Chemotherapy for womb cancer (endometrial cancer)
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs are carried in the blood and can reach cancer cells anywhere in the body.
If you have early-stage womb cancer, you’re unlikely to need chemotherapy.
When chemotherapy is given
Back to top
Chemotherapy is sometimes offered after surgery and radiotherapy, to reduce the risk of womb cancer coming back. This is called adjuvant chemotherapy. There may be more risk of the cancer coming back if it:
is high-grade (grade 3)
is a non-endometrial type
has spread to the lymph nodes.
Your specialist will talk to you about the possible benefits and side effects of chemotherapy, so that you can decide if it’s right for you. In some situations, chemotherapy may be given instead of radiotherapy after surgery. It may also be given before surgery to shrink the cancer before removing it, or to treat cancer that’s left behind after your operation.
Chemotherapy for advanced womb cancer
Back to top
If the cancer spreads to other parts of the body, chemotherapy can be given to help control it and relieve symptoms without causing too many side effects. This is sometimes called palliative treatment. Your cancer specialist or specialist nurse will explain what it involves and the likely side effects.
How chemotherapy is given
Back to top
You’re likely to have the chemotherapy drugs given by injection into a vein (intravenously) or as a drip (infusion). Occasionally, the drugs are given through a soft plastic line called a central line into a vein in your chest or through a thin tube inserted into your upper arm (a PICC line).
Chemotherapy is usually given as a session of treatment.
After each session, you’ll usually have a rest period of a few weeks before the next session. This allows your body to recover from the side effects. The chemotherapy session and the rest period make up a cycle of treatment. Your doctor or nurse will explain how many cycles of treatment are planned for you and how you’ll be given your chemotherapy.
Chemotherapy drugs used
Back to top
The drugs commonly used to treat womb cancer are:
Other drugs may also be used. You may be given a combination of two or three drugs, or just one. If you’re having adjuvant chemotherapy, you’re more likely to have a combination of drugs. Your doctor or specialist nurse will explain more about the chemotherapy treatment to you.
We have more information about individual chemotherapy drugs and combinations.
Side effects of chemotherapy drugs
Back to top
Chemotherapy drugs can cause side effects, but many of these can be well controlled with medicines and will usually go away when your treatment is finished. If the cancer is causing symptoms, chemotherapy can also make you feel better by relieving them. Your doctor or nurse will tell you more about what to expect. Always mention any side effects you’re having, as there are usually ways in which they can be controlled.
The main side effects are described here, along with some ways to control or reduce them.
Risk of infection
While the drugs are acting on the cancer cells in your body, they also temporarily reduce the number of white blood cells in your blood. When these cells are reduced, you’re more likely to get an infection.
Contact the hospital straight away and speak to a doctor or nurse if:
your temperature goes above 38°C (100.4°F)
you suddenly feel ill, even with a normal temperature.
If necessary, you’ll be given antibiotics to treat an infection.
You’ll have a blood test before each cycle of chemotherapy to make sure your cells have recovered. Occasionally, it may be necessary to delay treatment if the number of white blood cells is still low.
If the level of red blood cells in your blood is low, you may feel tired and breathless. This is called anaemia. Anaemia can be treated by having a blood transfusion.
Bruising and bleeding
Chemotherapy can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. If you develop any unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin, contact your doctor or the hospital straight away.
Some chemotherapy drugs can make you feel sick (nausea) or be sick (vomit). Your cancer specialist will prescribe anti-sickness (anti-emetic) drugs to prevent this. Let your doctor or nurse know if your anti-sickness drugs are not helping, as there are several different types you can take.
You’re likely to become tired and have to take things slowly. Try to pace yourself and save your energy for things that you want to do or that need doing. Balance rest with some physical activity - even going for short walks will help increase your energy levels.
You may lose your appetite during chemotherapy. Try to eat frequent, small meals and ask others for help in preparing meals. There are many ready-to-drink supplements that add energy and protein to your diet, some of which are available on prescription.
Some chemotherapy drugs can make your mouth sore and may cause ulcers. Keeping your mouth and teeth clean and using mouthwashes regularly is important. Your nurse will show you how to use these properly.
If you have diarrhoea, it can usually be controlled easily with medicine. Let your doctor know if it’s severe or if it continues. Try to drink 2-3 litres of fluid a day to replace lost fluid.
Your doctor or nurse will be able to tell you if the chemotherapy drugs that you are going to have will cause hair loss. Not all the drugs used to treat womb cancer have this side effect. If your hair does fall out, it will start to grow back again once your chemotherapy is over.
Bengu lost her hair after treatment for leukaemia. Watch her story.
Numbness or tingling in hands or feet
This is due to the effect of some chemotherapy drugs on the nerves and is called peripheral neuropathy. Tell your doctor if you notice these symptoms or have difficulty carrying out fiddly tasks. This problem usually improves slowly a few months after treatment is over, but it can sometimes be permanent.
Taxol may sometimes cause an allergic reaction while it’s being given. To reduce the chance of this happening, you’ll be given steroids before and after treatment. Signs of a reaction can include: skin rashes and itching; a high temperature; shivering; dizziness; a headache; and breathlessness. If you notice any of these effects, tell your nurse or doctor straight away so it can be treated quickly.
Risk of blood clots
Cancer can increase your risk of developing a blood clot (thrombosis), and having chemotherapy may increase this risk further. A blood clot may cause symptoms such as pain, redness and swelling in a leg, or breathlessness and chest pain. Blood clots can be very serious, so it’s important to tell your doctor straight away if you have any of these symptoms.
Most clots can be treated successfully with drugs that thin the blood. Your doctor or nurse can give you more information.
Although the side effects can be hard to deal with, they usually improve gradually when treatment finishes.