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It is recommended that treatment for uterine cancer be done by a gynecologic oncologist, a subspecialist who has done extra training in the diagnosis and treatment of gynecologic cancers. Treatment for uterine cancer is either local or systemic. Local treatments remove, destroy, or control cancer cells by focusing treatment in a certain area. Surgery and radiation are local treatments. Most women with uterine cancer first have surgery followed by radiation or chemotherapy.
Systemic treatments are treatments that go throughout the body and can destroy or control cancer cells in a local area (such as the pelvis) as well as other parts of the body. Chemotherapy and hormone therapy are systemic treatments.
You may have just one treatment. Or you may have a combination of treatments. The general types of treatment for uterine cancer (also called endometrial cancer) are the same. The order, intensity and goals of treatment may change based on the specific type and stage of cancer you have. Younger women who are still interested in childbearing should discuss those concerns with their doctor.
Surgery and radiation therapy are two local treatments for uterine cancer. They work to either remove or destroy the tumor from the uterus:
Surgery. Most women with uterine cancer have surgery as the first treatment. The goal of surgery is to completely remove the tumor from your body. With uterine cancer, this generally means that your entire uterus must be removed ( a hysterectomy). Usually, the fallopian tubes and ovaries are also removed. The surgery may be done using one of several different techniques: through an incision in the abdomen (a cut in your lower belly); through a laparoscope, using a camera and tools inserted in the abdomen through several very small incisions; with a robot operating a laparoscope; or through the vagina. Some of the lymph nodes surrounding your uterus may be removed to check for cancer cells to determine the surgical stage. If the tumor is discovered outside of the uterus and it can be removed, it will likely be removed during surgery.
Radiation therapy. Radiation is also called radiotherapy. The goal is to kill cancer cells using radiation such as that found in X-rays. Radiation therapy can be given from an external machine directed at the pelvis, or by implants that are put in through the vagina (brachytherapy). In a few instances, radiation therapy may be used by itself to kill all the cells of a tumor. It may also be used before surgery to shrink a tumor or after surgery to get rid of any remaining cancer cells. Radiation therapy can also be used after surgery has been completed.
Hormone therapy and chemotherapy are systemic treatments for uterine cancer. They both work to kill cancer cells or prevent new ones from growing anywhere in your body:
Hormone therapy. The goal of hormone therapy is to stop cancer cells from growing. Some cancer cells need certain hormones to grow. Drugs can reduce the production of these hormones. Drugs can also be used to block these hormones from working in cancer cells.
Chemotherapy. The goal of chemotherapy is to kill cancer cells throughout your body. As of yet, it has not been proven that chemotherapy can reduce the chance that uterine cancer will spread to other parts of your body. Chemotherapy improves the chances of a cure in some women who have minimal residual disease after surgery.
Treatments for uterine cancer can be divided into two groups:
Curative treatments. These treatments kill or remove cancer cells -- even cells that have spread are killed or removed. These treatments may cure the cancer. For small cancers, surgery alone is often curative. For more advanced cancers, a combination of treatments that includes surgery, radiation, and/or chemotherapy may be used in an effort to cure the cancer.
Palliative treatments. When a cancer is very advanced and the chance of cure is low, these treatments can be given to slow down the growth of cancer and treat symptoms. They don't cure the cancer, but they can help you live longer and feel better.
Before you have a treatment, ask your doctor what its goal is.
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