What is the treatment for advanced endometrial cancer?

Endometrial cancer is cancer that begins in the endometrium, the inner lining of the uterus. This is the tissue where a fertilized egg attaches when a person becomes pregnant and the tissue that is shed during menstruation when a person is not pregnant.

Endometrial cancer is the most common cancer that occurs in the female reproductive system and one of the most common cancers in general.

Advanced endometrial cancer refers to endometrial cancer that has spread into nearby tissues, organs, or lymph nodes (locally advanced cancer) or spread to distant parts of the body (metastatic cancer). In terms of staging, advanced endometrial cancer refers to cancers that are stage III or stage IV.

Every treatment plan is different

Each case of endometrial cancer is somewhat unique, and treatment for endometrial cancer is individualized, meaning that it is tailored to the person being treated.

When recommending treatment for advanced endometrial cancer, a healthcare team will need to consider the size of the tumor, where the cancer has spread (and how far), the mutations found in the cancer cells, and how the cancer cells are growing and interacting with surrounding tissues.

A plan will also have to consider a person’s age, overall health, medical history, and their personal preferences, needs, and treatment goals.

Treatment is a multi-step process

Treatment for advanced endometrial cancer is typically a multistep process that can involve a combination of surgery, radiation therapy, and systemic therapies.

Surgery

Treatment for advanced endometrial cancer may include surgery. This can include surgery to remove the female reproductive organs, remove other tissues where the cancer has spread, and remove as much of the cancer as possible. Surgery may also remove some or all of the nearby lymph nodes. The type of surgery recommended will depend on the size of the tumor, what tissues are affected, and how much the cancer has spread.

Surgery also helps a healthcare team learn more about the cancer. Analyzing the tumor and samples collected during surgery can provide details about the structure and behavior of the cancer cells, and guide the next steps in treatment.

Radiation therapy

Radiation therapy, also called radiotherapy, uses radiation to kill cancer cells. This includes using a machine to direct beams of radiation at tumors (external beam radiation) and placing a radioactive substance inside the body, close to tumors (internal radiation or brachytherapy). In the treatment of endometrial cancer, radiation therapy is often used after surgery to destroy any cancer cells that were not removed.

Systemic therapies

Because advanced endometrial cancer involves tumors that have grown into nearby tissues and/or cancer that has spread to other parts of the body, the cancer will also require treatment with a systemic therapy, a therapy that acts on cancer throughout the body.

Systemic therapies include:

• Chemotherapy, drugs that kill cancer cells or stop cancer cells from dividing. Two or more chemotherapy drugs are typically used in combination with one another.
• Immunotherapy, medications that help the body’s immune system fight cancer. For example, drugs that disable or block proteins that prevent immune cells from attacking cancer cells.
• Targeted therapy, drugs that target substances that cancer cells need to grow and spread. For example, blocking proteins tumors need to form new blood vessels.
• Hormone therapy, drugs that block hormones or mimic the function of hormones. For example, drugs called progestins, which block the activity of estrogen, which can help slow the growth of tumors.

Sometimes, different types of systemic therapies are used in combination with one another. For example, certain immunotherapy and targeted therapy drugs can be used together. Hormone therapy is often used alongside chemotherapy, and hormone therapy combined with radiation therapy is often used to treat recurrent endometrial cancer when a person is unable to have surgery.

Remember, treating advanced endometrial cancer is different for everyone. Learn about your diagnosis, learn about your treatment options, and talk to your healthcare team about your questions, concerns, and priorities with treatment.