Uterine Cancer Treatment

At Penn Medicine's Abramson Cancer Center, we offer a comprehensive cancer program that provides women more options for treating uterine cancer. Specialists at the Jordan Center for Gynecologic Cancers are dedicated to identifying uterine cancer, eliminating it, and preventing it from recurring.

Our treatment options for uterine cancer include:

Chemotherapy and Biologic Therapies for Uterine Cancer

Penn Gynecologic Oncology offers the latest advances in chemotherapy for treating uterine cancer. Our gynecologic oncologists are board certified in obstetrics and gynecology, and have completed additional training required for oncology. This training includes all currently available forms of treatment, including surgery and chemotherapy and clinical research therapies.

Bone Marrow and Stem Cell Transplant

Bone marrow and stem cell transplantation may be autologous or allogeneic. A bone marrow and stem cell transplant is a method of replacing immature blood-forming cells that are destroyed by treatment with high doses of chemotherapy or radiation. The stem cells, which are taken either from the bone marrow itself or from the bloodstream, are given back to the person after their cancer treatment to help the bone marrow recover and resume producing healthy blood cells.

Chemotherapy

Chemotherapy may be given before or after surgery, or on its own as a treatment for uterine cancer. In addition to managing your medical oncology treatment, Penn gynecologic oncologists at the Jordan Center for Gynecologic Cancer work closely with dedicated chemotherapy nurse practitioners. Nurse practitioners offer specialized care for those undergoing chemotherapy, making sure they receive seamless, coordinated care from the first chemotherapy session through follow-up care.

Hormone Therapy

Hormone therapy keeps cancer cells from receiving the hormones they need to grow and spread. Hormones are chemicals produced by various glands in the body. They circulate in the bloodstream and some hormones can affect the way certain cancers grow. Hormones that can stimulate cancer include:

  • Estrogen
  • Progesterone
  • Testosterone

Hormone therapy blocks the production or the effects of these hormones and helps stop the cancer from growing. Treatment may include the use of drugs that change the way hormones work, or surgery to remove the ovaries or the testicles in order to stop hormone production.

Clinical Trials for Uterine Cancer

Today, more and more people are surviving cancer. Clinical trials benefit patients with access to breakthrough therapies and treatments. These new advances in cancer treatment are occurring every day at Penn Medicine, giving patients hope that even greater discoveries lie ahead. Through clinical trials:

  • Diagnosing cancer has become more precise.
  • Radiation and surgical techniques have advanced.
  • Medications are more successful.
  • Combinations of medical, surgical and radiation therapy are improving treatment effectiveness and enhancing outcomes.

Strategies to address the late effects of cancer and its treatment are improving quality of life.

Radiation Therapy for Uterine Cancer

Radiation therapy uses high-energy X-rays to kill uterine cancer cells. Penn Radiation Oncology uses the latest equipment and technology available to treat uterine cancer. Our radiation oncologists are recognized leaders in techniques that target radiation precisely to the treatment area while sparing normal tissue.

At Penn, women with gynecologic cancer have access to new and advanced treatment options and ongoing clinical trials in radiation therapy. As part of our commitment to advancing cancer care in patients, radiation oncologists are also interested in understanding how radiation treatment affects the quality of life for cancer patients.

Radiation therapy for uterine cancer includes:

Brachytherapy

Radiation oncologists use both internal and external forms of radiation therapy to treat cancer. Brachytherapy is an internal therapy in which the radiation source is placed inside the body. Small radioactive implants, such as metal pellets, seeds, ribbons, wires, needles, capsules, or tubes are placed in small sealed holders inside the body. The implants may be left in the body for only a short time, or may be left in place permanently. This allows the doctor to give a high dose of radiation to a smaller area than is possible with external radiation treatment.

Image-Guided Radiation Therapy (IGRT)

Image-guided radiation therapy (IGRT) uses frequent imaging during a course of radiation therapy to improve the precision and accuracy of the delivery the radiation treatment.

In IGRT, the linear accelerators (machines that deliver radiation) are equipped with imaging technology that take pictures of the tumor immediately before or during the time radiation is delivered. Specialized computer software compares these images of the tumor to the images taken during the simulation to establish the treatment plan. Necessary adjustments can then be made to the patient's position and/or the radiation beams to more precisely target radiation at the cancer and avoid exposure to the healthy surrounding tissue.

Intensity-Modulated Radiation Therapy (IMRT)

At Penn, our radiation oncologists use intensity-modulated radiation therapy (IMRT) to treat uterine cancer. This advanced mode of high-precision radiotherapy utilizes computer-controlled linear accelerators to deliver precise radiation doses to tumors or specific areas within the tumors. Radiation therapy, including IMRT, stops cancer cells from dividing and growing, thus slowing or stopping tumor growth. In many cases, radiation therapy is capable of killing all of the cancer cells.

Using 3-D computed tomography (CT) images in conjunction with computerized dose calculations, IMRT allows for the radiation dose to conform more precisely to the three-dimensional shape of the tumor by controlling, or modulating the intensity of the radiation beam in multiple small volumes. The therapy allows higher radiation doses to be focused on regions within the tumor while minimizing the dose to surrounding normal critical tissues.

