Chemotherapy for uterine cancer

Chemotherapy uses anticancer, or cytotoxic, drugs to destroy cancer cells. It is sometimes used to treat uterine cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.

Chemotherapy is sometimes combined with radiation therapy to treat some types of uterine cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Sometimes a few cycles of chemotherapy are given, followed by radiation, and then chemotherapy is given again. This is called sandwich therapy. It may be used for some types of endometrial carcinoma such as papillary serous carcinoma and carcinosarcoma.

Chemotherapy is given for different reasons. You may have chemotherapy or chemoradiation to:

• destroy cancer cells in the body

• destroy cancer cells left behind after surgery and reduce the risk of the cancer recurring (called adjuvant chemotherapy)

• relieve pain or control the symptoms of advanced uterine cancer (called palliative chemotherapy)

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the uterus.

The types and combinations of chemotherapy drugs used vary depending on the type of tumour being treated. Usually 2 or more drugs are given in combination to treat uterine cancer.

The most common chemotherapy drugs used to treat endometrial carcinoma are:

• doxorubicin (Adriamycin)

• liposomal doxorubicin (Myocet)

• cisplatin (Platinol AQ)

• carboplatin (Paraplatin, Paraplatin AQ)

• ifosfamide (Ifex)

• paclitaxel (Taxol)

• docetaxel (Taxotere)

The most common drug combinations used to treat endometrial carcinoma are:

• cisplatin and doxorubicin

• paclitaxel and doxorubicin

• carboplatin and paclitaxel

• cisplatin, paclitaxel and doxorubicin

Carcinosarcoma may be treated with ifosfamide alone or combined with carboplatin, cisplatin or paclitaxel.

The most common chemotherapy drugs used to treat uterine sarcoma are:

• doxorubicin

• liposomal doxorubicin

• ifosfamide

• cisplatin

• paclitaxel

• docetaxel

• gemcitabine (Gemzar)

• dacarbazine (DTIC)

• temozolomide (Temodal)

• vinorelbine (Navelbine)

• trabectedin (Yondelis)

A common chemotherapy combination used to treat uterine sarcoma is docetaxel and gemcitabine.

Side effects can happen with any type of treatment for uterine cancer, but everyone's experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. Side effects can develop any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it's given and your overall health. Some common side effects of chemotherapy drugs used for uterine cancer are:

• low blood cell counts (called bone marrow suppression)

• nausea and vomiting

• loss of appetite

• sore mouth and throat

• constipation

• diarrhea

• fatigue

• hair loss

• skin problems

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.