Uterine cancer

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Research in uterine cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat uterine cancer. They are also looking for ways to improve the quality of life of people with uterine cancer.

The following is a selection of research showing promise for uterine cancer. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract).

Diagnosis and prognosis

A key area of research looks at better ways to diagnose and stage uterine cancer. Researchers are also trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.

Identifying and looking for cancer cells in the sentinel lymph node may be used to stage and accurately plan treatment for uterine cancer. The sentinel lymph node is the first lymph node or group of lymph nodes that receives lymph fluid from a tumour and the area around it. It is the first lymph node that cancer cells will likely spread to before they spread to other groups of lymph nodes. Researchers are trying to find the best way to identify the sentinel lymph node to avoid doing surgery to remove all the lymph nodes around the uterus to find out if endometrial cancer has spread (Gynecologic Oncology, PMID 26905211, PMID 29032824; Asian Pacific Journal of Cancer Prevention, PMID 28345826). They believe that identifying the sentinel lymph node and checking it for cancer cells may be as accurate at diagnosing cancer spread as surgery to remove more lymph nodes, but with fewer side effects and complications.

Magnetic resonance spectroscopy (MRS) is a technique that looks for changes in the metabolism of cells. Researchers found that using MRS to examine how cancer cells metabolize fat (lipid) may help doctors tell if the uterine tumour started in the cervix or the endometrium, which may lead to more accurate treatment planning (Journal of Magnetic Resonance Imaging, PMID 29178414).

Biomarkers are substances, such as proteins, genes or pieces of genetic material like DNA and RNA, that are found naturally in the body. They can be measured in body fluids like blood and urine or tissue that has been removed from the body. A gene mutation or a change in the normal amount of a biomarker can be linked with a certain type of cancer. If your doctor thinks you might have uterine cancer, tumour marker tests that look for these changes may help with the diagnosis. Biomarkers can also help doctors predict the prognosis or response to treatment in women with uterine cancer. Researchers are looking at HE4 and L1CAM to see if they can help doctors diagnose uterine cancer, predict a prognosis for it, and find out which treatment will benefit a woman with uterine cancer (Disease Markers, PMID 28182133; Journal of Clinical and Diagnostic Research, PMID 28893024; British Journal of Cancer, PMID 27505134, PMID 28751757; Journal of Pathology Clinical Research PMID 29085668).

A high body mass index (BMI) is a risk factor for uterine cancer. Researchers have been looking at the role that BMI plays in the development of endometrial cancer and if physical activity affects the prognosis for this cancer. The studies had mixed results (PloS One, PMID 28152055; British Journal of Cancer, PMID 28817836; Oncotarget PMID 29285243).

Find out more about research in diagnosis and prognosis.

Treatment

Researchers are looking for new ways to improve treatment for uterine cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for uterine cancer.

Robot-assisted laparoscopic hysterectomy allows surgeons to control robotic arms to perform surgery. These arms are placed through small incisions (cuts) in the abdomen. Studies show that people who have robotic surgery have a shorter stay in hospital, less blood loss, faster recovery time, fewer complications and better quality of life compared to people who have the standard treatment of surgery through a larger cut in the abdomen (open laparotomy). Robot-assisted laparoscopic hysterectomy is a possible surgery option for most women with endometrial carcinoma (Gynecologic Oncology, PMID 26197762; Archives of Gynecology and Obstetrics, PMID 25344420; Asian Pacific Journal of Cancer Prevention, PMID 26225698; Journal of Gynecologic Oncology, PMID 29027400).

Targeted therapy may be a treatment option for women with advanced, recurrent, refractory or metastatic uterine cancer. An early study found that some solid tumours, including endometrial carcinoma, responded to ridaforolimus combined with paclitaxel (Taxol) and carboplatin (Paraplatin, Paraplatin AQ). The study also showed that this combination had no unexpected side effects. Everolimus (Afinitor) plus letrozole (Femara) worked in treating recurrent endometrial carcinoma, and pembrolizumab (Keytruda) helped treat advanced endometrial carcinoma. Refractory uterine leiomyosarcomas responded to palbociclib (Ibrance). More research is needed to confirm the results of these findings (Journal of Clinical Oncology, PMID 25624430; Oncologist, PMID 28283584; Gynecologic Oncology Research and Practice, PMID 29214032; BMC Cancer, PMID 28595616).

