Treatments for uterine cancer
If you have uterine cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for uterine cancer, your healthcare team will consider:
- the stage
- the type of tumour
- the grade
- your age
- your overall health
- your personal preferences
You may be offered one or more of the following treatments for uterine cancer.
Staging is done during surgery. The surgeon does a pelvic exam while you are under general anesthetic. Then the surgeon makes an incision, or cut, in the abdomen to examine the organs and see if the cancer has spread to them. This is called abdominal exploration (laparotomy). The surgeon may remove abnormal tissue samples and lymph nodes during surgery. The surgeon may also rinse the abdomen with saline and collect a sample (called pelvic washings). Tissue samples, lymph nodes and pelvic washings are sent to the lab and examined under a microscope to check for the presence of cancer cells. The same surgery can also be done using less invasive methods with laparoscopy or robotic surgery.
Depending on the type of the tumour and whether or not you have other health problems, you may have one of the following types of surgery:
Total hysterectomy removes the cervix and uterus. The surgeon may also remove nearby lymph nodes.
Radical hysterectomy removes the cervix, the uterus, some of the structures and tissues near the cervix and upper vagina and nearby lymph nodes.
Bilateral salpingo-oophorectomy removes both ovaries and fallopian tubes. It is usually done at the same time as a hysterectomy.
Lymph node dissectionremoves lymph nodes in the pelvis, abdomen or both. It is commonly done during surgery to remove uterine cancer. The lymph nodes are then examined to see if they contain cancer. This helps doctors predict prognosis and decide if a woman needs other treatment.
Omentectomy removes the omentum to check for cancer cells.
Pelvic exenteration removes the cervix, uterus, vagina, ovaries, fallopian tubes and lymph nodes. The rectum, bladder or both may also be removed. Pelvic exenteration is sometimes done when uterine cancer recurs, or comes back, in the pelvis after it has been treated with radiation therapy.
Tumour debulking is surgery to remove as much of the tumour as possible. It may be used for advanced uterine cancer.
Radiation therapy may be used to treat any stage of uterine cancer. Women often receive external beam radiation therapy or brachytherapy.
Hormonal therapy may be given after surgery for some stages of uterine cancer. It may also be used as the main treatment for advanced or recurrent uterine cancer.
Chemotherapy may be given after surgery for some stages of uterine cancer. It may also be used as the main treatment for advanced or recurrent uterine cancer.
Chemotherapy is sometimes given during the same time period as radiation therapy to make the cells more sensitive to radiation. This is called chemoradiation. It may be used to treat some types of uterine cancer.
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first few years after treatment has finished. These visits allow your healthcare team to monitor your progress, detect early recurrences and help with recovery from previous treatment.
Some clinical trials in Canada are open to women with uterine cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.
Questions to ask about treatment
To make the decisions that are right for you, ask your healthcare team questions about treatment.
A procedure that uses an endoscope (a thin, tube-like instrument with a light and lens) to examine or treat organs inside the abdomen and pelvis.
Cells or tissue may be removed for examination under a microscope. Doctors may also use laparoscopy to perform different surgical procedures in the abdomen and pelvis.
The type of endoscope used for this procedure is called a laparoscope.
A fold in the peritoneum (the membrane that lines the walls of the abdomen and pelvis) that covers and supports organs and blood vessels in the abdomen.
The greater omentum hangs down from the bottom of the stomach, covers the small intestine and attaches to the transverse colon (the middle section of the large intestine). The lesser omentum is attached to the top of the stomach and bottom of the liver.