Treatment

Types of treatment

Most cancers of the womb are discovered at an early stage (when they have not spread beyond the womb) and are cured by a hysterectomy (surgical removal of the womb). As this treatment is very successful for many women, further treatment is not normally necessary.

Radiotherapy may be given after the operation if your surgeon feels that there is any risk of the cancer coming back. Radiotherapy may be used instead of surgery if the cancer cannot be removed surgically, or if you are not fit enough to have an operation. Radiotherapy may be used to shrink a tumour down before surgery and may also be used if the cancer comes back (recurs) in the pelvic area at a later date.

If the cancer has spread to other parts of the body, treatment with a female hormone called progesterone may be able to shrink the cancer and control symptoms. Chemotherapy is also being tried in this situation but its effectiveness has not yet been established.

Your treatment will depend on a number of factors including your age, general health, the type of tumour you have, and the stage and the grade of the cancer. The treatment will be decided by a team of doctors working together and following national treatment guidelines.

Giving your consent

Before you have any treatment your doctor will explain the aims of the treatment to you and you will usually be asked to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you sign the form you should have been given full information about:

• The type and extent of the treatment you are advised to have
• The advantages and disadvantages of the treatment
• Any possible alternative treatments that may be available
• Any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go for your appointment. You can also ask the doctor if you can tape-record the conversation.

Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you and the staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment, if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment, and the staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, immediately so that he or she can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can give you the best advice.

The benefits and disadvantages of treatment

Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. Some people ask what would happen if they did not have any treatment.

Although treatments such as radiotherapy can cause side effects, knowledge about how these treatments affect people and improved ways of reducing or avoiding many of these problems have made most of the treatments much easier to cope with.

Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. In women with early-stage endometrial cancer, surgery is usually done with the aim of curing the cancer and in most cases does this. Sometimes additional treatments such as radiotherapy are given after the surgery to reduce the risks of the cancer coming back.

If the cancer is at a more advanced stage or has come back, treatment may only be able to control it, leading to an improvement in symptoms and a better quality of life. However, for some people in this situation treatment will have no effect upon the cancer and they will get the side effects without any of the benefit.

If you have early-stage cancer and have been offered treatment that aims to cure it, deciding whether to accept the treatment may not be difficult. However, if you have more advanced cancer and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.

Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms.

Some women find it reassuring to have another medical opinion to help them decide about their treatment. Most doctors will be pleased to refer you to another specialist for a second opinion, if you feel this will be helpful. However, a second medical opinion may take some time to arrange and delay the start of your treatment, so you need to be sure that it will be helpful to you.