Uterine cancer treatment

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on May 23, 2022.

A wide range of treatments and technologies are available to treat uterine cancer. A comprehensive treatment team may involve several doctors, each of whom practices a specific area of medicine.

Following a uterine cancer diagnosis, these experts work in collaboration to answer the patient's questions and recommend treatment options based on her individual needs.

Common uterine cancer treatments

Common treatments for uterine cancer include those listed below.

Gynecologic oncology

After receiving a diagnosis of uterine cancer, gynecologic cancer patients meet with a gynecologic oncologist to discuss their health and address any questions or concerns.

The gynecologic oncologist reviews the patient's medical records and health history and performs a pelvic exam. He or she also orders the appropriate diagnostic tests to determine the recommended course of treatment. These may include biopsies, imaging scans and blood tests.

After reviewing the test results with the gynecologic oncologist, the care team discusses the treatment options available, as well as the ways in which supportive care services may be incorporated into the treatment plan.

After starting uterine cancer treatment, the patient meets with her gynecologic cancer team approximately every three to four weeks. Each time, she’ll undergo a comprehensive set of blood tests and a physical exam. She’ll also have access to every member of the treatment team, which may include a dietitian, naturopathic clinician and care manager.

For women with early uterine cancer, fertility-sparing surgery may be a treatment option. The care team considers fertility issues for younger women, and provides support for all women who experience sexual side effects as a result of uterine cancer treatment through the Survivorship Support program.

Uterine cancer surgery

Depending on the type and stage of uterine cancer, as well as the patient's individual fertility concerns, the care team may perform a variety of uterine cancer surgical procedures, including those listed below.

Simple hysterectomy: This is the most common type of hysterectomy for uterine cancer. During a simple hysterectomy, the uterus and cervix are removed.

Radical hysterectomy: This type of uterine cancer surgery involves removing the uterus, cervix and ovaries, as well as all of the surrounding tissue (the parametria) and the upper part of the vagina. This is sometimes used when the cancer has spread to the cervix.

Lymphadenectomy: The care team may recommend this surgery, during which the lymph nodes in the pelvis are removed. The doctor may remove lymph nodes as part of a hysterectomy to stage the cancer to determine whether the cancer has spread and whether additional treatment will be needed.

Prior to surgery, patients who want to preserve fertility may be referred to a fertility expert to preserve their ovaries or eggs.

Chemotherapy for uterine cancer

Chemotherapy, which uses drugs designed to destroy cancer cells and shrink tumors, is an important part of treatment for many uterine cancer patients, whether they have received previous chemotherapy treatments elsewhere or not.

Gynecologic oncologists treat uterine cancer with a comprehensive and personalized approach, which may include using various chemotherapy drug combinations.

Another uterine cancer treatment option is hormone therapy, which slows the growth of cancer cells by reducing hormone levels in the body. This type of hormone therapy may be used alone or in combination with surgery and other therapies, depending on the type and stage of the disease.

A common regimen may include progestins, which are a synthetic form of progesterone that slows or stops the growth of uterine cancer cells. Other drugs reduce estrogen levels or block their effect on cancer cells, including tamoxifen and gonadotropin-releasing hormone agonists.

Supportive care services help manage side effects of cancer hormone therapy, like hot flashes and low libido. These care team members may be able to anticipate side effects by focusing on prevention, and manage them with a variety of approaches if they do occur. All of this is integrated into the patient's overall uterine cancer treatment plan, with personalized support for the patient and her family.

Immunotherapy for uterine cancer

Immunotherapy drugs are designed to stimulate the immune system to help it work better or by making cancer cells easier to recognize, exposing them to a potential attack.

Checkpoint inhibitors work by blocking receptors that allow cancer cells to disguise themselves from the immune system. The U.S. Food and Drug Administration (FDA) has approved a checkpoint inhibitor drug to treat patients with inoperable metastatic endometrial cancer with genetic features called microsatellite instability-high (MSI-H) or mismatch repair deficiency (dMMR). These features may make it difficult for DNA in some cells to repair itself, which could lead to uncontrolled cell growth that produces tumors.MSI-H and dMMR may be found in patients with Lynch syndrome, a condition that elevates the risk for some cancers, including endometrial cancer, the most common type of uterine cancer.

Immunotherapy may not be used to treat all patients, and in some cases, it may only be used when other treatments, such as chemotherapy, are not producing positive results. In some cases, immunotherapy drugs may be used in combination with other cancer treatments, such as surgery.

Radiation therapy for uterine cancer

A highly targeted form of radiation therapy may be used to treat uterine cancer, along with other innovative treatments, like chemotherapy and hormone therapy, to fight against the growth of new cancer cells.

By focusing the radiation directly on the tumor or tumor bed, these therapies reduce the risk of developing common radiation side effects, including issues related to gastrointestinal and sexual function.

Specific technologies include those listed below.

External beam radiation therapy (EBRT) directs a beam of radiation from outside the body at cancerous tissues inside the body. It is a cancer treatment option that uses doses of radiation to destroy cancerous cells and shrink tumors. Targeted EBRT helps to lower the risk of gastrointestinal and sexual function side effects typically associated with radiation treatment for uterine cancer. Some additional advantages of EBRT may include:

  • It’s a fast, painless outpatient procedure.
  • It does not carry the standard risks or complications of surgery, such as surgical bleeding, post-operative pain, or the risk of stroke, heart attack or blood clot.
  • Unlike chemotherapy, which circulates through the body, ERBT is targeted to the area being treated.

High-dose rate (HDR) brachytherapy is a type of internal radiation therapy that delivers radiation from implants placed close to, or inside, the tumor(s) in the body. Because cancer often affects organs and other essential structures, it is important for radiation treatment to be tightly focused on tumors to minimize serious side effects. This technique ensures the maximum radiation dose is given to cancerous tissues, while minimizing exposure to the surrounding healthy tissue. The care team may combine HDR brachytherapy with EBRT and chemotherapy to treat uterine cancer.

Intensity modulated radiation therapy (IMRT) uses advanced software to plan a precise dose of radiation, based on tumor size, shape and location. A computer-controlled device called a linear accelerator delivers radiation in sculpted doses that match the 3D geometrical shape of the tumor, including concave and complex shapes.

If a patient previously had radiation therapy for uterine cancer and is experiencing recurrent tumors in the treated area, IMRT may be an option. Compared to standard radiotherapy, IMRT allows radiation oncologists to use higher radiation doses than traditional therapies would allow in these areas. At the same time, IMRT helps to spare more of the surrounding healthy uterine tissue from harmful doses of radiation.

Treatments for endometrial cancer and uterine sarcoma

Treatment options for endometrial cancer and uterine sarcoma are very similar. Surgery is a primary treatment option for both types of uterine cancer. Chemotherapy is also a treatment option, though there are differences in the chemotherapy drugs and regimens that may be recommended for each. Treatment options may vary depending on the stage of the disease, which may be determined during surgery, and whether it has spread beyond the uterus to other parts of the body.

Endometrial cancer treatments

Treatments for endometrial cancer may include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy
  • Targeted therapy
  • Immunotherapy

Uterine sarcoma treatments

Treatments for uterine sarcoma may include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy
  • Targeted therapy
Next topic: What are the top questions about uterine cancer?

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