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There are many treatment options available for people with endometrial cancer, also known as uterine cancer. Chemo is a common option for those with high-grade endometrial cancer, which is advanced and spreads quickly.
This article will help you understand what to expect from chemotherapy treatment for endometrial cancer.
Chemo is a treatment that kills cancer cells. Cancer cells usually grow and divide faster than other cells in your body. Chemotherapy targets fast-growing cells by slowing down their growth or stopping the cells from growing. Because cancer cells grow quickly, they’re targeted by chemo drugs. Chemotherapy moves through your whole body, so it’s considered a type of systemic cancer therapy.
For endometrial cancer, chemotherapy is most commonly given as a slow infusion into a vein in your arm or hand. It can also be given by mouth or as an injection into the muscle or under the skin.
Chemo is often given in cycles. One cycle involves a period of treatment followed by a period of rest. During the treatment cycle, you may receive chemo on one or more days. The rest period between cycles allows your body to recover from the effects of treatment. The exact schedule of your chemo cycle depends on the type you’re getting, the cancer stage, and how you react to treatment.
Your gynecologic oncologist (a doctor who specializes in treating cancers of the female reproductive system) will discuss your treatment options with you and help you choose the best cancer treatment based on your overall health, the subtype of cancer you have, and which stage the endometrial cancer is in.
Some common chemotherapy drugs used for endometrial cancer include:
Chemotherapy drugs may work better for endometrial cancer when they’re used in combination. Common drug combinations for endometrial cancer include:
Chemotherapy can also be combined with other cancer treatments. When chemo and radiation therapy are combined, it’s often referred to as chemoradiation. Your cancer care team may also recommend other systemic therapies, such as hormone therapy, targeted therapy, or immunotherapy.
Chemotherapy is the most common type of systemic treatment for endometrial cancer. It’s used to reduce the risk of recurrence (cancer coming back), help relieve your symptoms, and prevent the cancer from spreading.
In most cases, treatment is started after surgery. This is called adjuvant chemotherapy. Adjuvant chemotherapy can help prevent cancer from coming back by killing cancer cells that may remain after surgery. Chemotherapy can also be given before surgery if the tumor is too large to remove. It helps shrink the tumor, making it easier to remove with surgery. This is called neoadjuvant chemotherapy.
People with early-stage endometrial cancer (stage 1 or 2) may not need any systemic therapies after surgery. If you have early-stage endometrial cancer, your cancer care team may recommend chemotherapy if you’ve been diagnosed with high-grade cancers, such as:
If you do need chemotherapy after surgery, your doctor may use carboplatin plus paclitaxel, although other chemo drugs may be used. People with stage 2 uterine carcinosarcoma may receive ifosfamide plus either paclitaxel or cisplatin after surgery.
Chemo is a common treatment for advanced endometrial cancer (stage 3 or 4).
In stage 3 endometrial cancer, carboplatin plus paclitaxel or cisplatin plus doxorubicin may be used. If you have stage 3 uterine carcinosarcoma, your doctor may use ifosfamide with other chemo drugs. For those with stage 4 endometrial cancer, your cancer care team may recommend a combination of three chemo drugs. The most common drugs used for stage 4 cancer are paclitaxel plus doxorubicin plus either carboplatin or cisplatin.
Sometimes advanced endometrial cancer can't be removed with surgery, either because the tumor is too large and there is a risk of metastases (spreading) or because it is closely attached to other vital organs. In such cases, chemotherapy may be one of the main treatments to help relieve symptoms. Chemotherapy may also be used to treat recurrent endometrial cancer (when the cancer comes back). Recurrent endometrial cancer is usually treated with the same regimen as stage 4 cancer.
People with stage 4 or recurrent endometrial cancer may consider joining a clinical trial investigating new chemotherapy drugs and regimens.
Chemo for endometrial cancer is usually provided at an outpatient chemotherapy clinic. Most of the time, you can go home after your treatment is complete. You can also receive chemo treatment during a hospital stay, at home, or in another outpatient office.
Before your health care provider starts your treatment, they’ll usually check your vital signs (blood pressure, temperature, pulse, and respiratory rate) and run blood tests to check your blood count. You may also receive intravenous (IV) fluids or medications, which are given through a vein, to help prevent side effects. Each chemo session usually lasts a few hours. You may wish to bring a friend or family member to keep you company.
Your cancer care team can give you more information about what to expect during chemo treatment based on your specific cancer treatment plan.
Chemotherapy can cause side effects. While the drugs kill cancerous cells, they also kill normal, noncancerous cells in your body. Most often, these drugs affect parts of your body with fast-growing cells, such as:
Because those areas of the body are commonly affected, the side effects can be related to them. The most common side effects of chemo for endometrial cancer include:
Chemotherapy affects everyone differently and some people may not have any side effects. The side effects you experience may differ depending on which chemo drug is used, the dose, and the length of treatment.
Talk to your cancer care team about how to treat or prevent chemotherapy side effects. For example, antinausea medications before therapy can help prevent chemotherapy-related nausea.
Most of the time, side effects get better with time when your treatment ends. However long-term side effects can affect the heart, kidneys, or nervous system.
Doxorubicin is an example of a chemo drug that commonly causes cardiotoxicity (heart damage). The more doxorubicin you take, the higher the risk of heart damage. Because of this, your cancer care team will limit the total amount of doxorubicin you get during treatment. Cisplatin and carboplatin can occasionally cause heart damage, although this is rare.
If you need this therapy, your oncologist will check your heart function with a cardiac echocardiogram, an ultrasound that shows how well your heart is working, before starting treatment.
Cisplatin is a chemotherapy drug used for endometrial cancer that can cause kidney damage. To help prevent kidney damage from cisplatin, your cancer care team may give you extra IV fluids before and after treatment. Ifosfamide can damage your bladder and cause bleeding. Increased IV fluid and a drug called mesna can help prevent this side effect.
Some chemo drugs can also cause nerve damage, a condition known as neuropathy. Neuropathy usually affects the hand and feet, causing numbness, tingling, or pain. Cisplatin and paclitaxel are drugs used for endometrial cancer that can cause neuropathy.
Your cancer care team will monitor your side effects by asking how you feel and taking blood tests to check how chemo is affecting your body. It’s important to discuss any side effects you’re experiencing with your care team. Proper treatment can prevent some side effects from getting worse.
Your cancer care team will closely monitor you with frequent follow-up exams during treatment. A blood test called cancer antigen 125 (CA-125) can check to see if cancer has spread. Imaging tests, such as magnetic resonance imaging (MRI), positron emission tomography (PET), or computed tomography (CT) scans can take images of the inside of your body to see if the tumor has shrunk.
The severity of chemo side effects isn’t associated with how well a treatment works. The only way to know how well it’s working is through medical and imaging tests.
On MyEndometrialCancerTeam — the social network for people with endometrial cancer and their loved ones — members come together to ask questions, give advice, and share their stories with others who understand life with endometrial cancer.
What tips can you share with others about managing chemotherapy side effects? Do you have advice for staying comfortable during chemo sessions? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.
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