Therapy is based on the stage of uterine cancer and the patient’s age and overall health. Staging is critical, and ranges from early-stage disease to stage IV uterine cancer, which means the cancer cells have already spread to nearby organs or distant sites in the body.
Some patients' cases are discussed at Wilmot's multidisciplinary tumor board — a conference that is attended by all different specialties required for your care.
Five treatments are commonly used for uterine cancer: surgery, radiation, chemotherapy, hormone therapy, and targeted therapy.
This is the primary treatment for endometrial cancer and usually involves a hysterectomy. Wilmot oncologists offer a number of surgical options at Highland Hospital, the hub for our gynecologic cancer team, and perform the largest number of minimally invasive surgeries in the area. Highland was the first hospital in the Finger Lakes region to have new technology that provides virtually scarless surgery. Our surgeons also use the daVinci robotic surgical system, which offers precision and enhanced 3D, high-definition views of the tumor and surrounding operative field.
- Hysterectomy, during which the surgeon removes the uterus, cervix, and nearby lymph nodes. This type of operation can be performed through an abdominal incision or laparoscopically with smaller instruments and special tools. There are pros and cons to each method, and it’s very important to thoroughly discuss the surgical options with your doctor and to understand the risks and benefits. Wilmot surgeons have expertise in both procedures.
- Lymph node dissection, which is often done at the time of surgery, allowing doctors to locate and remove lymph nodes that may be cancerous. Wilmot uses a special technology called Firefly that involves injecting a fluorescent dye into the body. The dye illuminates the nodes and allows the surgeon to see, in real-time, the important areas where cancer might be present. Wilmot Cancer Institute is the only center in western New York that uses this technology. By properly identifying the sentinel lymph node, surgeons and pathologists can make the most accurate diagnosis; and removing fewer nodes also reduces the risk of lymphedema (swelling after surgery) and bleeding.
- Bilateral salpingo-oophorectomy, in which the surgeon removes fallopian tubes and both ovaries. It can be done at the same time as a hysterectomy. Removal of the ovaries causes women to go into menopause; for younger women it’s important to discuss the pros and cons of ovary removal in the context of a possible cancer recurrence.
Radiation therapy uses energy from radiation beams, radio isotopes, or charged particles to target tumors and to eradicate cancer cells. Brachytherapy is a special type of radiation therapy that can be used to treat uterine cancer: Doctors place a radioactive material into the body directly near the cancer in the vaginal area and uterus. It can be given in low or high doses.
Chemotherapy uses drugs or combinations of drugs — given intravenously or as pills — to destroy cancer cells. It can be given in combination with radiation therapy as the initial treatment; chemotherapy can also be offered if uterine cancer returns.
This type of therapy either removes hormones or blocks their action and stops cancer from growing. For endometrial cancer the main hormone therapy prescribed is progesterone (progestins) to slow the growth of cancer cells. Other hormone therapies might include tamoxifen or aromatase inhibitors (anti-estrogen drugs that are also used to treatment breast cancer), or luteinizing hormone-releasing hormone agonists, which stop the ovaries from producing estrogen.
These are newer drugs designed to target specific gene changes that result in endometrial cancer. They single out cancer cells and usually have less severe side effects compared to chemotherapy. Some targeted therapies also harness the patient’s own immune system to fight the cancer. These types of treatment might be used in combination with other therapies for endometrial cancer.
Many standard cancer treatments cause side effects such as hair loss or fatigue, but not everyone experiences side effects the same way.
The American Cancer Society also offers a free online class to help patients manage the side effects of their illness.
Wilmot's Cancer Control & Survivorship Program is one of the oldest and most highly regarded research programs in the country to investigate the management of side effects.