Advanced Treatment Options for Endometrial Cancer

Endometrial cancer treatment

The treatment of endometrial cancer is made depending on cancer stage, the state of health and the wishes of a patient. A step-by-step account is as follows:

Primary Treatment Options of Endometrial Cancer

Surgery

• Hysterectomy- removal of uterus.
• Bilateral salpingo-oophorectomy (BSO) Gives your fallopian tubes and your ovaries.
• Lymph node dissection- nearby lymph nodes may be removed to see whether there is a spread.
• Laparoscopic or robotic surgery is a low invasive procedure commonly preferred when available.

Radiation Therapy

• It may be administered by post-surgery levelling risk of recurrence or it may be used as primary treatment when surgery cannot be used.
• External beam radiation therapy-EBRT
• Vaginal brachytherapy (internal radiation)

Hormone Therapy

• Is used primarily on advanced or recurrent endometrial cancer.
• Targets estrogen and progesterone sensitive tumors.

Drugs:

• Progestins (medroxyprogesterone acetate, megestrol acetate)
• Aromatase inhibitors
• Tamoxifen

Chemotherapy

• As in advanced, recurring, aggressive forms.

Common drugs:

• Carboplatin + Paclitaxel (and standard first-line combination)
• Doxorubicin, Cisplatin (in specified cases)

Targeted Therapy and Immunotherapy

• Disease that is advanced or recurrent that does not respond to standard treatment.
• Pembrolizumab (Keytruda) - an immune checkpoint inhibitor, in particular, in MSI-H or dMMR tumors.
• Lenvatinib+Pembrolizumab - advanced disease not MSI-H or dMMR.
• Rastuzumab - in serous endometrial carcinoma with positive HER2.

Endometrial cancer symptoms and diagnosis

Here is how endometrial cancer can be diagnosed in relation to its symptoms:

Signs and Symptoms of Endometrial cancer

The most frequently occurring early symptom is aberrant uterine bleeding This is also manifested at an early stage in many cases thus making it detectable earlier than in the other gynaecological malignancies.

Common Symptoms:

• Vaginal abnormal bleeding
• Bleeding after the menopause (most common symptom)
• Bleeding between periods
• Diffuse and care or lengthy menstrual cycle
• Vaginal discharge (watery, blood-poisoned or foul-smelling)
• Pressure or pain in western pelvis
• Intercourse pain
• The unexplained weight loss (advanced stage)
• Problems urinating or bowel disturbances (in case the cancer transmits to the region close organs)

Diagnosis of Endometrial cancer:

Medical History/ Physical Examination

• Doctor takes history of menstruation, risk factors (obesity, PCOS, hormone therapy, family history).
• Bimanual exam to examine uterus, ovaries and vagina.

Diagnostic Tests

TVUS

• Endometrial thickness is measured.
• Thickened lining indicates that there might be cancer but it cannot confirm that.

Endometrial biopsy

• A slender tube is used to send into the womb and extract a tissue sample.
• In-office, fast and very precise.

Dilation and Curettage Hysteroscopy (D& C)

• Vision of the uterus cavity directly by scope.
• Scraping of the tissue to perform biopsy in case of inconclusive results of the initial biopsy.

Imaging - Staging (confirmed)

• CT scan / MRI -to detect local extension or metastasis.
• PET scan - used in advanced disease.

Pathology Tests

• Histopathology- established type and grading of cancer.
• Molecular genetic/genetic testing (distant disease)
• MSI-H/dMMR testing followed to help determine whether immunotherapy will be effective.
• Immunohistochemical expression of HER2 in aggressive forms (e.g. serous carcinoma).

Best hospitals for endometrial cancer treatment

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Advanced endometrial cancer therapies in India

Below you can find a closer look at high-stage endometrial cancer treatment options ( III, IV or advanced recurrence).

Surgery (in case of possibility)

• Cytoreductive (debulking) surgery may be attempted by the surgeon even at advanced stages in an effort to remove as much cancer as possible.
• With the subsequent use of chemotherapy/radiation to eradicate remaining disease.

Chemotherapy

• First-line therapy of advanced/recurrent cancer.

Common regimens:

• Carboplatin/Paclitaxel (the most commonly accepted and proven).
• In selected cases: Cisplatin or Doxorubicin.
• Pairing with targeted or immunotherapy is part of novice protocols.

Radiation Therapy

• Used in local control, pain relief, in the event where surgery is not possible.
• EBRT + brachytherapy (sometimes in some locations).
• Is able to be combined with chemotherapy (chemoradiation) to greater effect.

Hormone Therapy

• Works optimally in low-grade tumors that are hormone receptor-positive.

Options:

• Medroxyprogesterone acetate, megestrol acetate (progestins)
• Aromatase inhibitors (letrozole, anastrozole, exemestane)
• Tamoxifen
• Perhaps these may be used in combination with focused treatment in selected protocols.
• Alternatively, it is often taken into account in the case of slow-growing disease, or when the patient was unable to endure chemotherapy.

Targeted Therapy

• Trastuzumab as HER2-positive serous endometrial carcinoma (combined with carboplatin and paclitaxel).
• TOR inhibitors (everolimus, temsirolimus) - in individual ascents of positive hormone receptors.
• Bevacizumab (anti-VEGF) anti- VEGF anti- VEGF under investigation sometimes used in combination therapy.

Immunotherapy

• Checkpoint inhibitors have been a breakthrough in advanced endometrial cancer.

Pembrolizumab (Keytruda)

• Appropriate in MSI-H (microsatellite instability -high ) or dMMR ( DNA mismatch repair-deficient ) endometrial cancers.

Dostarlimab (Jemperli)

• Another drug able to block PD-1, approval given to recurrent or advanced dMMR.

Pembrolizumab + Lenvatinib (Topol, oral targeted agent)

• In non-MSI-H/non-dMMR advanced disease in situations where standard therapy has failed.
• One of the most powerful combinations which is being used.

Clinical Trial & Emerging Therapies

• New regimens of immunotherapy + targeted therapy + chemotherapy are investigational.
• Personalized medicine (on the basis of tumor genomics) is emerging.
• CAR-T cell treatment and cancer immunization are still under investigation.

Factors Affecting Endometrial cancer surgery cost in India

The key factors that influence endometrial (uterine) cancer surgery costs in India are:

• Type & Complexity of Surgery
• Hospital Type & Location
• Surgeon’s Expertise
• Pre- and Post-Operative Expenses
• Additional Treatments
• Geographic & Institutional Variation

Top oncologists for endometrial cancer

• Dr. Rupinder Sekhon
• Dr. Sabhyata Gupta
• Dr. Rama Joshi
• Dr. Charu Garg

Factors Affecting Affordable endometrial cancer treatment in India

Here are the key factors influencing the affordability of endometrial cancer treatment in India:

• Stage of Disease & Treatment Complexity
• Availability and Cost of Medications and Technology
• Infrastructure & Public vs. Private Facilities
• Access to Affordable Medications
• Geographic & Facility-Level Variations

Endometrial cancer treatment in India by GetWellGo

GetWellGo is a medical tourism portal that facilitates the relationship between overseas patients and top hospitals of India and healthcare providers. They prioritize making quality cancer care to be more widely available--including endometrial cancer--by using customized guidance, upfront pricing, and easy coordination.

Why Choose GetWellGo for Endometrial Cancer Treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for Endometrial Cancer treatment.
• Expert gynae-oncologist with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food