Chemotherapy for Uterine Sarcomas

Chemotherapy (chemo) is the use of drugs to treat cancer. The drugs can be swallowed as pills or they can be injected by needle into a vein or muscle. Chemo is systemic therapy. This means that the drug enters the bloodstream and circulates throughout the body to reach and destroy cancer cells. This makes chemo a useful treatment for cancer that has spread beyond the uterus. When chemo is given to shrink the cancer before surgery, it's called neoadjuvant treatment. If it's given after the cancer has been removed with surgery, it's called adjuvant therapy. Here are some ways chemo may be used for uterine sarcoma:

  • Adjuvant chemo is often used to help keep the cancer from coming back later.
  • Chemo can also be used as the main therapy to treat the cancer if a woman is unable to have surgery.
  • Sometimes chemo is used to control uterine sarcoma that has spread to other parts of the body or came back after surgery. In this case, the goal may be to ease symptoms and try to keep the tumor from growing.

Chemo may not work for certain types of uterine sarcoma. Better results seem to be seen with earlier stages of this cancer, and types that are more likely to come back after surgery. And some types of uterine sarcoma have been found to respond better to certain drugs and drug combinations. The role of chemo, as well as the best chemo drugs to use are not clear. Still, there are a lot of clinical trials looking at this, and some studies have shown that chemo can help some women live longer after surgery.

Some of the drugs commonly 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®)

In most cases, more than one drug 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 chemo 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

Chemo can damage the blood-producing cells of the bone marrow, leading to low blood cell counts. This can cause:

  • An increased chance of serious infection (from a shortage of white blood cells)
  • Problems with bleeding or bruising (from a shortage of blood platelets)
  • Feeling tired or short of breath (due to low red blood cell counts)

It's 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 instance, there are many good medicines to prevent or reduce nausea and vomiting. Most side effects of chemo go away over time when the treatment is over.

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 limit how much doxorubicin can be given. Cisplatin can cause kidney damage. Giving large amounts of fluid before and after chemo can help protect the kidneys. Both cisplatin and paclitaxel can cause nerve damage (called neuropathy). This can cause numbness, tingling, or even pain in the hands and feet.

More information about chemotherapy

For more general information about how chemotherapy is used to treat cancer, see Chemotherapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

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Last Revised: November 13, 2017

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