Uterine cancer and endometrial cancer treatment

Chemotherapy for uterine and endometrial cancer is most often given after uterine cancer surgery, but if the cancer has spread, chemotherapy may be given before surgery in order to shrink the cancer. Chemotherapy might also be prescribed to prevent uterine cancer from coming back (recurrence).

At Penn Medicine, dedicated chemotherapy nurse practitioners work closely with the oncology team as well as any necessary specialists to ensure that you receive seamless, coordinated care from your first chemotherapy session through follow-up care.

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 in order to stop hormone production.

Cancer specialists at Penn Medicine are pioneers in using a patient’s own immune system to fight cancer. Immunotherapy involves triggering the immune system to fight the cancer or to lessen the side effects that may be caused by some cancer treatments.

Immunotherapy is designed to repair, stimulate or enhance your immune system’s responses to cancer. The immune system fights viruses and bacteria to prevent disease; it can also play a role in preventing cancer from developing or spreading. The goal of immunotherapy is to enhance your body’s natural defense and its ability to recognize and fight cancer.

At Penn, medical oncologists help the immune system function better by introducing substances that occur naturally in your body. The therapy may stimulate the immune system to make more of the substance, or the therapy may be a man-made version of that natural substance itself. Other types of therapies use cells from your body, which are then altered in a laboratory and given back to you.

Immunotherapy is less invasive and less toxic than some other therapies because it uses your body’s immune system to fight cancer cells. It works by:

• Targeting specific cancer cells, avoiding damage to normal cells
• Making cancer cells easy for your immune system to recognize
• Possibly preventing or slowing tumor growth
• Potentially preventing the spread of cancer cells
• Using your immune system better to more effectively attack cancer cells

Surgery is the most common first step in treating uterine and endometrial cancer, and total hysterectomy is the most common procedure.

A hysterectomy is a surgery to remove the uterus and the cervix. When used to treat uterine and endometrial cancer, hysterectomy will most often include removal of the fallopian tubes and ovaries, as well.

At Penn, hysterectomies are most often performed using one of two minimally invasive techniques:

• Laparoscopic surgery, which creates a few small incisions in the abdomen
• Robotic-assisted surgery, which allows for better visualization of the area and more precise actions

The type of surgery chosen will depend on the stage of cancer.

During this procedure, your surgeon will also examine the area to see if the cancer has spread. This may include a lymph node biopsy.

Brachytherapy, also called internal radiation therapy, is a procedure that temporarily places sources of radiation in the body, either directly into or near the cancer. This allows the delivery of a high dose of radiation to a much smaller area than is possible with radiation therapy that is performed externally.

Brachytherapy requires the significant expertise and experience available at Penn Medicine to safely and effectively deliver the radiation.

Image-guided radiation therapy (IGRT) uses frequent imaging during a course of radiation therapy to improve the precision and accuracy of the delivery of the radiation treatment. In IGRT, the linear accelerators (machines that deliver radiation) are equipped with imaging technology that takes pictures of the tumor immediately before or even during the time radiation is delivered.

Specialized computer software compares images of the tumor to images taken during a simulation to establish the treatment plan. Necessary adjustments can then be made to your position and/or the radiation beams to more precisely target radiation at the cancer and avoid the healthy surrounding tissue.

Intensity-modulated radiation therapy (IMRT) is a type of high-precision radiotherapy using computer-controlled linear accelerators to deliver precise radiation doses to tumors or specific areas within the tumors.

IMRT uses 3-D computed tomography (CT) images in conjunction with computerized dose calculations. This allows 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 tissues.

Palliative care provides physical, emotional and spiritual care that can enhance your quality of life. It can be used to complement traditional cancer therapies or when curative therapies are no longer an option. Services include palliative chemotherapy, radiation therapy and surgery, as well as psychological counseling, art therapy and support groups for patients and families.

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.

If you have been diagnosed with uterine or endometrial cancer, we offer the most advanced treatment options.