Treatments and Therapies for Endometrial Cancer

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Fred Hutch Cancer Center offers comprehensive care and treatment for endometrial cancer. We offer advanced therapies and new options available only through clinical trials (studies). Endometrial cancer can often be cured, especially when diagnosed early.

Endometrial Cancer Care Tailored to You

You and your family are our top priority. At Fred Hutch Cancer Center, we offer comprehensive and compassionate care — personalized to you. You'll have access to the latest treatment options, clinical trials and supportive care services.

Referrals are required for new patients. Please request your primary care provider or specialist fax all relevant medical information to the fax number listed below.

How We Treat Endometrial Cancer at Fred Hutch

The most common, and usually the first, endometrial cancer treatment is surgery. This may be all the treatment you need, or you might have radiation therapy or chemotherapy. Some patients have hormone therapy, targeted therapy or immunotherapy. But not everyone needs all of these endometrial cancer treatment options. We’ll tailor your treatment to you.

Endometrial Cancer Surgery

As a patient at Fred Hutch, you’ll have surgery by a UW Medicine gynecologic oncologist. Your surgeon will be specially trained and board certified in gynecologic oncology. They will recommend the best procedure to match your needs.

Gynecologic oncology is a unique specialty because your physician is a surgical oncologist and a medical oncologist, all in one.

“Patients benefit from having a surgeon who can manage all aspects of their cancer care and understands all the new treatments,” said gynecologic oncologist Barbara Goff, MD. “By performing the right surgery, selecting the right chemotherapy, using genetic testing to select targeted therapies, and connecting patients with clinical trials, we are slowly improving patient survival.”

How Surgery Can Treat Endometrial Cancer

The goal of surgery for endometrial cancer is to remove all of the cancer or as much cancer as possible. Some people only need surgery followed by checkups to monitor their condition. Others have radiation therapy or other treatments after surgery.

Rarely, physicians advise against surgery as a treatment for endometrial cancer. Your physician may feel surgery is not the best treatment for you because of the size of the cancer, where it is or other health problems you have. In this case, you have other options: radiation therapy, chemotherapy or both.

Hysterectomy

Most people with endometrial cancer have a total hysterectomy (surgery to remove the uterus, including the cervix). If cancer has spread to your cervix or the tissue around it (parametrium), your surgeon will also remove that tissue, the ligaments that connect your uterus to your sacrum, and the upper part of your vagina. This is called a radical hysterectomy.

With either surgery, the surgeon will probably remove your fallopian tubes and ovaries (bilateral salpingo-oophorectomy) at the same time. These are places where endometrial cancer may spread.

Lymph-Node Removal

In this type of endometrial cancer treatment, your surgeon will also remove lymph nodes from your pelvic area and around the major artery (aorta) in your abdomen (pelvic and para-aortic nodes). They will check the lymph nodes to see if cancer has spread there.

Other Steps During Surgery

At the start of your surgery, your surgeon may wash your abdominal and pelvic cavities with salt water (peritoneal lavage). They will also send a sample of this fluid to a lab to check for cancer cells. Knowing the results can help your physician recommend additional endometrial cancer treatments for you. The surgeon may also remove abdominal fat (omentum) and small samples of the lining of your abdominal and pelvic cavities (peritoneum) for testing.

Laparoscopic and Robot-Assisted Surgery

Our surgeons can use minimally invasive techniques to do hysterectomies, lymph-node removals and the other parts of surgery you may need. The surgeon can operate through small “keyhole” incisions in the belly (laparoscopically). They may insert tools directly through small incisions made by hand. Or they may use a robotic system, like the da Vinci Surgical System, to assist with the surgery. Minimally invasive methods reduce pain after surgery, infection, blood loss and recovery time.

Open surgery through a larger incision (laparotomy) is still done, too. In some cases, it’s the best option. If you need open surgery, your surgeon will explain the reasons.

Radiation Therapy for Endometrial Cancer

Radiation therapy (also called radiotherapy) uses high-energy beams to damage the DNA inside cancer cells. After enough damage, the cells cannot multiply, and they die.

How Radiation Therapy Can Treat Endometrial Cancer

Your physician may recommend having radiation therapy after surgery. If you’re not having surgery, then radiation therapy will likely be part of your endometrial cancer treatment.

There are two main types of radiation therapy: external-beam radiation therapy (EBRT) and internal radiation therapy.

External-Beam Radiation Therapy (EBRT)

EBRT means radiation comes from a source outside your body. A machine sends a beam of photons (such as X-rays or gamma rays) or subatomic particles (tiny particles that are smaller than atoms, such as electrons or protons) aimed at your cancer.

Typically, you’ll have EBRT five days a week (Monday to Friday) for five to six weeks. It’s not painful, and each treatment lasts only about five to seven minutes.

Internal Radiation Therapy

Internal radiation therapy (brachytherapy) means putting radioactive “seeds,” or pellets, inside your body. When used as an endometrial cancer treatment, the seeds are sealed in a rod that is inserted into the vagina or uterus.

Based on your needs, your care team might recommend a high-dose radiation source that’s inserted for a short time. Or you might need a low-dose radiation source that’s inserted and left for two to three days.

Radiation Plus Chemotherapy

Clinical trials are currently underway at Fred Hutch to test the combination of radiation therapy plus chemotherapy as endometrial cancer treatment options. Our gynecologic oncologists and radiation oncologists are involved in this research.

Chemotherapy for Endometrial Cancer

Chemotherapy helps to destroy cancer cells wherever they may be in your body. Usually, it means you get anti-cancer medicine through an intravenous (IV) line. Then the medicine travels throughout your body through your bloodstream.

