Chemotherapy (chemo) is the use of cancer-fighting drugs given into a vein or by mouth. These drugs enter the bloodstream and reach throughout the body, making this treatment potentially useful for cancer that has spread beyond the endometrium. If this treatment is chosen, you may receive a combination of drugs. Combination chemotherapy sometimes works better in treating cancer than one drug alone.
Chemo is often given in cycles: a period of treatment, followed by a rest period. The chemo drugs may be given on one or more days in each cycle.
Drugs used in treating endometrial cancer may include:
- Paclitaxel (Taxol®)
- Doxorubicin (Adriamycin®) or liposomal doxorubicin (Doxil®)
Most often, 2 or more drugs are combined for treatment. The most common combinations include carboplatin with paclitaxel and cisplatin with doxorubicin. Less often, paclitaxel and doxorubicin and cisplatin/paclitaxel/doxorubicin may be used.
For carcinosarcoma, the chemo drug ifosfamide (Ifex®) is often used, either alone or in combination with either carboplatin, cisplatin or paclitaxel. The combination of carboplatin and paclitaxel is also often being used for carcinosarcoma.
Sometimes chemo is given for a few cycles, followed by radiation. Then chemo is given again. This is called sandwich therapy and is sometimes used for endometrial papillary serous cancer and uterine carcinosarcoma.
Another treatment option is to give chemo with radiation (called chemoradiation). The chemo can help the radiation work better, but it can be harder on the patient because it causes more side effects.
Side effects of chemotherapy
These drugs kill cancer cells but can also damage some normal cells, which in turn can cause side effects. Side effects of chemotherapy depend on the specific drugs, the amount taken, and the length of time you are treated. Common side effects include:
- Nausea and vomiting
- Loss of appetite
- Mouth and vaginal sores
- Hair loss
Also, most chemotherapy drugs can damage the blood-producing cells of the bone marrow. This can result in low blood cell counts, such as:
- Low white blood cells which increases the risk of infection
- Low platelet counts which can cause bleeding or bruising after minor cuts or injuries
- Low red blood cells (anemia) which can cause problems like fatigue and shortness of breath
Most of the side effects of chemotherapy stop when the treatment is over, but some can last a long time. Different drugs can cause different side effects. For example, the drug doxorubicin can damage the heart muscle over time. The chance of heart damage goes up as the total dose of the drug goes up, so doctors place a limit on how much doxorubicin is given.
Cisplatin can cause kidney damage, so you will be given large amounts of IV fluids before and after chemotherapy to help protect the kidneys. Both cisplatin and paclitaxel can cause nerve damage (called neuropathy). This can lead to numbness, tingling, or even pain in the hands and feet. Ifosfamide can injure the lining of the bladder, causing it to bleed (called hemorrhagic cystitis). To prevent this, you might be given large amounts of IV fluids and a drug called mesna along with the chemo. Before starting chemotherapy, be sure to discuss the drugs and their possible side effects with your health care team.
If you have side effects while on chemotherapy, remember that there are ways to prevent or treat many of them. For example, modern anti-nausea drugs can prevent or reduce nausea and vomiting. Be sure to talk with your doctor or nurse about any side effects you are having.
For more information, please see the Chemotherapy section of our website.
Last Revised: 02/29/2016