Surgery for Uterine Cancer

Surgery is an essential part of treatment for many women with uterine cancer. In the majority of uterine cancer cases, a hysterectomy, removal of the uterus, is needed.

At Penn, our pathologists work with surgical oncologists, examining the uterine cells to determine how much tissue needs to be removed. The type of hysterectomy performed is dependent upon the extent of the uterine cancer.

We are national leaders in surgical treatment of uterine cancer and our surgeons are at the forefront of developing and using new minimally invasive surgical techniques. Benefits of minimally invasive surgical techniques include:

  • Smaller incisions/less scarring
  • Significantly less pain
  • Less blood loss
  • Shorter recovery time
  • Faster return to normal daily activities

Using advanced techniques, our surgeons can treat patients without performing a major incision during surgery. The addition of robotic-assisted techniques to laparoscopic, minimally invasive surgery, is a progressive innovation, transforming the practice of gynecologic surgery.

Penn gynecologic specialists continue their efforts to devise and enhance new and better options for complex gynecologic surgery through the Penn Center for Advanced Gynecologic Surgery.

Hysterectomy

Our minimally invasive techniques, such as robotic-assisted surgery, have become the standard of care for treating gynecologic cancers. For some types of cancer, surgeons remove the body of the uterus and the cervix in a procedure known as a hysterectomy.

A hysterectomy may be performed as an open procedure, known as an abdominal hysterectomy, with the uterus removed through an incision in the abdomen. If lymph node sampling is needed, this can be done through the same incision as the abdominal hysterectomy.

When the uterus is removed through the vagina, it is called a vaginal hysterectomy. Often done as a minimally invasive procedure using a laparoscope, the vagina and any lymph nodes can be removed using a laparoscope.

A variety of surgical options are used to perform a hysterectomy. Penn surgeons consider the patient's medical history, stage of cancer and current health condition to determine the type of surgery needed.

  • Abdominal hysterectomy
  • Vaginal hysterectomy
  • Laparoscopic hysterectomy
  • Laparoscopically assisted vaginal hysterectomy
  • Robotic-assisted hysterectomy

Partial Hysterectomy

In a partial, or supracervical, hysterectomy just the upper part of the uterus is removed. The adjacent tissues are left intact and the cervix is left in place.

Simple Hysterectomy

In a simple hysterectomy, the loose connective tissue around the uterus (parametrium), the tissue connecting the uterus and sacrum (uterosacral ligaments) and the vagina remain intact.

Radical Hysterectomy

In a radical hysterectomy, the entire uterus as well as the tissues next to the uterus (parametrium and uterosacral ligaments) and the upper part (about an inch) of the vagina (near the cervix) are removed.

Usually performed abdominally, a radical hysterectomy can also be performed through the vagina. Most patients undergoing a radical hysterectomy also have a lymph node dissection, in which lymph nodes are removed either through the abdominal incision or by laparoscopic lymph node sampling.

Oophorectomy

An oophorectomy is the removal of both ovaries.

Pelvic Exenteration

Pelvic exenteration is a radical surgery that removes all organs from the pelvic region. It is not a common surgery, but may be used to treat cancer that has spread to surrounding reproductive and pelvic organs.

Other Treatments for Uterine Cancer

In addition to standard treatments and clinical trials, you may wish to add additional therapies and treatments such as massage therapy, acupuncture and art therapy. These therapies do not have curative intent, and are designed to complement standard treatments, not take their place.

Integrative Oncology Services

At Penn, our integrative oncology services can supplement traditional cancer treatments such as chemotherapy, surgery and radiation therapy. While conventional medicine plays a critical role in eradicating cancer, integrative oncology services offer you ways to enhance the quality of your life, minimize or reduce the side effects of cancer and cancer treatment, and promote healing and recovery.

Our cancer specialists are knowledgeable and supportive of complementary cancer treatments. Our cancer team works with you and your family to integrate these supportive programs into the overall care plan, while ensuring your health and safety.

The Abramson Cancer Center's range of integrative oncology services is designed to help you cope with the cancer experience and improve your overall sense of well-being.

Services include:

Joan Karnell Supportive Services at Pennsylvania Hospital offers an extensive variety of supportive care programs for patients and families, from diagnosis through survivorship. These programs are available at no cost to the patients treated at Pennsylvania Hospital, and some are open to patients treated elsewhere. These services include social work counseling, nutrition counseling, psychological counseling and spiritual counseling.

The Cancer Appetite and Rehabilitation Clinic focuses on patients with loss of appetite and weight.

The Supportive Oncology Clinic helps to manage cancer-related symptoms. Integrative support programs include:

Palliative Care

Palliative care provides medical and non-medical interventions to ease the symptoms of cancer and its treatment. Palliative care includes physical, emotional and spiritual care that can enhance the quality of life for cancer patients. Palliative care can be used to complement traditional cancer therapies, or can be used when curative therapies are no longer an option to treat symptoms and improve quality of life.

Palliative care is an approach to patient care that can be integrated with curative therapies at any point from diagnosis to survivorship or end of life care. Palliative care services include palliative chemotherapy, radiation therapy and surgery as well as psychological counseling, art therapy and support groups for patients and families.

Penn Home Care and Hospice Services

Penn Medicine offers a full range of “at home” health care services, including specialized therapies and medications, for patients with cancer and cancer-related conditions.