecan-nxki (Enhertu)
larotrectinib (Vitrakyi)
lenvatinib (Lenvima)
temsirolimus (Torisel)
Immunotherapy
Immunotherapy uses drugs that help the patient’s own immune system fight the cancer. In the case of uterine cancer, a type of immunotherapy known as a checkpoint inhibitor, specifically a drug called pembrolizumab (Keytruda), may be used. Pembrolizumab is sometimes used in tandem with the targeted therapy lenvatinib (Lenvima). Dostarlimab is another immune checkpoint inhibitor that may be used alongside chemotherapy to treat advanced or recurrent endometrial cancer.
