Treatment for womb cancer

Types of treatment Back to top

Most womb cancers are discovered at an early stage (when they have not spread beyond the womb) and may be cured by a hysterectomy| (surgical removal of the womb). As this treatment is very successful for many women, further treatment is not normally necessary.

Radiotherapy| may be given after the operation, if your surgeon feels that there is any risk of the cancer coming back. Radiotherapy may be used instead of surgery if the cancer cannot be removed surgically, or if you are not fit enough to have an operation. Radiotherapy may be used if the cancer comes back (recurs) in the pelvic area at a later date.

If the cancer has spread to other parts of the body, treatment with a female hormone called progesterone| may be able to shrink the cancer and control symptoms. Chemotherapy| is also used sometimes for people in this situation, and can help to shrink the cancer and control its growth for a time.

Your treatment will depend on a number of factors, including:

• your age
• your general health
• the type of tumour you have
• the stage and the grade of the cancer.

Multidisciplinary team Back to top

If your tests show that you have womb cancer, you will be looked after by a multidisciplinary team. This is a team of staff who specialise in treating gynaecological cancer and in giving information and support. It will normally include:

• gynaecological surgeons
• specialist nurses who give information and support
• oncologists – doctors who have experience in gynaecological cancer treatment using chemotherapy, radiotherapy and hormonal therapy
• radiologists who help to analyse x-rays
• pathologists who advise on the type and extent of the cancer.

Other staff will also be available to help you if necessary, such as:

• physiotherapists
• counsellors and psychologists
• social workers
• dietitians.

Giving your consent Back to top

Before you have any treatment, your doctor will explain its aims to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

• the type and extent of the treatment that you are advised to have
• the advantages and disadvantages of the treatment
• any other treatments that may be available
• any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go to your appointment.

Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is important to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

Benefits and disadvantages of treatment Back to top

Many people are frightened at the idea of having cancer treatments, because of the side effects that can occur. Some people ask what would happen if they did not have any treatment. Although treatments such as radiotherapy can cause side effects, these can usually be well controlled with medicines.

Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation.

Early-stage womb cancer

In women with early-stage endometrial cancer, surgery is usually done with the aim of curing the cancer and, in most cases, is successful. Sometimes additional treatments such as radiotherapy are given after the surgery to reduce the risks of the cancer coming back.

Advanced womb cancer

If the cancer is at a more advanced stage or has come back (recurred), treatment may only be able to control it, leading to an improvement in symptoms and a better quality of life. However, for some people in this situation, treatment will not have much effect upon the cancer and they will get the side effects with little benefit.

Making decisions about treatment Back to top

If you have early-stage cancer and have been offered treatment that aims to cure it, deciding whether or not to accept the treatment may not be difficult. However, if you have more advanced cancer and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.

Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms.

Second opinion Back to top

Some women find it reassuring to have another medical opinion to help them decide about their treatment. Most doctors will be pleased to refer you to another specialist for a second opinion, if you feel this will be helpful. However, a second medical opinion may take some time to arrange and may delay the start of your treatment, so you need to be sure that it will be helpful to you.