Chemotherapy for uterine cancer

Chemotherapy uses drugs to destroy cancer cells. These drugs target rapidly dividing cells throughout the whole body. This means that chemotherapy kills cancer cells but it can also damage healthy cells.

With most types of chemotherapy, the drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic therapy.

Chemotherapy is sometimes used to treat both endometrial carcinoma and uterine sarcoma. If you have chemotherapy, your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

Chemotherapy may be the only treatment you have or it may be used along with other cancer treatments. You may have chemotherapy or chemoradiation to:

• destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (recur) (called adjuvant chemotherapy)

• relieve pain or control the symptoms of advanced or metastatic uterine cancer (called palliative chemotherapy)

• try to shrink a tumour before surgery to try to make it operable (called neoadjuvant chemotherapy)

Most people with uterine cancer who have chemotherapy will be given 2 or more chemotherapy drugs during the same time period. This is called a chemotherapy drug combination.

Chemotherapy and radiation therapy may be given during the same time period for uterine sarcoma. This is called chemoradiation. Some chemotherapy drugs can help make radiation work better by making cancer cells more sensitive to radiation. Combining chemotherapy and radiation therapy can be more effective than either treatment on its own.

The types and combinations of chemotherapy drugs used vary depending on the type of tumour being treated.

The most common chemotherapy drug combinations used to treat endometrial carcinoma are:

• cisplatin (or carboplatin) and paclitaxel
• carboplatin and docetaxel
• carboplatin and nab-paclitaxel
• cisplatin (or carboplatin) and doxorubicin
• paclitaxel, ifosfamide and mesna
• carboplatin and paclitaxel with the targeted therapy drug trastuzumab (Herceptin and biosimilars)
• carboplatin and paclitaxel with the immunotherapy drug dostarlimab-gxly (Jemperli)
• carboplatin and paclitaxel with the immunotherapy drug durvalumab (Imfinzi)
• cyclophosphamide, doxorubicin and vincristine

The most common chemotherapy drugs used alone to treat endometrial carcinoma are:

• paclitaxel
• cisplatin
• doxorubicin
• carboplatin

The most common chemotherapy drug combinations used to treat uterine sarcoma are:

• docetaxel and gemcitabine
• doxorubicin and cisplatin
• doxorubicin, ifosfamide and mesna
• ifosfamide and mesna
• doxorubicin and dacarbazine
• doxorubicin and trabectedin

The most common chemotherapy drugs used alone to treat uterine sarcoma are:

• doxorubicin
• gemcitabine
• carboplatin
• ifosfamide
• dacarbazine
• trabectedin

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it's given and your overall health. Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Common side effects of chemotherapy drugs used for uterine cancer are:

• fatigue
• nausea and vomiting
• loss of appetite
• hair loss
• low blood cell counts, causing increased risk of infection and bruising more easily than before
• sore mouth and throat
• sores in your vagina
• diarrhea
• constipation
• shortness of breath

Doxorubicin may also cause heart problems. Cisplatin may also cause peripheral nerve damage.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.

Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.