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Endometrial Cancer: Treatment Planning
Treatment for endometrial cancer can cure or control the disease. It can also improve your quality of life by limiting symptoms of the disease.
Treatment varies greatly depending on the stage (or extent) of the cancer, whether it’s slow-growing, and your preferences and goals.
Surgery is often the most effective treatment for early stages of endometrial cancer. Sometimes that is followed by radiation therapy and drug therapy.
WHAT TO KNOW ABOUT TREATMENTS FOR ENDOMETRIAL CANCER
1Getting Started In Your Care
2Getting Your Diagnosis
3Planning Your Treatment
Considering Your Options »
4Undergoing Treatment & Follow-Up
Select your type of treatment below.
Assessment
Evaluating Options
Choosing Treatment
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Stage of the endometrial cancer
- Whether it has spread (metastasized) to the lymph nodes (small glands that filter bacteria, viruses, cancer cells, and other impurities from the body) or other parts of the body
- Type of endometrial cancer you have:
- Your age and overall health
- Whether you have had cancer before
- There are a number of other consideration which may impact your treatment plan.
We discuss different types of treatment and how to combine them in a sequence that will best treat the cancer.
a. Your doctors may prescribe a treatment plan that combines one or more of the three main types of treatment: surgery, radiation therapy, and drug therapy (medications that travel through the bloodstream to attack cancer anywhere in the body). The combination of treatment types may need to take place in a specific order to best treat your specific condition.
Learn about treatments for endometrial cancer »
b. Your treatment options will also be determined by the stage of your cancer. We can treat all the stages of endometrial cancer, from the least to the most severe.
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. A gynecologic oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for endometrial cancer have different goals, such as:
- Slowing or stopping the growth of cancer
- Destroying cancer cells
- Destroying any cancer cells that may have spread (metastasized) to other areas
- Delaying or preventing cancer from coming back (recurrence)
- Managing symptoms of incurable cancer
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing endometrial cancer treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
The team evaluates different options for your treatment plan, based on the details of your diagnosis, including:
- Stage of the endometrial cancer
- Whether it has spread (metastasized) to the lymph nodes (small glands that filter bacteria, viruses, cancer cells, and other impurities from the body) or other parts of the body
- Type of endometrial cancer you have:
- Your age and overall health
- Whether you have had cancer before
- There are a number of other consideration which may impact your treatment plan.
close Assessment
We discuss different types of treatment and how to combine them in a sequence that will best treat the cancer.
a. Your doctors may prescribe a treatment plan that combines one or more of the three main types of treatment: surgery, radiation therapy, and drug therapy (medications that travel through the bloodstream to attack cancer anywhere in the body). The combination of treatment types may need to take place in a specific order to best treat your specific condition.
Learn about treatments for endometrial cancer »
b. Your treatment options will also be determined by the stage of your cancer. We can treat all the stages of endometrial cancer, from the least to the most severe.
close Evaluating Options
Your care team will explain the options and the possible treatment sequence. Your doctors will help you make an informed decision about which options may be right for you. A gynecologic oncologist leads your team and remains your main doctor throughout treatment.
The best treatment for one person might not be the best treatment for another. There are three topics to consider when discussing with your doctor what works best for you.
Medical goals
Your care team will recommend treatment options based on your specific diagnosis. Different types of treatment for endometrial cancer have different goals, such as:
- Slowing or stopping the growth of cancer
- Destroying cancer cells
- Destroying any cancer cells that may have spread (metastasized) to other areas
- Delaying or preventing cancer from coming back (recurrence)
- Managing symptoms of incurable cancer
Personal treatment goals
As you and your care team discuss and make decisions about your treatment plan, it helps to think about your goals for treatment. These goals are different for each person, but health and quality of life are likely at the top of your list. Within those two priorities, there are several questions to consider:
- What’s important to me?
- What do I value?
- What do I need from my relationships?
- What do I want from the treatment experience?
It’s important for your loved ones to understand your treatment goals and wishes, so talk to them. You can ask family and friends for emotional support and help with a variety of issues during your care journey.
