Endometrial Cancer Treatment (PDQ�)
General Information About Endometrial Cancer
Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.
Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can affect the risk of developing endometrial cancer.
Possible signs of endometrial cancer include unusual vaginal discharge or pain in the pelvis.
These and other
dischargenot related to menstruation(periods).
Difficult or painful
Pain during sexual intercourse.
Pain in the
Tests that examine the endometrium are used to detect (find) and diagnose endometrial cancer.
Because endometrial cancer begins inside the uterus, it does not usually show up in the results of a
Endometrial biopsy: The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervixand into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologistviews the tissue under a microscopeto look for cancer cells. Dilatation and curettage: Surgeryto remove samples of tissue or the inner lining of the uterus. The cervix is dilated and a curette(spoon-shaped instrument) is inserted into the uterus to remove tissue. Tissue samples may be taken and checked under a microscope for signs of disease. This procedure is also called a D&C.
Certain factors affect prognosis (chance of recovery) and treatment options.
stageof the cancer (whether it is in the endometrium only, involves the whole uterus, or has spread to other places in the body).
How the cancer cells look under a microscope.
Whether the cancer cells are affected by progesterone.
Endometrial cancer is highly
Stages of Endometrial Cancer
After endometrial cancer has been diagnosed, tests are done to find out if cancer cells have spread within the uterus or to other parts of the body.
The process used to find out whether the
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
tissue. Cancer invadesthe surrounding normal tissue.
lymph system. Cancer invades the lymph system and travels through the lymph vesselsto other places in the body.
blood. Cancer invades the veinsand capillariesand travels through the blood to other places in the body.
The following stages are used for endometrial cancer:
Stage IA: Canceris in the endometriumonly or less than halfway through the myometrium(muscle layer of the uterus). Stage IB: Cancerhas spread halfway or more into the myometrium.
Stage IIIA: Cancerhas spread to the outer layer of the uterusand/or to the fallopian tubes, ovaries, and ligaments of the uterus. Stage IIIB: Cancerhas spread to the vaginaor to the parametrium ( connective tissueand fat around the uterus). Stage IIIC: Cancerhas spread to lymph nodesin the pelvisand/or around the aorta(largest arteryin the body, which carries bloodaway from the heart).
Stage IVA: Cancerhas spread to the bladderand/or bowelwall. Stage IVB: Cancerhas spread to other parts of the body beyond the pelvis, including the abdomenand/or lymph nodesin the groin.
Recurrent Endometrial Cancer
Treatment Option Overview
There are different types of treatment for patients with endometrial cancer.
Different types of treatment are available for patients with
Three types of standard treatment are used:
Total hysterectomy: Surgery to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision(cut) in the abdomen, the operation is called a total abdominalhysterectomy. If the uterus and cervix are taken out through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy. Bilateral salpingo-oophorectomy: Surgery to remove both ovariesand both fallopian tubes. Radical hysterectomy: Surgery to remove the uterus, cervix, and part of the vagina. The ovaries, fallopian tubes, or nearby lymph nodesmay also be removed.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given
Radiation therapy is a cancer treatment that uses high-energy
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from
Follow-up tests may be needed.
Some of the tests that were done to
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has
Treatment Options by Stage
A link to a list of current
Stage I Endometrial Cancer
Surgery(total abdominal hysterectomyand bilateral salpingo-oophorectomy). Lymph nodesin the pelvisand abdomenmay also be removed and viewed under a microscopeto check for cancer cells.
Surgery (total abdominal hysterectomy and bilateral salpingo-oophorectomy, with or without removal of lymph nodes in the pelvis and abdomen) followed by
internal radiation therapyor external radiation therapyto the pelvis. After surgery, a plastic cylinder containing a source of radiationmay be placed in the vaginato kill any remaining cancer cells. Radiation therapyalone for patients who cannot have surgery. Clinical trialsof radiation therapy and/or chemotherapy.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Stage II Endometrial Cancer
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Stage III Endometrial Cancer
Surgery( radical hysterectomyand removal of lymph nodesin the pelvisso they can be viewed under a microscopeto check for cancer cells) followed by internal radiation therapyand external radiation therapy. Radiation therapyalone for patients who cannot have surgery. Hormone therapyfor patients who cannot have surgery or radiation therapy. Clinical trialsof chemotherapy.
Clinical trials of new
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Stage IV Endometrial Cancer
Internal radiation therapyand external radiation therapy. Hormone therapy. Clinical trialsof chemotherapy.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Treatment Options for Recurrent Endometrial Cancer
Radiation therapyas palliative therapyto relieve symptomsand improve the patient?s quality of life. Hormone therapy. Clinical trialsof chemotherapy.
Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with recurrent endometrial carcinoma. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
To Learn More About Endometrial Cancer
For more information from the
Endometrial Cancer Home Page
What You Need to Know About? Cancer of the Uterus
Endometrial Cancer Prevention
Endometrial Cancer Screening
Tamoxifen: Questions and Answers
What You Need to Know About? Cancer
Understanding Cancer Series: Cancer
Chemotherapy and You: Support for People With Cancer
Radiation Therapy and You: Support for People With Cancer
Coping with Cancer: Supportive and Palliative Care
Information For Survivors/Caregivers/Advocates
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Changes to This Summary (09/09/2011)
Changes were made to this summary to match those made to the health professional version.
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
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PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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