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Endometrial Cancer Treatment (PDQ®)
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General Information About Endometrial Cancer
Key Points:
Endometrial cancer is a disease in which malignant (cancer)
cells form in the tissues of the endometrium.
The endometrium is the
lining of the uterus, a hollow, muscular organ in a woman’s
pelvis. The uterus is where a
fetus grows. In most nonpregnant
women, the uterus is about 3 inches long. The lower, narrow end of the uterus is the cervix, which leads to the vagina.
Cancer of the endometrium
is different from cancer of the muscle of the uterus, which is called
sarcoma of the uterus. Refer to the
PDQ summary on Uterine Sarcoma Treatment for more information.
Taking tamoxifen for breast cancer or taking estrogen alone
(without progesterone) can affect the risk of developing endometrial cancer.
Endometrial cancer may develop in breast cancer patients who have
been treated with tamoxifen. A
patient taking this drug should have a pelvic exam every year and report
any vaginal bleeding (other than
menstrual bleeding) as soon as
possible. Women taking estrogen (a
hormone that can affect the growth
of some cancers) alone have an increased risk of developing endometrial cancer.
Taking estrogen in combination with progesterone (another hormone) does not increase a
woman’s risk of this cancer.
Possible signs of endometrial cancer include unusual vaginal
discharge or pain in the pelvis.
These and other symptoms may be caused by endometrial cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
- Bleeding or discharge not related to
menstruation (periods).
- Difficult or painful urination.
- Pain during sexual intercourse.
- Pain in the pelvic area.
Tests that examine the endometrium are used to detect (find) and diagnose
endometrial cancer.
Because endometrial cancer begins inside the uterus, it does not
usually show up in the results of a Pap
test. For this reason, a sample of endometrial
tissue must be removed and examined
under a microscope to look for cancer cells. One of the following procedures may be
used:
-
Endometrial biopsy: The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells.
-
Dilatation and curettage: A surgical procedure to remove samples of tissue or the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. Tissue samples may be taken for biopsy. This procedure is also called a D&C.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:
- The stage of the cancer (whether it is in the endometrium only, involves the whole uterus, or has spread to other places in the body).
- How the cancer cells look under a microscope.
- Whether the cancer cells are affected by progesterone.
Endometrial cancer is highly curable.
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Stages of Endometrial Cancer
Key Points:
After endometrial cancer has been diagnosed, tests are
done to find out if cancer cells have spread within the uterus or to other
parts of the body.
The process used to find out whether the cancer has spread within the
uterus or to other parts of the body
is called staging. The information gathered from the
staging process determines the stage of the disease. It is important
to know the stage in
order to plan treatment. Certain tests and procedures are used in the staging process. A hysterectomy (an operation in
which the uterus is removed) will usually be done to help find out how far the
cancer has spread.
The following stages are used for endometrial
cancer:
Stage I
In stage I, cancer is
found in the uterus only. Stage I is divided
into stages IA, IB, and IC, based on how far the cancer has spread.
Stage II
In stage II, cancer
has spread from the uterus to the cervix, but has not spread outside the uterus. Stage II
is divided into stages IIA and IIB, based on how far the cancer has spread
into the cervix.
Stage III
In stage III, cancer
has spread beyond the uterus and cervix, but has not spread beyond the
pelvis. Stage III is divided into
stages IIIA, IIIB, and IIIC, based on how far the cancer has spread within the pelvis.
Stage IV
In stage IV, cancer
has spread beyond the pelvis. Stage IV is divided into stages IVA and IVB,
based on how far the cancer has spread.
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Recurrent Endometrial Cancer
Recurrent
endometrial
cancer is cancer that has recurred
(come back) after it has been treated. The cancer may come back in the
pelvis, in
lymph nodes in the
abdomen, or in other parts of the
body.
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Treatment Option Overview
Key Points:
There are different types of treatment for patients with endometrial
cancer.
Different types of treatment are available for patients with endometrial
cancer. Some treatments are standard (the currently used treatment), and some
are being tested in clinical trials.
Before starting treatment, patients may want to think about taking part in a
clinical trial. A treatment clinical trial is a research study meant to help
improve current treatments or obtain information on new treatments for patients
with cancer. When clinical trials show that a new treatment is better than the
standard treatment, the new
treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country.
Information about ongoing clinical trials is available from the
NCI Web site. Choosing the most appropriate cancer treatment is a
decision that ideally involves the patient, family, and health care
team.
Four types of standard treatment are used:
Surgery
Surgery (removing the cancer in
an operation) is the most common treatment for endometrial cancer. The
following surgical procedures may be used:
Even if the doctor removes all the cancer that can be seen at the
time of the surgery, some patients may be given radiation therapy or
hormone treatment after surgery to kill any cancer cells that are left. Treatment given
after the surgery, to increase the chances of a cure, is called
adjuvant therapy.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Hormone therapy
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.
New types of treatment are being tested in clinical
trials.
Information about ongoing clinical trials is available from the
NCI Web site.
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Treatment Options by Stage
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Stage I Endometrial Cancer
Treatment of stage I endometrial
cancer may include the following:
This summary section refers to specific treatments under study in
clinical trials, but it may not mention every new treatment being studied.
Information about ongoing clinical trials is available from the
NCI Web site.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I uterine corpus cancer.
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Stage II Endometrial Cancer
Treatment of stage IIA endometrial
cancer is usually a combination of therapies, including internal
and external radiation therapy and surgery.
Stage IIA
Treatment of stage IIA endometrial cancer may include the
following:
This summary section refers to specific treatments under study in
clinical trials, but it may not mention every new treatment being studied.
Information about ongoing clinical trials is available from the
NCI Web site.
Stage IIB
Treatment of stage IIB endometrial
cancer may include the following:
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II uterine corpus cancer.
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Stage III Endometrial Cancer
Treatment of stage III endometrial
cancer may include the following:
Information about ongoing clinical trials is available from the
NCI Web site.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III uterine corpus cancer.
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Stage IV Endometrial Cancer
Treatment of stage IV endometrial
cancer may include the following:
This summary section refers to specific treatments under study in
clinical trials, but it may not mention every new treatment being studied.
Information about ongoing clinical trials is available from the
NCI Web site.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV uterine corpus cancer.
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Treatment Options for Recurrent Endometrial Cancer
Treatment of recurrent
endometrial
cancer may include the
following:
This summary section refers to specific treatments under study in
clinical trials, but it may not mention every new treatment being studied.
Information about ongoing clinical trials is available from the
NCI Web site.
Check for clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent uterine corpus cancer.
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Changes to This Summary (06/19/2006)
The PDQ cancer information summaries are reviewed regularly and updated as
new information becomes available. This section describes the latest
changes made to this summary as of the date above.
Editorial changes were made to this summary.
This information is provided from the PDQ® database in collaboration with the NCI.
