Treatment Overview

Endometrial cancer detected in its early stages can be cured with surgery and close follow-up. Treatment choices depend on where the cancer is and how much it has grown. Treatment may include one or more of the following:

• Hysterectomy with bilateral salpingo-oophorectomy surgery to remove the uterus, ovaries, fallopian tubes, and sometimes the pelvic lymph nodes
• Lymphadenectomy surgery to remove lymph nodes
• Radiation therapy to kill cancer cells
• Progestin hormone therapy to block cancer growth
• Chemotherapy to kill cancer cells

Initial treatment

After a diagnosis of endometrial cancer is confirmed, your doctor may recommend surgery to remove the uterus, ovaries, and fallopian tubes (hysterectomy with bilateral salpingo-oophorectomy). All tissues removed in surgery will be examined to find out the stage and grade of the cancer. Lymph nodes near the uterus may be examined to find out if cancer has spread outside of the uterus.⁶

Treatment for endometrial cancer depends on the size of the cancer, the extent of the cancer's growth, and how the cancer cells look under the microscope.

If you have recently been diagnosed with endometrial cancer, you may experience a wide variety of emotions in reaction to your diagnosis. There is no "normal" or "right" way to react to a diagnosis of cancer. But if your emotions are interfering with your ability to make decisions about your health and to move forward with your life, it is important to talk with your doctor. Your cancer treatment center may offer counseling services.

You may also contact your local chapter of the American Cancer Society to help you find a support group. Talking with other women who have had similar feelings after a diagnosis such as yours can help you accept and deal with your disease.

What to think about during initial treatment

Most treatments for endometrial cancer cause side effects. Side effects may differ, depending on the type of treatment used and your age and overall health. Your doctor can talk to you about your treatment choices and the side effects associated with each treatment.

• Your surgeon and oncologist will explain the possible side effects of your surgery. A hysterectomy means you will no longer be able to become pregnant.
• Side effects of radiation therapy may include fatigue, skin irritation, or changes in your bowel or urinary habits.
• Side effects of chemotherapy may include loss of appetite, nausea, vomiting, diarrhea, mouth sores, hair loss, anemia, or infections.

Your quality of life becomes a critical issue when you are considering your treatment options. Be sure to discuss your personal preferences with your oncologist when he or she recommends treatment.

Use home treatment measures to help manage the side effects of treatment. For more information, see the Home Treatment section of this topic. Your doctor also may prescribe medicines to control nausea and vomiting.

Cancer: Controlling Nausea and Vomiting From Chemotherapy

Having cancer treatments such as radiation therapy or a hysterectomy may affect your ability to have or enjoy sexual intercourse. If you do have sexual problems, talk with your doctor.

If you are perimenopausal or have not yet reached menopause, your menstrual period will end immediately after most treatments for endometrial cancer. If your uterus and ovaries have been removed or have had radiation therapy, your body will have a decrease in estrogen. Estrogen normally prevents:

• Menopausal symptoms, such as hot flashes, changes in mood, vaginal dryness, and atrophy (shrinking) of pelvic tissues. Talk with your doctor about how to manage your symptoms if they are bothersome. For more information, see the topic Menopause and Perimenopause.
• An increased risk of heart disease and changes in your bones, such as osteoporosis.

Some women with endometrial cancer may be interested in taking part in research studies called clinical trials. Clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Women who do not want standard treatments or are not cured using standard treatments may want to be in clinical trials. These are ongoing in most parts of the United States and in some other countries for all stages of endometrial cancer.

Ongoing treatment

After your initial treatment for endometrial cancer, it is important to receive follow-up care. Your doctor will set up a regular schedule of checkups that will happen less often as time goes on.

Treatment if the condition gets worse

Endometrial cancer may come back (recur). But this is not likely when the first cancer is caught early and is low-risk. Of those cancers that do come back, nearly all do so within 3 years of the first diagnosis. This is why regular follow-up is extremely important after initial treatment.¹

Cancer that comes back only in the pelvic area sometimes is treated with radiation therapy. This may stop the progress of cancer and may even cure it if it is only in the vagina. If cancer has spread to other parts of the body, radiation therapy often provides relief (palliation) from symptoms. Chemotherapy may also be used.

Progestin hormone therapy often is used to slow the growth of cancer that has recurred or spread. These hormone treatments can help 15 to 30 out of 100 women who have endometrial cancer that has spread to other organs (metastasized).²

Participation in clinical trials to test new treatments may be appropriate if cancer has spread to other parts of the body and hormonal therapy is ineffective in stopping the growth.

Palliative care

Cancer treatment has two main goals: curing cancer and making your quality of life as good as possible. Palliative care can improve your quality of life by helping you to manage your symptoms. It can also help you with other concerns that you may have when you are living with a serious illness.

For some people with advanced-stage cancer, a time comes when treatment to cure cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But this isn't the end of treatment. You and your doctor can decide when you may be ready for hospice care.

It can be hard to decide when to stop treatment aimed at prolonging your life and shift the focus to end-of-life care. For more information, see the topics:

• Palliative Care.
• Hospice Care.
• Care at the End of Life.