Learn The BasicsSeveral different strategies can be used to treat endometrial cancer (EC). These include surgery such as hysterectomy and lymph node removal, radiation therapy, physical therapy and rehabilitation and supportive or palliative care for advanced disease.
Surgery
Surgery is the main treatment option for EC if the cancer has not spread to other areas of the body.
Surgery to remove the uterus is called a hysterectomy. There are several different types of hysterectomies:
- A total hysterectomy in which the whole uterus and cervix are removed
- A partial hysterectomy in which the uterus is removed but the cervix is left untouched
- A radical hysterectomy in which the uterus, cervix, upper vagina and surrounding tissues are all removed
- A hysterectomy with salpingo-oophorectomy in which the uterus, cervix, one or both ovaries and fallopian tubes are removed.
A hysterectomy can be done using different surgical techniques, including a laparotomy or open surgery, vaginal surgery or laparoscopy.
During a laparotomy, the affected organs are removed through a cut made in the front of the abdomen. During a vaginal hysterectomy, the uterus is removed through the vagina. During a laparoscopic surgery, also called a key hole surgery, small cuts are made in the abdomen through which the doctor inserts a laparoscope or thin tube to see the inside of the abdomen as well as other instruments to cut around the organs to be removed.
When a patient has a hysterectomy, they can no longer become pregnant. If a patient has an oophorectomy, the patient will also go into menopause.
Lymph node removal, also known as a lymphadenectomy, can be done to examine the lymph nodes in the pelvis and near the aorta, the main blood vessel that carries blood from the heart to the rest of the body. These lymph nodes are examined for the presence of endometrial cancer cells and can help grade the cancer as well as reduce its spread.
Radiation therapy
In radiation therapy, high energy coming from X-rays, protons or other sources is used to kill the cancer cells.
For the treatment of EC, two types of radiation therapy may be used: external radiation therapy and internal radiation therapy.
In external radiation therapy, the radiation is applied from outside the body to the desired location. In internal radiation therapy, also called brachytherapy, a radiation-filled device that looks like small seeds, wires or a cylinder is placed inside the vagina for a short period.
Physical therapy and rehabilitation
Physical therapy and rehabilitation can help manage some of the side effects of EC and its treatment affecting the bladder, bowel and sexual function. The type of therapy that focuses on these problems is called pelvic physical therapy.
To improve the function of pelvic floor muscles, recommendations include soft tissue mobilization and stretching of tight muscles, exercises to strengthen the core and pelvic floor muscles, dietary changes including avoiding alcohol or caffeine to reduce urinary symptoms, relaxation and deep breathing for muscle relaxation, biofeedback techniques, vaginal dilators to lessen pain during intercourse and self-care techniques to promote quality of life.
Palliative care
Palliative care is a type of supportive care that focuses on making a patient feel better by reducing pain and other symptoms of the disease.
Palliative care can be given at the same time as other cancer treatments like surgery, radiation therapy and chemotherapy to improve the quality of life of patients.