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Endometrial Cancer Treatment

How Is Endometrial Cancer Treated?

The treatment for endometrial cancer often consists of a combination of the following treatments, which are often based on multiple factors, including a patient’s age and general health.

Surgery

Most patients with endometrial cancer will have surgery as the initial step of treatment. Many patients will not require any additional treatment after surgery, though some will be recommended chemotherapy and/or radiation therapy. The goal of surgery is to remove as much of the cancer as possible. Usually, this involves removing the uterus and cervix (a procedure called a hysterectomy). Most patients will also have their ovaries and fallopian tubes removed in a procedure called a bilateral salpingo-oophorectomy (BSO). In many cases, lymph nodes will be removed to determine if the cancer has spread beyond the uterus. If it has, the surgeon may attempt to remove it in a process known as debulking. If endometrial cancer is diagnosed at an early stage, the surgeon has a greater chance of removing all of the cancer. If patients are diagnosed at a later stage, they may require more than one surgical procedure.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells. The drugs are either taken orally or injected through a vein directly into the bloodstream. Several chemotherapy drugs can be used to treat endometrial cancer. A medical oncologist will discuss these options with the patient to determine the best treatment plan. Some patients may experience side effects while undergoing chemotherapy treatment. Possible side effects include nausea, vomiting, mouth sores, loss of appetite, fatigue, hair loss, and rashes on the hands and feet. In recent years, chemotherapy treatment has improved significantly and become much more manageable.

Radiation Therapy

Radiation uses special equipment to deliver high-energy particles, such as x-rays, gamma rays, electron beams or protons, to kill or damage cancer cells. Radiation (also called radiotherapy, irradiation, or x-ray therapy) can be delivered internally through seed implantation or externally using linear accelerators (called external beam radiotherapy, or EBRT). Radiation may be used as a solitary treatment or with surgery and/or chemotherapy. The equipment used to deliver the radiation therapy is called a linear accelerator. The linear accelerator has a moveable arm, which enables the radiation to be focused on the part of your body where the cancer is located. Developments in EBRT equipment have enabled physicians to offer conformal radiation. With conformal radiation, computer software uses imaging scans to map the cancer three-dimensionally. The radiation beams are then shaped to conform, or match, the shape of the tumor.

Radiation works by breaking a portion of the DNA of a cancer cell, which prevents it from dividing and growing. Radiation therapy can be systemic, meaning it moves throughout your bloodstream. Systemic therapies are usually given as an injection into a blood vessel or are taken as a pill. Systemic treatments expose your entire body to cancer-fighting medication. Radiation therapy is typically given as a "local" treatment however, meaning it affects only the part of the body that needs therapy.

Vaginal Brachytherapy

For vaginal brachytherapy, an applicator containing radioactive seeds is placed inside you to deliver a high dose of radiation therapy to the upper vagina. This procedure is done in the clinic as an outpatient, but may require overnight stay in the hospital.

External Beam Radiation Therapy

External beam radiation therapy is one of the most common types of radiation for cancer treatment. Radiation comes from a machine outside the body and delivers radiation to a specific location inside the body.

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