Surgery

Surgery is often performed using minimally invasive robotically assisted technology and typically involves a hysterectomy (removal of the uterus and cervix) or a radical hysterectomy (removal of uterus, cervix, and additional tissue along the sides of the uterus and cervix). Surgery also involves staging with lymph node dissection, in which lymph nodes are removed from the pelvic area and sometimes also from the aorta (large blood vessel that carries blood away from the heart) so that lymphatic tissue samples can be checked under the microscope for signs of cancer spread. Injection of the cervix with a fluorescent dye called indocyanine green at the start of surgery aids in more precise identification of lymph nodes that may carry cancer cells. A bilateral salpingo-oophorectomy (removal of both fallopian tubes and ovaries) may also be performed, depending on your age and extent of disease. If endometrial cancer is diagnosed early, surgical removal alone may cure endometrial cancer.

Medical team

Chemotherapy/Radiation

After the doctor removes all the cancer that can be seen at the time of surgery, some patients may require a combination of chemotherapy (drugs that are taken by mouth or injected into a vein or muscle) and radiation (high-energy x-rays) to kill any remaining cancer cells. This will depend on imaging findings, fertility preservation and aggressiveness of the disease. Chemotherapy and radiation given after surgery, to reduce the risk of cancer coming back, is called adjuvant therapy. Depending on the extent of the disease at the time of diagnosis, some patients may require chemotherapy and radiation prior to surgery, in order to shrink the tumor to an optimal size for complete surgical removal; this is called neoadjuvant therapy.

Biological Targeted Therapy and Immunomodulation

Molecular profiling can be done on biopsy tissue and is often an option in cases of unusual cell type cancers or for recurrence.  This is also called next generation sequencing and can help determine if targeted biological agent therapy may be useful. Testing can also help determine if immunologic therapy is an option.