Treatment for womb cancer (endometrial cancer)
The main treatment for womb cancer is an operation to remove the womb (hysterectomy), and the fallopian tubes and ovaries. For some women, this may be the only treatment they need to cure the cancer.
Women who are advised by their doctor not to have a general anaesthetic for health reasons can be treated with radiotherapy instead of surgery.
If the cancer has spread but is still in the pelvic area, you will usually still have an operation to remove as much of it as possible. This can make any treatment you have after surgery more effective.
After surgery, you may be advised to have other treatments to reduce the risk of the cancer coming back – this is known as adjuvant treatment. The stage and grade of the cancer helps your specialist decide if you need further treatment. The most common treatment is radiotherapy to the pelvic area. Some women are given chemotherapy as well as radiotherapy to reduce the risk of the cancer coming back. Sometimes chemotherapy is given on its own instead of radiotherapy. You may also be asked if you would like to take part in a clinical trial.
Chemotherapy, or sometimes hormonal therapy, is used to treat cancer that has spread to other parts of the body, such as the liver or lungs. This is known as palliative treatment. Chemotherapy can help to shrink and control the cancer and relieve symptoms.
Hormonal therapy may be given when chemotherapy is no longer working. Occasionally, an operation may be done to remove a cancer that has spread if it is small and confined to one part of the body.
How treatment is planned
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In most hospitals, a team of specialists will meet to discuss and to decide on the best treatment for you. This multidisciplinary team (MDT) will include a:
surgeon who specialises in gynaecological cancers (gynaecological oncologist)
medical oncologist (chemotherapy specialist)
clinical oncologist (radiotherapy and chemotherapy specialist) who specialises in gynaecological cancers
gynae-oncology nurse specialist
radiographer who delivers the radiotherapy
pathologist to advise on the type and extent of the cancer.
It may also include other healthcare professionals, such as a dietitian, physiotherapist, occupational therapist, psychologist or counsellor.
After the MDT meet, your specialist will discuss treatment options with you. Remember to ask questions about anything you don’t understand or feel worried about. You can discuss the benefits and disadvantages of different treatments with your specialist doctor or nurse. You can also talk to our cancer support specialists on 0808 808 00 00.
We have more information on making treatment decisions, which may be helpful.
The benefits and disadvantages of treatment
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Many people are frightened by the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines. Treatment can be given for different reasons and the potential benefits will vary depending on your individual situation.
For most women with womb cancer, surgery is done with the aim of curing the cancer. You may also be given additional treatments to reduce the risk of it coming back.
If the cancer is advanced and has spread to other parts of the body, treatment may only be able to control it, improving symptoms and quality of life. However, for some people in this situation, the treatment will have no effect on the cancer and they will get the side effects without any of the benefits.
If you’ve been offered treatment that aims to cure the cancer, deciding whether to accept it may not be difficult.
However, if a cure is not possible and the purpose of treatment is 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 have it, you can still be given supportive (palliative) care, with medicines to control any symptoms.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide on the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to feel that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you. You could also prepare a list of questions, so that you can make sure your concerns are covered during the discussion.
Before you have any treatment, your doctor will explain its aims. They will ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.
No medical treatment can be given without your consent.
Before you’re asked to make any decisions, you should be given full information about:
the type and extent of the treatment
its benefits and disadvantages
any significant risks or side effects
any other treatments that may be available.
If there’s anything you don’t understand, let the staff know straight away so they can explain again. Some treatments are complex, so it’s not unusual to need explanations repeated.
It’s a good idea to have a relative or friend with you when the treatment is explained,
to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.
Making the decision about treatment was so hard…My advice is talk about it as much as you can, and ask all your questions however silly you think they are.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You’re also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.