Treatment Overview
Receiving a diagnosis of endometrial cancer can be a deeply unsettling experience. For many women, the journey begins with the anxiety of unexpected bleeding or pelvic pain, followed by a whirlwind of medical appointments and tests. This diagnosis impacts not only physical health but also emotional well-being and future plans. While the news is serious, it is important to know that endometrial cancer is frequently detected early, making it highly treatable for many women.
Treatment is vital to remove the cancer, prevent it from spreading to other organs, and manage potential symptoms. Because this cancer develops in the lining of the uterus, treatment plans depend heavily on the stage of the disease, the specific type of cells involved, and a woman’s overall health. Treatment needs vary significantly; while some patients may only require a surgical procedure, others will benefit from a combination of therapies to ensure the best outcome (American Cancer Society, 2023).
Overview of treatment options for Endometrial Cancer
The primary treatment for endometrial cancer is almost always surgery to remove the uterus (hysterectomy), usually along with the fallopian tubes and ovaries. For many women with early-stage disease, surgery alone is curative. However, medication-based treatments—known as systemic therapies, play a crucial role when the cancer has spread, is at high risk of returning, or cannot be completely removed surgically.
The main goals of medication are to destroy remaining cancer cells after surgery (adjuvant therapy), shrink tumors to relieve symptoms, or control the disease in advanced stages. Doctors may use chemotherapy, hormone therapy, immunotherapy, or targeted therapy. The choice depends largely on whether the cancer cells have specific receptors or genetic markers (National Cancer Institute, 2023).
Medications used for Endometrial Cancer
Chemotherapy is the standard drug treatment for cancer that has spread beyond the uterus or is considered aggressive. The most common regimen involves a combination of two drugs: carboplatin and paclitaxel. Clinical experience suggests that using these two drugs together is often more effective and better tolerated than older regimens. These are typically given intravenously in cycles.
Hormone Therapy is frequently used for advanced endometrial cancer or for women who wish to preserve fertility. Since many endometrial tumors grow in response to estrogen, doctors prescribe progestins (synthetic progesterone) to counteract this. Common examples include megestrol acetate and medroxyprogesterone. Alternatively, drugs like tamoxifen may be used.
Immunotherapy has become a vital option for specific genetic types of endometrial cancer. Drugs like pembrolizumab and dostarlimab are checkpoint inhibitors used for cancers that have a specific genetic feature known as mismatch repair deficiency (dMMR).
Targeted Therapy focuses on specific weaknesses in cancer cells. Lenvatinib is a drug often prescribed in combination with immunotherapy (pembrolizumab) for patients whose cancer does not have the dMMR marker (Mayo Clinic, 2023).
How these medications work
Chemotherapy drugs target rapidly dividing cells throughout the body, damaging their internal structure, preventing replication, and causing cell death.
Hormone therapy changes the body’s hormonal environment. Progestins slow endometrial cancer growth by blocking estrogen’s effects, essentially “starving” the tumor.
Immunotherapy “unmasks” cancer cells that normally hide from the immune system. Drugs like pembrolizumab block the disguising proteins, allowing the immune system to recognize and attack the tumor. Targeted therapies like lenvatinib block signals that tell cancer cells to create new blood vessels, limiting the tumor’s blood supply.
Side effects and safety considerations
Chemotherapy commonly causes fatigue, hair loss, nausea, and increased infection risk due to low blood cell counts. Hormone therapy is milder, potentially causing weight gain, fluid retention, and hot flashes.
Immunotherapy can trigger the immune system to attack healthy organs, causing inflammation in the lungs, colon, or thyroid. Targeted therapies may lead to high blood pressure or fatigue. Regular blood tests are necessary to monitor liver and kidney function. Patients must seek immediate care for high fever, severe abdominal pain, or difficulty breathing (American Society of Clinical Oncology, 2022).
Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.
References
- American Cancer Society. https://www.cancer.org
- National Cancer Institute. https://www.cancer.gov
- Mayo Clinic. https://www.mayoclinic.org
- American Society of Clinical Oncology. https://www.cancer.net
Medications for Endometrial Cancer
These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Endometrial Cancer.