Chemoradiation is a treatment that gives chemotherapy during the same time period as radiation therapy. Researchers studied chemoradiation as a treatment for uterine cancer. Results suggest that it is helpful for advanced (stage 3) uterine cancer, but it doesn’t work very well for early stage disease. More research is needed to find out what role chemoradiation may have in treating uterine cancer (Gynecologic Oncology, PMID 26115977; Journal of Gynecologic Oncology, PMID 26197768; Cancer Research and Treatment, PMID 25544573; International Journal of Gynecological Cancer, PMID 28005619).

Intensity-modulated radiotherapy (IMRT) given after surgery may improve survival. Uterine cancer came back less often in women with a high risk for recurrence who were treated with IMRT. High-risk uterine cancers include higher-grade tumours and tumours that have grown deeply into the muscle layer of the wall of the uterus. Results from other studies are needed to find out if IMRT should become a standard treatment. IMRT given after surgery is linked to a lower rate of bowel obstruction in women with cervical and endometrial cancer (Gynecologic Oncology, PMID 27486131; Critical Reviews in Oncology/Hematology, PMID 25600840).

Vaginal brachytherapy is a type of radiation therapy in which a radioactive implant is placed in the vagina. Researchers found that vaginal brachytherapy lowers the rate of relapse for vaginal uterine cancer after surgery. They also found that women with certain types of early stage uterine cancer who were treated with vaginal brachytherapy had excellent survival outcomes with few side effects. Women who received this treatment also reported a better quality of life and sexual function than those who were treated with external beam radiation therapy. Researchers are trying to find out the best dose, cylinder diameter and cylinder position for vaginal brachytherapy. They are also trying to find out if combining vaginal brachytherapy with chemotherapy will be an effective treatment for uterine cancer (Journal of Contemporary Brachytherapy, PMID 25829935, PMID 28725246; Journal of Gynecologic Oncology, PMID 29027402; Brachytherapy, PMID 27260082; International Journal of Gynecologic Cancer, PMID 26207785).

Progestin therapy is a treatment that uses the hormone progesterone. It can be taken by mouth or by a device placed in the uterus (called an intrauterine device, or IUD) that slowly releases progestin. Researchers are studying progestin therapy as an alternative treatment to hysterectomy for women with early stage uterine cancer who are of child-bearing age and may want to have children in the future. Progestin therapy can help shrink a uterine tumour or can even make it go away completely (Archives of Gynecology and Obstetrics, PMID 25118836; The Oncologist, PMID 25673106; Oncotarget, PMID 28915701).

Find out more about research in cancer surgery, research in targeted therapy, research in radiation therapy and research in fertility options.

Supportive care

Living with cancer can be challenging in many different ways. Supportive care can help people cope with cancer, its treatment and possible side effects. The following is noteworthy research into supportive care for uterine cancer.

Lower-limb lymphedema (swelling in the legs) can develop after a radical lymphadenectomy, which is surgery that removes most of the lymph nodes in the pelvis. Researchers found that physical activity, especially walking, helps reduce the chance that lymphedema will develop and the severity of its symptoms in women who had a lymphadenectomy during uterine cancer surgery. More research is needed to find ways to reduce and prevent lower-limb lymphedema and improve quality of life for women who have been treated for uterine cancer (Gynecologic Oncology, PMID 25448454; European Journal of Obstetrics, Gynecology and Reproductive Biology,PMID 26142914; Supportive Care in Cancer, PMID 28386788; Western Journal of Nursing Research, PMID 27151079).

Learn more about cancer research

Researchers continue to try to find out more about uterine cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage uterine cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for uterine cancer were first shown to be effective through clinical trials.

Find out more about cancer research and clinical trials.

body mass index (BMI)

A measure that relates body weight to height.

BMI is used to measure underweight, overweight, obesity and normal weight.

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