Chemotherapy for Uterine Sarcomas
Chemotherapy (chemo) is the use of drugs to treat cancer. The drugs can be swallowed in pill form or they can be injected by needle into a vein or muscle. Chemotherapy is considered systemic therapy. This means that the drug enters the bloodstream and circulates throughout the body to reach and destroy cancer cells, making this treatment useful for cancer that has spread beyond the uterus. When chemotherapy is given to shrink the cancer before surgery, it is called neoadjuvant treatment. If it is given after the cancer has been completely removed with surgery it is called adjuvant therapy. Adjuvant treatments are meant to keep the cancer from coming back later. Chemo can also be used as the main therapy to treat the cancer.
Some of the drugs used to treat uterine sarcomas include:
- Dacarbazine (DTIC)
- Docetaxel (Taxotere®)
- Doxorubicin (Adriamycin®)
- Liposomal doxorubicin (Doxil®)
- Epirubicin (Ellence®)
- Gemcitabine (Gemzar®)
- Ifosfamide (Ifex®)
- Paclitaxel (Taxol®)
- Temozolomide (Temodar®)
- Trabectedin (Yondelis®)
- Vinorelbine (Navelbine®)
Often a combination of drugs is used. For example, gemcitabine and docetaxel are often used together to treat leiomyosarcoma.
These drugs kill cancer cells but can also damage some normal cells. This is what causes many side effects. Side effects of chemotherapy depend on the specific drugs, the amount taken, and the length of time you are treated. Some common side effects include:
- Nausea and vomiting
- Loss of appetite
- Hair loss
- Low blood counts
Chemotherapy can damage the blood-producing cells of the bone marrow, leading to low blood cell counts. This can result in:
- An increased chance of serious infection (due to a shortage of white blood cells)
- Problems with bleeding or bruising (due to a shortage of blood platelets)
- Feeling tired or short of breath (due to low red blood cell counts)
It is important to let your cancer care team know about any problems you have while on chemo, because many side effects can be prevented or treated. For example, there are many good medicines to prevent or reduce nausea and vomiting. Most side effects of chemotherapy stop when the treatment is over.
However, some side effects from chemotherapy can last a long time. 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 can be given. Cisplatin can cause kidney damage. Giving large amounts of fluid before and after chemotherapy can 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.
For more information on chemotherapy, see our document A Guide to Chemotherapy.
Last Medical Review: May 12, 2014 Last Revised: February 15, 2016