The effect of treatment on everyday life
Your care team can help you understand how various treatments can help you achieve your goals. Discuss what you want to be able to do, both during treatment and after it is complete. Issues specific to your health include:
- Treatment: How cancer and treatments will affect you and your ability to continue your everyday activities at work and home
- Side effects and symptoms: How to manage and cope with disease symptoms and treatment side effects
- Balance: Ways to balance aggressive treatment that prolongs survival with side effect management that maintains a good quality of life
Other important issues to consider include:
- Communication: Ways to talk to your family, friends, and others (such as co-workers) about your diagnosis, and how to ask for help
- Emotional well-being: How to manage your own emotions and the emotional impact of your diagnosis on your family and friends
- Relationships: How to maintain relationships with your partner, family, and friends, including intimacy, everyday activities, and responsibilities
- Appearance and body image: Ways to cope with changes that may result from treatment and the cancer itself
- Daily activities: How to take care of yourself, look after your family, and balance work responsibilities while undergoing endometrial cancer treatment
- Travel and distance: How to manage family and work responsibilities if you are coming to Stanford from outside the Bay Area
close Choosing Treatment
Every cancer is different, even in the early stages. The best treatment for one person might not be the best treatment for another. Your doctor will help you make an informed decision about which options may be right for you. Your treatment plan may consist of one or any combination of the following:
Surgery
Your care team may recommend surgery to diagnose, stage, or treat cancer:
- Diagnosis: Endometrial cancer is diagnosed by a pathologist who specializes in gynecologic cancers, after analyzing tissue taken during biopsy or surgery.
- Staging: Surgery can help determine the stage of endometrial cancer, by showing the size of the tumor and other details.
- Treatment: Surgically removing the uterus is an important part of your treatment.
Surgery Resources
Should surgery be part of your care plan, we are here to help guide you through the process.
If surgery provides a good treatment option, you will meet with a gynecologic oncologist to develop a plan. Surgery for endometrial cancer is different for every patient. Your gynecologic oncologist (cancer surgeon) will work with you to determine the least invasive and most effective surgery for the type of endometrial cancer you have.
Combining surgery with other treatments
To achieve the best possible outcome, your care team may recommend combining surgery with other treatments such as radiation therapy or chemotherapy. The additional treatment can be given 1 of 2 ways:
- Neoadjuvant therapy: This treatment occurs before surgery to make it easier and more effective. Undergoing chemotherapy before surgery, for example, may shrink a tumor and make removal more successful.
Adjuvant therapy: This treatment occurs after surgery to reduce the risk of the cancer coming back. Chemotherapy or radiation therapy after surgery can destroy remaining cancer cells. - Adjuvant therapy: This treatment occurs after surgery to reduce the risk of the cancer coming back. Chemotherapy or radiation therapy after surgery can destroy remaining cancer cells.
Drug Therapy (Medical Oncology)
Drug therapy, also called systemic or medical therapy, is treatment that works throughout the body to fight endometrial cancer. These drugs slow the growth of cancer cells or destroy them.
At Stanford, our gynecologic oncologists use several types of drug therapy, including:
Chemotherapy: This group of medications stops the growth of rapidly dividing cells in the body, both cancerous and noncancerous. While powerful, chemotherapy can cause more side effects than other medication types, because it cannot distinguish between cancerous and healthy cells. Chemotherapy is a treatment option for many cancers.
Chemotherapy Resources
Chemotherapy is a treatment option for advanced or aggressive types of endometrial cancer. We are here to help you prepare and guide you through the process.
Hormone (endocrine) therapy: Some cancers grow in response to hormones like estrogen. Hormone therapy lowers the amount of these hormones or blocks their effect, slowing or even stopping the cancer’s growth.
You can receive drug therapy:
- By mouth (orally) as a pill
- Through the blood vessels (intravenously, or IV) as an injection or infusion
Hormone Therapy Resources
Hormone therapy is a treatment option for certain types of endometrial cancer. We are here to help you prepare and guide you through the process.
Drug therapy scheduling
If your treatment plan involves drug therapy, you will have routine visits to have lab work done, see your doctor, and receive medication. You may need to come in once or twice per week. If you need an infusion, you will visit one of Stanford’s infusion treatment centers, where a nurse specializing in Endometrial cancer care will provide your treatment.
Drug therapy side effects
Side effects from drug therapies vary depending on the type of medication you receive. Ask your care team – we can help you manage or prevent many symptoms and side effects that can affect your everyday life.
