Surgery, chemotherapy, radiation therapy, and immunotherapy are just some of the treatments doctors use for uterine cancer, depending on the type and stage of the cancer.
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Most treatment plans for uterine cancer — whether endometrial or uterine sarcoma — start with surgery. However, you may need one or more other therapies. Before recommending treatment, a doctor or healthcare professional will consider the specific type of uterine cancer as well as your overall health.
When caught at an early stage, uterine cancer is often curable.
This article discusses different therapies for uterine cancer, when they’re used, and what you can expect from treatment.
Treatment options for uterine cancer include:
- surgery
- chemotherapy
- radiation therapy
- hormone therapy
- immunotherapy
- targeted therapy
Choosing which treatment or combination of treatments is right for you depends on factors such as:
- Cancer type: Some types of uterine cancer are more aggressive than others. And some respond differently to certain treatments.
- Tumor grade: This reflects how abnormal the cancer cells are and how fast they’re likely to grow and spread.
- Stage of cancer: The stage describes how far the cancer has spread beyond the place where it started.
An oncology team will also consider any other health needs related to:
- your age
- conditions that can affect how well you tolerate certain treatments such as obesity, diabetes, or other comorbidities
- reproductive plans and personal preferences
In the following sections, we dive deeper into each potential treatment option.
Surgery is useful in diagnosing and staging. And removing the cancer stops it from growing or spreading. That’s why it’s almost always the first treatment. Surgical options depend on how far the cancer has spread and include:
- Hysterectomy: a procedure to remove the uterus and cervix
- Hysterectomy with salpingo-oophorectomy: also includes removal of the fallopian tubes and ovaries
- Radical hysterectomy: also includes removal of some nearby tissue
These procedures may also involve removing nearby lymph nodes to see if cancer has spread. A surgeon can use a traditional abdominal incision or laparoscopy. A third option is to go through the vagina to conduct the surgery. This option is typically used for earlier stage cancers.
Pelvic exenteration is a procedure for advanced uterine cancer when a person has limited treatment options. In addition to the reproductive organs, the surgeon may remove the bladder, urethra, and rectum.
Potential risks of surgery
Risks from surgery can include:
- bleeding
- infection
- damage to nearby tissues
Having your uterus removed means you won’t be able to get pregnant. In addition, if you’re premenopausal and have your ovaries removed, you’ll experience immediate menopause.
Menopausal symptoms in this instance will be more intense than during nonsurgical menopause. A doctor may prescribe hormone replacement therapy to help with symptoms.
Chemotherapy is a systemic therapy, so it can attack cancer cells anywhere in the body. Chemotherapy usually involves a combination of two or more drugs. Some are available in pill form and others require intravenous (IV) infusion, usually in cycles.
Some reasons you may need chemotherapy are:
- Your cancer has spread outside the uterus.
- It’s a fast-growing type of cancer.
- You need to destroy any cancer cells left behind after surgery.
Potential side effects of chemotherapy
Side effects can include:
- fatigue
- nausea, vomiting
- loss of appetite, weight loss
- diarrhea
- constipation
- hair loss
- mouth sores
- increased risk of infection
- anemia
A care team can help manage side effects, and they generally start improving after you finish treatment.
Radiation uses high energy rays to destroy cancer cells. You may need radiation therapy when cancer has spread beyond the uterus. This may be in addition to surgery and chemotherapy.
There are two ways to administer radiation for uterine cancer. Internal radiation therapy involves putting radioactive materials inside the body. With external beam radiation therapy, a machine sends beams of radiation to a specific area of your body.
Potential side effects of radiation therapy
Side effects can include:
- feeling tired, fatigue
- diarrhea
- constipation
- skin redness, peeling, or blistering
- irritation to the bladder, vagina, or intestines
Long-term side effects may include
Hormone therapy is also known as endocrine therapy. It prevents cancer cells from using the hormones they need to grow and spread. A doctor might recommend this for specific types of advanced or recurrent uterine cancers.
Hormone therapy for uterine cancer may include:
- progestins
- tamoxifen
- luteinizing hormone-releasing hormone agonists
- aromatase inhibitors
Potential side effects of hormone therapy
Potential side effects include:
- hot flashes, night sweats
- fluid retention, increased appetite
- weight gain
Immunotherapy helps your immune system find and kill cancer cells. Immunotherapies for certain uterine cancers include PD-1 inhibitors such as pembrolizumab (Keytruda) and dostarlimab (Jemperli).
You’ll get these drugs by IV infusion.
Potential side effects of immunotherapy
Potential side effects include:
- tiredness, weakness
- fever
- nausea
- cough
- skin rash or itching
- loss of appetite
- muscle or joint pain
Targeted therapies are drugs designed to target particular changes in cancer cells. They can be helpful for high risk or advanced uterine cancer.
Lenvatinib (Lenvima)
Lenvatinib (Lenvima) is a kinase inhibitor. It stops tumors from forming new blood vessels. It also targets proteins in cancer cells that help them grow. A doctor may use Lenvima in combination with Keytruda. It comes as an oral capsule you take every day.
Bevacizumab (Avastin)
Bevacizumab (Avastin) is an angiogenesis inhibitor. It also helps prevent new blood vessels from forming. A doctor may use Avastin in combination with chemotherapy.
Potential side effects of targeted therapy
Side effects from targeted therapy depend on the particular medications used.
| Potential side effects of lenvatinib | Potential side effects of bevacizumab |
| fatigue | high blood pressure |
| nausea and vomiting | headaches |
| swelling in the arms and legs | diarrhea |
People with earlier stage uterine cancer generally have a favorable outlook. The overall 5-year relative
| Stage of cancer | 5-year relative survival rate |
| localized (the cancer hasn’t spread beyond the uterus) | 96% |
| regional (the cancer has spread to nearby lymph nodes or structures) | 71% |
| distant (the cancer has spread to distant parts of the body) | 20% |
| overall (all stages combined) | 84% |
Keep in mind that these are overall statistics based on people who received a diagnosis between 2011 and 2017. Cancer treatments progress quickly, and the outlook for people with uterine cancer may be improving.
One key factor in a person’s outlook is the specific type of uterine cancer. For example, endometrial cancer is the
It’s worth noting that uterine sarcoma has much lower overall 5-year survival rates, ranging from 50 to 55% for early stage cancers and 8 to 12% for advanced cancers.
A lot depends on your unique circumstances. An oncology team will be able to give you a more personalized outlook.
What’s a relative survival rate?
A relative survival rate gives you an idea of how long someone with a specific condition may live after their diagnosis compared with someone without the condition. For example, a 5-year relative survival rate of 96% means that someone with that condition is 96% as likely to live for 5 years as someone without the condition.
When caught early, uterine cancer is treatable and often curable.
Surgery is typically the first-line treatment for uterine cancer. Other treatments include chemotherapy, radiation, and medications that target cancer cells.
To decide which treatments are most likely to work, a doctor will assess the characteristics of your cancer and your overall health.
Each type of treatment offers potential benefits and side effects. A doctor can address any questions or concerns before and during treatment.