Clinical conversation: Questions and answers in connection with the therapeutic options of endometrium cancer

By Editor On Jul 4, 2025

English

Endometrium cancer is formed in the mucous membrane of the uterus, which is known as an endometrium. It is the most common type of women’s cancer in the USA and affects 1 of 50 women.

The good news? Doctors have many instruments for treating endometrium cancer that work well, especially if cancer is detected early. More than 80% of women who receive a diagnosis of endometrium cancer are still alive five years later and the number increases to 95% if cancer has not spread outside the uterus.

Understanding the therapeutic options of endometrium cancer, including operations, radiation and medication, can be useful for you to prepare for what is approaching. We spoke to Nita Lee, MD, adhering to obstetrics and gynecology at the University of Chicago, about how endometrium cancer is

What types of operations are used for endometrium cancer?

The most common type is currently a laparoscopic and robot surgery that is minimally invasive (it is carried out by tiny cuts). We use this type of surgery for most patients with endometrium cancer to remove the uterus and fallopian tubes and collect information from lymph nodes.

If patients have a more advanced disorder that has spread to lymph nodes or ovaries or if the uterus is too great to carry out a minimally invasive operation, open abdominal operation may be required.

What role does radiation therapy play in the treatment of endometrium cancer?

Radiation therapy is used more often than additional treatment after operations. Care after operations, which is referred to as postoperative care, can sometimes imply radiation therapy, depending on certain findings that are carried out during the operation.

For example, if a person has certain risk factors in the uterus, your medical provider (HCP) could recommend that you carry out vaginal radiation or possibly more complex pelvic radiation. Or if you have certain risk factors, such as this cancer in the cervix after surgical removal, radiation could be required in the pelvis area.

Some patients with more advanced diseases need radiation on lymph nodes and chemotherapy. Occasionally, patients who have no operations and have no treatments with fertility maintenance only receive radiation, but that is unusual. It really depends on the patient.

What systemic treatments (the entire body) are used for endometrium cancer?

Chemotherapy is the basis for the treatment of patients who receive diagnoses in advanced stages. For example, if we find that a person has 3 or 4 cancer during the operation, chemotherapy is often received as part of their postoperative therapeutic plan.
People with this level 1 disorder that have certain types of cells with high risk also receive chemotherapy after the operation.
The Immunotherapy It is a new treatment. It is similar to chemotherapy because the drug is administered intravenously, but immunotherapy medication have other effects on the body.
Although chemotherapy medication often affects cancer cells, immunotherapy should help to attack the body’s immune system.

One of the possibilities of how cancer cells survive their immune system is to hide behind certain proteins or produce such proteins so that their body does not recognize that cancer cells are harmful. Immunotherapy facilitates the detection of cancer.

Immunotherapy works optimally for certain categories of endometrium cancer, ie it works better for certain people than for others. This has changed the rules of the game for patients with recurrent endometrium cancer and for people who are given diagnoses in advanced stages.
The Hormonal terpia It is used for endometrium cancer with estrogens or progestogenic receptors, which means that cancer cells contain estrogen or progesterone receptors. We manipulate these receptors with hormones for the treatment of cancer.
The Directed therapy Eliminates cancer cells without damaging other cells. The probably best -known goal is the Her2 protein, a protein that is often mentioned when we talk about breast cancer.
Recent research has shown that a connection between endometrium cancer and Her2 protein and directed therapies can be useful.

Are there treatments with fertility conservation for endometrium cancer?

Yes. Hormonal therapy is the most common treatment of patients who are concerned about their fertility. We usually tend to limit treatments with fertility maintenance in patients in whom stage 1 was diagnosed with this disorder and for people with low endometrium cancer (compared to people with types of cells with high risk).

Which factors are taken into account when therapeutic decisions are made?

Many of our therapeutic decisions are made on the basis of the patient’s molecular profile, which analyzes the biomarkers and tumor cells and specifies exactly what type of endometrium cancer the patient has and whether certain treatments have an impact on the tumor. We also analyze any other medical problem that the patient and her therapeutic goals can have, and always take into account the quality of life.

This educational resource was created with the support of Karyopharm and Merck.

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