Drugs known as platinum salts serve as the basis for treatment of endometrial cancer. The current data sup-ports a three-drug combination of cisplatin, doxoru-bicin, and paclitaxel. However, it is quite a difficult treatment to tolerate.
Therefore, another combination is frequently given, which employs carboplatin and paclitaxel. The optimal chemotherapy treatment for endometrial cancer is still being studied and you may choose to enter a clinical trial for treatment.
Cisplatin works by breaking up the DNA of cells, causing them to undergo cell death, or apoptosis. It is given by vein (intravenously, or IV). It is a powerful drug that, unfortunately, also affects normal cells, which is responsible for its side effects. Common side effects include severe nausea and vomiting, kidney problems, numbness and tingling, and ringing in the ears.
Fortunately, there are good drugs to help prevent or even treat the nausea and vomiting. The other side effects tend to happen as treatment continues, and your doctor will ask if any are present. If they are, he or she might have to decrease the dose or even stop this drug so the symptoms do not become worse.
Fortunately, another drug of the same class as cisplatin is available. It is called carboplatin and, unlike cisplatin, it is not as toxic to normal cells and its side effects are in turn different. It causes problems with blood counts, particularly platelets, which can put you at risk for bleeding complications. It can also cause nausea and vomiting, but not to the same degree as cisplatin.
Doxorubicin works by interfering with the DNA as well. It is usually given as a slow IV push in the chemotherapy unit and it is critical that the IV is working as it should because if it leaks out of the vein and into your soft tissue, it can cause a very severe chemical burn. Doxoru-bicin also causes problems with blood counts, nausea, and vomiting. Its most serious complication though affects your heart.
If you get too much of it (over your lifetime), then it can make the heart weak, a condition called a cardiomyopathy. Fortunately, oncologists have worked out the safe dosing of doxorubicin so as to stay clear of this risk. If your doctor decides that you need more than the accepted risk allows, there is a drug available to protect your heart from doxorubicin caused damage. This drug is called dexrazoxane.
Paclitaxel works by stopping cancer cells as they divide, which causes them to die. It is also an IV drug and is delivered over a 3-hour time period in most cases. Its major toxicities are hair loss (which happens after the very first treatment), numbness and tingling, and joint aches and pains.
It can also cause an allergic-type reaction when it is first given. Symptoms can include flushing of the skin, a sensation of heat, coughing, rapid heartbeat, high blood pressure, and chest tightness. In order to prevent this, you will need to take steroids before the treatment. If the first dose goes well with premedication, then you may not need to take steroids again, but this should be discussed with your doctor.
Your doctor may talk to you about being treated with progesterone therapy. This is not a chemotherapy agent, but is a hormone that is sometimes used if a woman has something called a positive “washing.” Your surgeon will pour sterile fluid into your abdomen and suction this off right before your hysterectomy.
If cells are found in this fluid but your cancer is otherwise low risk for recurrence (low grade, minimal muscle invasion, negative lymph nodes), your doctor may talk to you about taking pro-gesterone. The most common progesterone used in this case is called megestrol acetate.
Joan said:
Each oncologist has their own approach to treatment (this is true for radiation also). Sometimes it depends on what trials they are involved in or what papers they are writing.
Along with most modern medicine, cancer treatments and medications are changing all the time. You just have to be comfortable that your doctor is at the forefront of the information and trust that the approach the doctor recommends is the proper one for your type/level of cancer and for you.