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National Cancer Institute

PDQ® bullet Treatment  bullet Patients

Endometrial cancer


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is cancer of the endometrium?
STAGE EXPLANATION
Stages of cancer of the endometrium
Stage I
Stage II
Stage III
Stage IV
Recurrent
TREATMENT OPTION OVERVIEW
How cancer of the endometrium is treated
Treatment by stage
STAGE I ENDOMETRIAL CANCER
STAGE II ENDOMETRIAL CANCER
STAGE III ENDOMETRIAL CANCER
STAGE IV ENDOMETRIAL CANCER
RECURRENT ENDOMETRIAL CANCER
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is cancer of the endometrium?

Cancer of the endometrium, a common kind of cancer in women, is a disease in which cancer (malignant) cells are found in the lining of the uterus (endometrium). The uterus is the hollow, pear-shaped organ where a baby grows. Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called sarcoma of the uterus. A separate summary containing information on uterine sarcoma is also available in PDQ.

A doctor should be seen if there are any of the following problems: bleeding or discharge not related to periods (menstruation), difficult or painful urination, pain during intercourse, and pain in the pelvic area.

Endometrial cancer has been found in a few breast cancer patients who have been treated with the hormone tamoxifen. If this hormone is being taken, a patient should go to a doctor for a pelvic examination every year and report any vaginal bleeding other than menstrual bleeding as soon as possible.

A doctor may use several tests to see if a person has cancer, usually beginning with an internal (pelvic) examination. During the examination, the doctor will feel for any lumps or changes in the shape of the uterus. The doctor will then do a Pap test, using a piece of cotton, a brush, or a small wooden stick to gently scrape the outside of the cervix (opening of the uterus) and vagina to pick up cells.

Because cancer of the endometrium begins inside the uterus, it does not usually show up on the Pap test. For this reason, a doctor may also do a dilation and curettage (D & C) or similar test to remove pieces of the lining of the uterus. During a D & C, the opening of the cervix is stretched with a spoon-shaped instrument and the walls of the uterus are scraped gently to remove any growths. This tissue is then checked for cancer cells.

The chance of recovery (prognosis) and choice of treatment depend on the stage of the cancer (whether it is just in the endometrium or has spread to other parts of the uterus or other parts of the body) and the patient's general health. The chance of recovery may also depend on how cells look under the microscope. If there is early-stage cancer, the prognosis may also depend on whether female hormones (progesterones) affect the growth of the cancer.


STAGE EXPLANATION


Stages of cancer of the endometrium

Once cancer of the endometrium has been found, more tests will be done to find out if the cancer has spread from the endometrium to other parts of the body (staging). To plan treatment, a doctor needs to know the stage of the disease. The following stages are used for cancer of the endometrium:


Stage I

Cancer is found only in the main part of the uterus (it is not found in the cervix).


Stage II

Cancer cells have spread to the cervix.


Stage III

Cancer cells have spread outside the uterus but have not spread outside the pelvis.


Stage IV

Cancer cells have spread beyond the pelvis, to other body parts, or into the lining of the bladder (the sac which holds urine) or rectum.


Recurrent

Recurrent disease means the cancer has come back (recurred) after it has been treated.


TREATMENT OPTION OVERVIEW


How cancer of the endometrium is treated

There are treatments for all patients with cancer of the endometrium. Four kinds of treatment are used:

Surgery is the most common treatment of cancer of the endometrium. A doctor may take out the cancer using one of the following operations.

Total abdominal hysterectomy and bilateral salpingo-oophorectomy: taking
out the uterus, fallopian tubes, and ovaries through a cut in the abdomen.
Lymph nodes in the pelvis may also be taken out (lymph node dissection).
(The lymph nodes are small, bean-shaped structures that are found throughout
the body. They produce and store infection-fighting cells, but may contain
cancer cells.)

Radical hysterectomy: taking out the cervix, uterus, fallopian tubes,
ovaries, and part of the vagina. Lymph nodes in the area may also be taken
out (lymph node dissection).

Radiation therapy is the use of high-dose x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes into the area where the cancer cells are found (internal radiation). Radiation may be used alone or before or after surgery.

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by inserting a needle into a vein. Chemotherapy is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells outside the uterus.

Hormone therapy is the use of hormones, usually taken by pill, to kill cancer cells.


Treatment by stage

Treatment for cancer of the endometrium depends on the stage of the disease, the type of disease, and the patient's age and overall condition.

Standard treatment may be considered based on its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of cancer of the endometrium. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


STAGE I ENDOMETRIAL CANCER

Treatment may be one of the following:

1. Surgery to remove the uterus and both ovaries and fallopian tubes (total abdominal hysterectomy and bilateral salpingo-oophorectomy) with removal of some of the lymph nodes in the pelvis and abdomen to see if they contain cancer.

2. Total abdominal hysterectomy and bilateral salpingo-oophorectomy with removal of some of the lymph nodes in the pelvis and abdomen to see if they contain cancer, followed by radiation therapy to the pelvis.

3. Clinical trials of radiation and/or chemotherapy following surgery.

4. Radiation therapy alone for selected patients.


STAGE II ENDOMETRIAL CANCER

Treatment may be one of the following:

1. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and removal of some of the lymph nodes in the pelvis and abdomen to see if they contain cancer, followed by radiation therapy.

2. Internal and external-beam radiation therapy followed by surgery to remove the uterus and both ovaries and fallopian tubes (total abdominal hysterectomy and bilateral salpingo-oophorectomy). Some of the lymph nodes in the pelvis and abdomen are also removed to see if they contain cancer.

3. Surgery to remove the cervix, uterus, fallopian tubes, ovaries, and part of the vagina (radical hysterectomy). Lymph nodes in the area may also be taken out (lymph node dissection).


STAGE III ENDOMETRIAL CANCER

Treatment may be one of the following:

1. Surgery to remove the cervix, uterus, fallopian tubes, ovaries, and part of the vagina (radical hysterectomy). Lymph nodes in the area may also be taken out (lymph node dissection). Surgery is usually followed by radiation therapy.

2. Internal and external-beam radiation therapy.

3. Hormone therapy.


STAGE IV ENDOMETRIAL CANCER

Treatment may be one of the following:

1. Internal and external-beam radiation therapy.

2. Hormone therapy.

3. Clinical trials of chemotherapy.


RECURRENT ENDOMETRIAL CANCER

If the cancer has come back, treatment may be one of the following:

1. Radiation therapy to relieve symptoms, such as pain, nausea, and abnormal bowel functions.

2. Hormone therapy.

3. Clinical trials of chemotherapy.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cancer of the endometrium, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, trained information specialists can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public on request. The following booklet may be of some help:

What You Need To Know About Cancer of the Uterus

The following general booklets on questions related to cancer may also be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 12/1997


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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