Hormonal therapy for womb cancer
What is hormonal therapy?
Hormones are made in the body and help control how cells and organs work. The hormones oestrogen and progesterone can affect how cells in the the womb lining grow. Hormonal therapy drugs can help shrink or control a womb cancer.
When is hormonal therapy used for womb cancer?
Your cancer doctor may suggest hormonal therapy if you:
- have advanced womb cancer
- have womb cancer that has come back after treatment (recurrent cancer)
- cannot have surgery or radiotherapy because of other health issues.
The aim of treatment is to try to shrink the cancer and control symptoms.
If you are younger and who want to have children in the future, you may be offered hormone therapy instead of a hysterectomy. This is called fertility-sparing treatment. After you have had children, you would then have a hysterectomy.
Hormonal therapy for advanced or recurrent womb cancer
The main hormonal treatment for womb cancer that has spread or come back is progesterone. You usually have it as a tablet. The most common types of progesterone are:
- medroxyprogesterone acetate (Provera®)
- megestrol acetate (Megace®).
Other hormonal treatments are sometimes used, such as tamoxifen and letrozole.
Hormonal treatment for low risk early stage womb cancer
Fertility-sparing treatment
An operation to remove the womb and ovaries (hysterectomy) is usually the standard treatment for womb cancers. But it is sometimes possible to have fertility-sparing treatment instead if you want the chance to have children in future. It is only suitable if you have stage 1, grade 1 womb cancer.
The treatment usually involves taking daily progesterone tablets. Sometimes, progesterone is given directly into the womb through a hormone-releasing intrauterine device (sometimes called an IUD or coil).
This treatment is only done in a few specialist centres. You may have to travel further to have it. You will have regular checks during and after treatment. This is because with this type of treatment, there is a higher risk that the cancer may not respond to treatment or may come back. You will need a hysterectomy:
- if the cancer does not respond to hormone treatment
- after you have had children.
Your specialist doctor can explain the possible risks and benefits of fertility-sparing treatment.
Side effects of hormonal therapy for womb cancer
The most common side effects of progesterone are:
- increased appetite
- weight gain
- fluid build-up (for example, swollen ankles)
- feeling sick
- a small risk of developing a blood clot.
The side effects can be mild, and you are not likely to get all of them. They usually get better after 3 to 4 weeks. Tell your doctor or nurse if you are having side effects.
About our information
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References
Below is a sample of the sources used in our womb cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Concin et al. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. International Journal of Clinical Oncology. 2021. Available from www.pubmed.ncbi.nlm.nih.gov/33397713/
Royal College of Radiotherapy: Clinical Oncology. Radiotherapy dose fractionation, third edition. 2019. Available from www.rcr.ac.uk/publication/radiotherapy-dose-fractionation-third-edition
Sundar et al. BGCS uterine cancer guidelines: Recommendations for practice. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2017. Available from www.bgcs.org.uk/wp-content/uploads/2019/05/BGCSEndometrial-Guidelines-2017.pdf
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Nick Reed, Consultant Clinical Oncologist.
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