Radiation Oncology
Radiation therapy is painless treatment that uses high-energy X-rays or other types of radiation to destroy cancer cells. Our radiation oncologists have years of experience safely and effectively treating endometrial cancer with radiation. Using the latest technology, we can precisely target tumors and minimize damage to nearby healthy tissue.
Radiation therapy may provide effective treatment for the type of endometrial cancer you have. If so, your doctor will speak with you about the best options. The types of radiation therapy we use for endometrial cancer treatment at Stanford include:
External radiation uses a machine called a linear accelerator (LINAC) to deliver radiation to the area where the cancer cells are found. Some of the types of external radiation we use include:
- 3D (3-dimensional) conformal radiation therapy (3D-CRT)
With this method, 3D images help the doctor better target the tumor. The images are created using a special machine — a computed tomography (CT) or magnetic resonance imaging (MRI) machine. The radiation beams can be aimed from many different angles to match the exact shape of the cancer.
Radiation Therapy Resources
Should radiation therapy be part of your care plan, we are here to help you prepare and guide you through the process.
What to expect during external radiation therapy and how to prepare »
- Intensity-modulated radiation therapy (IMRT)
This method is similar to the first method, but the doctor can adjust how much radiation you get from each beam. In certain situations, this enables the doctor to avoid nearby normal cells to reduce the risk for side effects. - Stereotactic body radiation therapy (SBRT) or stereotactic ablative radiation therapy (SABR)
This method works like the first two methods, and the total amount of radiation you get is similar. But with SBRT, the radiation is given in fewer but stronger doses. This is often used for cervical cancers or other cancers.
Internal radiation (Brachytherapy)
When giving internal radiation, your doctor puts small amounts of radioactive material into the area where the cancer was found or removed. This kind of internal radiation is called brachytherapy. For endometrial cancer, brachytherapy is given in the vagina.
Each internal radiation treatment usually lasts between 4 and 6 hours total. During this treatment, your doctor will keep you comfortable with pain medicine or sometimes with light sedation or anesthesia.
There are 2 kinds of internal radiation therapy, or brachytherapy:
- Low-dose rate (LDR): the radioactive material is delivered to your body and stays in place 1 to 7 days. You may stay in the hospital during that time, and are radioactive until the end when the doctor removes the radioactive material. At Stanford, we do not perform this type of brachytherapy.
- High-dose rate (HDR): the radioactive material is implanted for only 10 to 20 minutes at a time, then removed. You are not radioactive at any time other than the few minutes of treatment, meaning you can safely be around others when you return home. There are typically 3-6 treatments total, given once a day, twice a week. Most of the time, treatments can be done as an outpatient (no hospital stay), with a return home the same day. At Stanford, we exclusively use HDR-brachytherapy.
Sometimes, brachytherapy is offered in combination with external beam therapy. The exact combination of your treatment will be determined by your doctor.
Receiving radiation treatments
Radiation therapy does not cause pain, so you won’t feel anything during your treatments. Radiation does not make you radioactive, and you can safely be around other people, including children.
Clinical Trials
At Stanford, our doctors are always working to improve care for people with endometrial cancer. As an academic medical center, we conduct clinical trials to evaluate new medical techniques, devices, medications, and other treatments for safety and effectiveness.
For endometrial cancer, we study new approaches to preventing, screening, detecting, diagnosing, and treating endometrial cancer. Some clinical trials look at new methods, while others evaluate new combinations of approved, existing approaches.
Depending on your individual circumstances, a clinical trial may provide a treatment option for you. Like any treatment, clinical trials have possible risks and benefits, including:
Possible benefits of joining a clinical trial:
- Access to a new treatment that isn’t widely available
- Expert care from our world-renowned cancer specialists and their teams
- Low- or no-cost treatment
- Participation in research that can save lives in the future
Possible risks of a clinical trial:
- Treatment that may not work for you
- Side effects that may be unexpected or worse than current standard-of-care treatments
- Additional doctor visits, meaning more time and travel
- Additional tests, which may be uncomfortable or time consuming
- Extra expenses if your health insurance does not cover all patient costs for a trial
To learn more about Stanford’s clinical trials for endometrial cancer, speak with your care team. We can help you decide if a clinical trial may be right for you.
Stage 1
Stage 2
Stage 3
Stage 4
The mainstay treatment for stage 1 endometrial cancer is surgery. It provides a very high chance for cure of early stage endometrial cancer.
