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Endometrial cancer is formed in the mucosa of the uterus, which is known as endometrium. It is the most common type of women’s cancer in the United States and affects 1 in 50 women.
The good news? Doctors have many tools to treat endometrial cancer, which work well, especially when cancer is detected early. More than 80% of women who receive a diagnosis of endometrial cancer are still alive five years later and the figure rises to 95% if cancer has not spread outside the uterus.
Understanding the therapeutic options of endometrial cancer, including surgeries, radiation and medications, can be useful for you to prepare for what is approaching. We talked to Nita Lee, MD, attachment of obstetrics and gynecology at the University of Chicago, about how endometrial cancer is about
What types of surgeries are used for endometrial cancer?
Currently, the most common type is laparoscopic and robotic surgery that is minimally invasive (it is performed through tiny incisions). We use this type of surgery for most patients with endometrial cancer to remove the uterus and fallopian tubes and collect information from lymph nodes.
If patients have a more advanced disorder that has spread to lymph nodes or ovaries, or if the uterus is too large to perform minimally invasive surgery, open abdominal surgery may be required.
What role does radiotherapy play in the treatment of endometrial cancer?
Radiotherapy is more commonly used as additional treatment after surgeries. Care after surgeries, called postoperative care, could sometimes imply radiotherapy depending on specific findings that are done during surgery.
For example, if a person has certain risk factors in the uterus, his medical care provider (HCP) could recommend that he undergo vaginal radiation or perhaps more complex pelvic radiation. Or if you have certain risk factors, such as that cancer in the cervix is detected after having surgically removed it, radiation could be required in the pelvic area.
Some patients with more advanced disorders will need radiation to lymph nodes and chemotherapy. Occasionally, patients who are not eligible for surgeries and do not want treatments with fertility conservation will only receive radiation, but that is uncommon. It really depends on the patient.
What systemic treatments (of the entire body) are used for endometrial cancer?
- Chemotherapy is the basis of the treatment of patients receiving diagnoses in advanced stages. For example, if we detect during surgery that a person has stage 3 or 4 cancer, chemotherapy will frequently receive as part of their postoperative therapeutic plan.
People with this stage 1 disorder who have certain types of high -risk cells will also receive chemotherapy after surgery.
- The Immunotherapy It is a new treatment. It is similar to chemotherapy because the medicine is administered intravenously but immunotherapy drugs have other effects on the body.
Although chemotherapy drugs commonly exert effect on cancer cells, immunotherapy is designed to help the body’s immune system attack cancer.
One of the ways in which cancer cells survive your immune system is hiding behind certain proteins or producing such proteins so that your body does not recognize that cancer cells are harmful. Immunotherapy facilitates cancer detection.
Immunotherapy works optimally for certain categories of endometrial cancer, that is, it works better for certain people than for others. This has changed the rules of the game for patients with recurrent endometrial cancer, as well as for people who receive diagnoses in advanced stages.
- The hormonal terpia It is used for endometrial cancers with estrogenic or gestagenic receptors, which means that cancer cells contain estrogen or progesterone receptors. We manipulate these receptors with hormones to treat cancer.
- The directed therapy Eliminates cancer cells without damaging other cells. Probably the best known objective is her2 protein, a protein that is commonly mentioned when we talk about breast cancer.
Recent research has demonstrated a connection between endometrial cancer and her2 protein and directed therapies can be useful.
Are there treatments with fertility conservation available for endometrial cancer?
Yes. Hormonal therapy is the most common treatment for patients who are concerned about their fertility. We usually tend to limit treatments with fertility conservation for patients who were diagnosed with stage 1 of that disorder and for people who have low -risk endometrial cancers (compared to people with types of high -risk cells).
What factors are considered when therapeutic decisions are made?
Many of our therapeutic decisions are made based on the patient’s molecular profile, which analyzes the biomarkers and tumor cells and indicates exactly what type of endometrial cancer the patient has and if certain treatments will have effects on the tumor. We also analyze any other medical problem that the patient and her therapeutic goals can have and we always take into account the quality of life.
This educational resource was prepared with the support of Karyopharm and Merck.
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