How Chemotherapy Can Treat Endometrial Cancer

Some people have chemotherapy after their surgery for endometrial cancer. Chemotherapy may also be one of your options if you don’t have surgery.

Usually, physicians use chemotherapy for endometrial cancer treatment only if:

  • The cancer has already metastasized, or spread, outside of the uterus by the time of surgery.
  • The cancer has come back after earlier treatment

Chemotherapy Schedule

Chemotherapy schedules differ, based in part on which drugs you receive. Most people have chemotherapy every three weeks. Some chemotherapy regimens require weekly treatments. Treatment typically continues for three to six months. Each treatment takes about two to three hours.

Hormone Therapy for Endometrial Cancer

Like chemotherapy, hormone therapy is a systemic therapy. It moves around your body through the bloodstream to affect cancer cells wherever they are.

How Hormone Therapy Can Treat Endometrial Cancer

Some cancer cells have hormone receptors. These are points where hormones can attach and make the cells grow. Reducing or stopping hormone production helps prevent the growth of these cancers, which are called hormone-receptor positive.

Hormone therapy is sometimes used for endometrial cancer treatment, mainly if:

  • The cancer has spread beyond the uterus
  • The cancer has come back after earlier treatment

Types of Hormone Therapy

Your physician may suggest using one of these hormone therapies to slow the growth of your cancer:

  • Progestins: These medicines are like the hormone progesterone that occurs naturally in your body.
  • Tamoxifen: This drug helps prevent any estrogens that are circulating in your body from making cancer cells grow.
  • Aromatase inhibitors: If your ovaries have been removed (or no longer function), your body fat still makes estrogen. These drugs can stop this estrogen from being made.
  • Fulvestrant: This is an anti-estrogen drug given as an injection.
  • CDK 4/6 inhibitors: These drugs block proteins to keep cancer cells from dividing.

Why Choose Fred Hutch for Endometrial Cancer Treatment

At Fred Hutch, we understand going through endometrial cancer treatment may be one of the most intense and challenging experiences you and your family ever go through. We are here to provide the care you need.

Team-Based Care from Specialists

Fred Hutch has gynecologic oncologists and pathologists who specialize in gynecologic cancer. We offer the most advanced diagnostic, treatment and recovery programs. Along with treating your cancer, we also offer a range of services to support you and your caregiver. This is part of how we take care of you — not just your disease. From registered dietitians to Spiritual Health clinicians to social workers, our experts know how to care for people with endometrial cancer.

Treatment Tailored to You

We view treatment as a collaborative effort. Your Fred Hutch physicians will explain all your options. We’ll recommend a treatment plan to get you the best results based on the stage and size of your cancer, where it is and your overall health. We have access to the latest developments in treating cancer and offer patients the chance to get promising therapies through clinical trials done by researchers from Fred Hutch and UW Medicine.

Follow-Up Care

When your treatment for endometrial cancer is complete, we’ll keep close watch on your health with periodic follow-up visits. You’ll see the same team members who treated your disease. It’s specially designed to provide follow-up care for women who are five years out from their primary treatment.

Endometrial Cancer Treatment FAQ

The best treatment for endometrial cancer depends on many factors, like the size of the tumor, where it is and if it has spread. For many people, the main treatment is surgery. The idea is that the most effective treatment is to remove any tumor from the body, if possible. For some women, this may be the only treatment they need.

In some cases, surgery might not work well enough on its own. You might need other treatments, too, like radiation therapy or chemotherapy. And there are times when surgery may not be helpful, but other treatments may help control the disease. At Fred Hutch, we design your treatment plan around what will be most effective for you.

In general, people who have the same stage of endometrial cancer have the same or similar treatments. The grade of your cancer (how aggressive it is) also matters. Common treatments by stage may include:

  • Stage I (1) and stage II (2): Surgery to remove the tumor. Sometimes surgeons need to remove nearby organs or lymph nodes. Some people have radiation therapy or chemotherapy after surgery.
  • Stage III (3) and stage IV (4): Surgery to remove the tumor, if possible, along with lymph nodes in the pelvis, and then radiation therapy, chemotherapy or both. For people who cannot have surgery, options may include radiation therapy, chemotherapy, hormone therapy, targeted therapy and immunotherapy.

Fred Hutch offers all standard endometrial cancer treatment options. Our patients also have access to newer options or treatment combinations that you can only get through clinical trials.

Fred Hutch researchers are always looking for better ways to treat endometrial cancer. We are doing clinical trials of new treatments and combinations of treatments for endometrial cancer that is advanced or has come back, including chemotherapies, targeted therapies and immunotherapies.

Learn more about endometrial cancer research.

Your care team at Fred Hutch is here to help you prevent or prepare for side effects and to relieve any side effects you have. The most important step you can take is to let your team know what you’re feeling. We’ve helped many patients and families through this process and know ways to ease your experience.

Often, there are medicines to help, like anti-nausea drugs. Based on the side effect, there may be a range of other helpful options too, like diet changes, physical therapy and emotional and practical support. Fred Hutch researchers continue to look for the best ways to keep side effects at bay.

Your team at Fred Hutch offers long-term follow-up care for as long as you choose after your treatment for endometrial cancer. Our patients find it reassuring to see the same team members who treated them — experts in gynecologic cancers — for their follow-up visits. This includes physicians as well as advanced registered nurse practitioners.

Typically, people come for checkups, including pelvic exams, every three months for the first two years after treatment. Some patients choose to have all these follow-up visits at Fred Hutch. Some alternate between coming to Fred Hutch and seeing their local primary gynecologist.

After you reach the two-year mark without your disease coming back, you are less likely to have a recurrence. From that point, you can come in less often. We usually ask you to come in every six months for a checkup until you are five years out from your primary treatment. After five years, an annual checkup is all that we recommend.