Stage 2 endometrial cancer has spread from the uterus to the cervix, but not outside the uterus and cervix. Surgery is still the most common treatment.
After surgery, radiation therapy may be effective in some cases in decreasing the risk that the cancer could return.
Stage 3 endometrial cancer has spread to the ovaries or fallopian tubes, or to the pelvic lymph nodes. Surgery to remove all these organs is usually the first step of treatment.
Depending on your individual case, the doctor may also recommend additional radiation therapy to kill any microscopic cancer cells left after surgery. Drug therapy is also an option.
Stage 4 endometrial cancer has spread outside the reproductive tract to other parts of the body. At this stage, endometrial cancer usually cannot be cured, but it can be controlled to ease symptoms and preserve your quality of life.
Surgery, radiation therapy, and drug therapy are all options.
The mainstay treatment for stage 1 endometrial cancer is surgery. It provides a very high chance for cure of early stage endometrial cancer.
close Stage 1
Stage 2 endometrial cancer has spread from the uterus to the cervix, but not outside the uterus and cervix. Surgery is still the most common treatment.
After surgery, radiation therapy may be effective in some cases in decreasing the risk that the cancer could return.
close Stage 2
Stage 3 endometrial cancer has spread to the ovaries or fallopian tubes, or to the pelvic lymph nodes. Surgery to remove all these organs is usually the first step of treatment.
Depending on your individual case, the doctor may also recommend additional radiation therapy to kill any microscopic cancer cells left after surgery. Drug therapy is also an option.
close Stage 3
Stage 4 endometrial cancer has spread outside the reproductive tract to other parts of the body. At this stage, endometrial cancer usually cannot be cured, but it can be controlled to ease symptoms and preserve your quality of life.
Surgery, radiation therapy, and drug therapy are all options.
close Stage 4
Your health care team for endometrial cancer brings together a multispecialty team of experts dedicated to treating gynecologic cancers, including cancer of the uterus and endometrium.
Your doctors
Gynecologic Oncologist
A gynecologic oncologist is a medical doctor who specializes in diagnosing and treating cancers that are located in a woman's reproductive system.
View All {0} Gynecologic Oncologists »Pathologist
A gynecologist pathologist is a medical doctor who has advanced training in diagnosing gynecologic cancer by examining samples of body cells obtained in a biopsy or surgery.
View All {0} Pathologists »
Extended care team
This health care provider works in collaboration with your medical oncologist to help care for you during your treatment and follow up. An APP can be a physician’s assistant (PA) or nurse practitioner (NP). A nurse practitioner is an advance practice nurse who has completed graduate education and is trained to do physical exams, diagnose, prescribe, and treat medical conditions. Our APPs can help manage your side effects and help carry out your treatment plan safely. You may alternate visits between your APP and oncologist.
These specialized registered nurses provide one-on-one support to guide you through your cancer journey. MCCs serve as your point of contact to help manage your care, from your first appointment through follow-up visits. They assess your needs, answer your questions, make referrals, coordinate appointments, and provide patient education.
The administrative assistants help with administrative issues such as scheduling your appointments, managing your paperwork, and requesting your medical records and disability papers.
This team member helps you during your doctor visits by:
- Bringing you to your exam room after you check in for an appointment
- Providing you with a hospital gown or other clothing for your physical exam
- Taking your vital signs before your doctor sees you
A staff member calls you before your first appointment to:
- Provide information that you need to know to prepare
- Provide a list of what you need to bring
- Help gather your medical records
Support services
PathWell is your connection to personalized support services before, during, and after your treatment. Our teams of doctors, nurses, social workers, spiritual care providers, nutrition experts, financial counselors, and more work with your cancer care team to provide comprehensive specialized care to you and to your family.
PathWell can also connect you to the Stanford Cancer Supportive Care Program, which provides free classes, workshops, fitness classes, services, and support to all cancer patients.
650-498-6000 Ask for the PathWell team
Stanford Health Library
For confidential help with your health care questions, contact the Stanford Health Library. Professional medical librarians and trained volunteers can help you access journals, books, e-books, databases, and videos to learn more about medical conditions, treatment options, and related issues.
- 875 Blake Wilbur, Palo Alto: 1st floor near the cafe, 650-736-1960
- South Bay Cancer Center: 3rd floor lobby, 408-353-0197
- Email us your questions: healthlibrary@stanfordhealthcare.org