Endometrial cancer treatment: what to ask your care team

Endometrial cancer is the most common cancer of the female reproductive organs. Treatment for endometrial cancer will depend on the stage of the cancer, as well as other factors. Below is a look at what treatment options can look like at different stages, and some questions you may want to discuss with a healthcare team when making treatment decisions.

What is endometrial cancer?

All cancers begin in the same general way, with mutations or changes to healthy cells that result in the formation of cancer cells. Cancer cells behave differently than healthy cells, including in how they grow and how they expire. Cancer cells grow more quickly than healthy cells. They also expire at a slower rate. This leads to large numbers of cancer cells. As cancer cells increase in number, cancer can invade nearby tissues and spread to other areas of the body.

Endometrial cancers begin when this occurs in the cells of the endometrium, the tissue that forms the inner lining of the uterus (womb).

How is endometrial cancer treated?

The stage of endometrial cancer is often the most significant factor a healthcare team will consider when making treatment recommendations. Stage refers to the extent of the cancer. Other important factors include the type of endometrial cancer, the cancer's grade, and a person’s age, overall health, and if they want to become pregnant.

Treatment for endometrial cancer will be different for everyone. Some of the treatment options you may discuss with a healthcare provider include:

• Surgery to remove the cancer and some or all of the reproductive organs.
• Radiation therapy, which is often used after surgery.
• Chemotherapy, also often used after surgery.
• Immunotherapy and/or targeted therapy (often used for advanced endometrial cancers and recurrences).
• Progestin therapy (a type of hormone therapy) which may be used to delay other treatments and spare fertility for a period of time, allowing someone an opportunity to become pregnant.

A treatment plan may include more than one type of therapy—for example, surgery may be followed by radiation therapy and/or chemotherapy, or radiation may be followed by surgery.

Working with your healthcare team

When talking to your healthcare team, these questions can help you understand the goals, the benefits, the side effects, and the day-to-day impact of different cancer treatments, and help you take an active role in making treatment decisions.

Questions about your treatment goals:

• What are the most important things I should know about this diagnosis?
• What treatment approach do you recommend and why do you recommend this approach?
• What are the goals of treatment?
• Are there other providers or specialists you recommend I work with? For example, consulting a fertility expert if you are planning on becoming pregnant.
• What are the next steps in treatment?

Questions when starting a therapy:

• How does this therapy work?
• How is the therapy taken and how often?
• How will we know if the therapy is working?
• What side effects can this therapy cause? What can be done to manage side effects from this therapy?
• Can this therapy interact with other medications?
• What do I need to avoid while using this therapy? For example, alcohol or certain foods.
• Can this therapy affect any coexisting medical conditions?
• What treatment options are available if this therapy doesn’t work?
• Should I consider participating in a clinical trial?

Questions about support and quality of life:

• What can be done to manage pain, discomfort, fatigue, digestive problems, and/or other symptoms?
• What can I do to take care of my mental and emotional health?
• What can I do to keep myself as healthy as possible? What should I avoid?
• Who can I talk to if I need help or support during treatment?
• What will treatment cost? Who can I talk to if I am concerned about the cost of treatment?

If you have questions about your diagnosis, your treatment, and your quality of life while living with and treating endometrial cancer, your healthcare providers will be your best source of information.