What are the treatment options for endometrial cancer?
Surgery is the main treatment for cancer of the inside lining of the womb (uterus) - known as endometrial cancer. Radiotherapy or chemotherapy is also used in some circumstances. The treatment advised for each case depends on various factors such as the stage of the cancer (how large the cancer is and whether it has spread) and your general health.
You should have a full discussion with a specialist who knows your case. He or she will be able to give the pros and cons, likely success rate, possible side-effects and other details about the various possible treatment options for your type of cancer. You should also discuss with your specialist the aims of treatment. For example:
- In some cases, treatment aims to cure the cancer. Most cases of endometrial cancer are diagnosed at an early stage. There is a good chance of a cure if it is treated in the early stages. (Doctors tend to use the word remission rather than the word cured. Remission means there is no evidence of cancer following treatment. If you are in remission, you may be cured. However, in some cases a cancer returns months or years later. This is why doctors are sometimes reluctant to use the word cured.)
- In some cases, treatment aims to control the cancer. If a cure is not realistic, with treatment it is often possible to limit the growth or spread of the cancer so that it progresses less rapidly. This may keep you free of symptoms for some time.
- In some cases, treatment aims to ease symptoms. For example, if a cancer is advanced then you may require treatments such as painkillers or other treatments to help keep you free of pain or other symptoms. Some treatments may be used to reduce the size of a cancer, which may ease symptoms such as pain.
An operation to remove your uterus (hysterectomy) and ovaries is a common treatment. It is common for your Fallopian tubes and both ovaries to be removed as well. Many operations are now performed by a keyhole procedure (laparoscopically). If the cancer is at an early stage and has not spread then surgery alone can be curative.
If the cancer has spread to other parts of the body, surgery may still be advised, often in addition to other treatments. Even if the cancer is advanced and a cure is not possible, some surgical techniques may still have a place to ease symptoms - for example, to relieve a blockage of the bowel or urinary tract which has been caused by the spread of the cancer.
Radiotherapy is a treatment which uses high-energy beams of radiation which are focused on cancerous (malignant) tissue. This kills cancer cells or stops cancer cells from multiplying. Radiotherapy alone can be curative for early-stage endometrial cancer and may be an alternative to surgery. In some cases radiotherapy may be advised in addition to surgery.
Even if the cancer is advanced and a cure is not possible, radiotherapy may still have a place to ease symptoms. For example, radiotherapy may be used to shrink secondary tumours which have developed in other parts of the body and are causing pain.
Chemotherapy is a treatment of cancer using anti-cancer drugs. They kill cancer cells, or stop them from multiplying. Chemotherapy is not a standard treatment for endometrial cancer but may be given in certain situations (usually in addition to radiotherapy or surgery).
Treatment with progesterone is used in some types of endometrial cancer. It is generally not used in the initial treatments but may be considered if the cancer spreads or comes back after those treatments.
Further reading and references
Endometrial cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up; European Society for Medical Oncology (2013)
Morice P, Leary A, Creutzberg C, et al; Endometrial cancer. Lancet. 2015 Sep 4. pii: S0140-6736(15)00130-0. doi: 10.1016/S0140-6736(15)00130-0.
Wong AW, Lao TH, Cheung CW, et al; Reappraisal of endometrial thickness for the detection of endometrial cancer in postmenopausal bleeding: a retrospective cohort study. BJOG. 2015 Mar 20. doi: 10.1111/1471-0528.13342.
Kwon JS; Improving survival after endometrial cancer: the big picture. J Gynecol Oncol. 2015 Jul26(3):227-31. doi: 10.3802/jgo.2015.26.3.227.
In November last year I had a smear that came back abnormal and was given an appointment for a colposcopy January just gone, also abnormal CN1 and I have another colposcopy this coming January again....jane96717
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