2019 Uterine/Endometrial Cancer
Uterine cancer is the most common type of gynecologic cancer and the fourth most common cancer among women. Uterine cancer is in a minority of cancers increasing in incidence, with more than 63,000 new cases being diagnosed in the U.S. each year.
There is positive news, however. You can substantially lower your risk for developing this type of cancer by maintaining a healthy weight and exercising regularly. Also, research is making significant progress toward the treatment of uterine cancer, resulting in new, targeted medicines aimed at better outcomes for women affected by this disease.
Prevention and Detection
Experts have identified a strong link between obesity and endometrial cancer, saying it accounts for about 95 percent of all uterine cancers. In fact, studies show that three out of five cases of endometrial cancer cases in the U.S. could have been prevented if affected women had maintained a healthy weight and exercised regularly.
There are three things you can do to decrease your risk factors for many cancers, including uterine: maintain a healthy weight, avoid smoking and exercise regularly.
Genetic risk factors such as Lynch syndrome also can predispose women to endometrial cancer. Due to increased awareness, more women are being screened for Lynch and other rare syndromes, which should result in earlier detection and better treatment options. Gynecologic oncologists recommend that genetically high-risk groups receive annual endometrial biopsies. To find a gynecologic oncologist in your area, use our Seek a Specialist tool.
Early detection of this disease affords more opportunities for diagnosis and treatment. This means being aware of abnormal bleeding, the most common warning sign of uterine cancers. You should always report any abnormal or heavy bleeding to your doctor, regardless of menopausal status.
Immunotherapies: A Major Breakthrough
Immunotherapies have emerged in recent years and are considered one of the most significant new discoveries in cancer treatment. Pembrolizumab is one of these immunotherapies. Classified as an immune checkpoint inhibitor, pembrolizumab was approved by the FDA in 2018 for use in treating all solid tumors with defective DNA mismatch repair, including endometrial cancers. It could provide benefit for up to 30 percent of patients with advanced endometrial cancer.
The Nobel Prize in Physiology or Medicine was awarded in 2018 to Dr. James P. Allison and Dr. Tasuku Honjo for their work, which led to the development of immunotherapies. Before immunotherapies, cancer treatment included surgery, radiation, chemotherapy and hormonal therapy. Pembrolizumab is one of several new immunotherapies developed and has only been approved to treat certain cancers.
Less Invasive Surgical Options
Mounting evidence supports the use of minimally invasive surgical methods for most endometrial cancer patients. This includes laparoscopic surgery, which provides similar cancer outcomes but improved quality of life and a host of other benefits. By opting for laparoscopic surgery, you may experience benefits such as shorter recovery times, shorter hospital stays and fewer postoperative complications.
Another less invasive method is sentinel lymph node (SLN) mapping, a rapidly evolving area in the treatment of endometrial cancer. A sentinel lymph node is the first lymph node (or nodes, sometimes there are more than one) to which cancer cells are most likely to spread from a primary tumor.
Studies such as the FIRES and SENTI-ENDO trials have determined that SLN mapping can safely replace more extensive pelvic lymphadenectomy to identify whether a patient’s cancer has spread to any lymph nodes. When feasible, SLN offers fewer side effects, lower morbidity and highly accurate diagnostic information, which can lead to more tailored treatment options.
Sentinel lymph node mapping is an effective alternative to complete pelvic lymphadenectomy in staging endometrial cancer
Clinical Trials
Clinical trials aren’t just an opportunity for researchers to learn how to treat cancer more effectively. They are oftentimes a way for you to receive the best treatment for your type of cancer. You could be one of the first to receive an optimal treatment that is later approved for use by the FDA. To find out more about ongoing clinical trials for endometrial and other types of cancer, visit MD Anderson Cancer Center’s list of Gynecologic Oncology Clinical Trials.
Recent studies have led us to better understand uterine cancer. Physicians now have the ability to tailor treatments and determine, for example, whether a patient needs chemotherapy, radiation, or possibly a combination of both. As more is discovered about the molecular landscape of endometrial cancer, more effective, tailored treatments can be delivered to all patients.
Gynecologic oncologists are obstetrician-gynecologists who have an additional three to four years of specialized training in treating gynecologic cancers, including uterine cancer, and are often the best subspecialist to manage your care—your treatment team may also include medical, surgical and radiation oncologists; pathologists and diagnostic radiologists
Support groups that specialize in your type of cancer may offer the type of assistance you need
