Medical oncologist Vicky Makker (left) confers with a nurse in clinic. She is part of a team of doctors and nurses with world-class expertise in diagnosing and treating gynecologic cancers.
About 1,300 women with some form of gynecologic cancer come to Memorial Sloan-Kettering Cancer Center each year, including about 190 new patients with endometrial cancer.
Memorial Sloan-Kettering has a multidisciplinary team approach to providing screening, counseling, and treatment for uterine cancers. Although each of our patients has a primary doctor who coordinates her care, all patients — regardless of the type of treatment they receive — are cared for by a team of experts.
The team includes:
- surgical gynecologic oncologists
- medical oncologists
- radiation oncologists
- general gynecologists
- radiologists
- pathologists
- nurses
- social workers
- a psychologist
This team of doctors and other healthcare professionals works to provide a full range of cancer care.
We believe that treating the whole person, not just the disease, is the best approach for patients and family members. At Memorial Sloan-Kettering, we offer a broad range of emotional support programs designed to help patients and family members cope with the range of issues related to life during and after cancer treatment.
Our Nursing Staff
At Memorial Sloan-Kettering, we have a dedicated team of nurses who care for patients with endometrial cancer during both outpatient visits and inpatient hospital stays. Each nurse — who has knowledge and experience treating patients with endometrial cancer — works in collaboration with one primary physician to oversee every patient's care. This allows our nurses to assess a patient's needs, triage symptoms, and, if necessary, make referrals to other departments within Memorial Sloan-Kettering, such as integrative medicine, nutrition, and social work. Nurses also help patients understand the details of the treatment plan and what to expect throughout the course of treatment. They are actively involved with teaching both patients and their families, and provide educational materials as needed.
As the liaison between patients and physicians, nurses play an important role in the team approach to care offered at the Center.
Individualized Treatment
The primary form of treatment for endometrial cancer is surgery, followed by a combination of radiation therapy, chemotherapy, and/or hormone therapy. Our team approach to treatment gives each patient the benefit of unequaled expertise in treating every aspect of endometrial cancer.
Videos
Experts from Memorial Sloan-Kettering discuss the latest approaches to early detection, screening, and treatment for women with endometrial cancer.
We believe our most significant impact occurs when we can apply our expertise early in the cancer treatment program. Women who choose to have surgery at Memorial Sloan-Kettering benefit from the excellence and experience of our surgical staff. For patients whose cancers are more advanced, our medical oncologists are investigating chemotherapy regimens that include novel drugs and drug combinations available only through clinical trials at Memorial Sloan-Kettering. We have clinical experience in combination chemotherapy and radiation therapy (called combined modality therapy), including high-dose brachytherapy — a type of internal radiation in which radioactive material is placed directly into or near a tumor. Brachytherapy may be used in conjunction with intensity-modulated radiation therapy (IMRT), one of the most advanced and precise radiation treatment techniques. IMRT uses radiation beams of varying intensities that are created to match specific tumor shapes and sizes, which helps to reduce the dosage of radiation to healthy tissues and possibly the side effects of treatment.
We also have experts devoted to the detection and management of rarer uterine cancers, such as uterine sarcomas. In addition, we are committed to clinical research that will improve both survival and quality of life for women with endometrial and other uterine cancers.
Our Surgical Expertise
Because endometrial cancer develops in the lining of the uterus, most women need to have the uterus removed through a procedure called a hysterectomy. Memorial Sloan-Kettering surgeons have been leaders in the adoption of less-invasive techniques, such as laparoscopic-assisted surgery for hysterectomy. In this procedure, a thin, lighted tube with a video camera at its tip (called a laparoscope) is inserted through a tiny incision in the abdominal wall, and the image is projected onto a large viewing screen. Guided by this highly magnified image, the surgeon can operate through tiny surgical “ports” using specially designed surgical instruments to remove the uterus through the vagina. This minimally invasive surgical approach results in fewer complications, shorter hospital stays, and lower costs compared with open abdominal surgery.
Sentinel Lymph Node Biopsy
Our surgeons are evaluating the use of sentinel lymph node biopsy to determine whether endometrial cancer has spread to surrounding lymph nodes — and whether removal of all the lymph nodes is necessary. Sentinel node mapping may help avoid the unnecessary removal of all the lymph nodes in some women, leaving these nodes in place to continue their important role in draining fluids and fighting infection. This may also lower the risk of lymphedema, or swelling, in the groin.
Use of Robotics for Surgery
Memorial Sloan-Kettering was the first cancer hospital to acquire a state-of-the-art robotic da Vinci® Surgical System for cancer surgery. This technology offers the surgeon a number of significant advantages, among them an enhanced view of the operating field and a greater range of motion. Our gynecologic surgeons may use the robot to perform minimally invasive procedures for women with uterine cancers.
Surgery for Recurrent Uterine Cancer
For women needing additional surgery for advanced and recurrent uterine cancer, we also have a multispecialty group of surgeons known as the Pelvic Reconstruction Group that is dedicated to optimizing the surgical removal of cancer while maintaining function. Visit the Treatment section of this cancer information overview for more information about these options.
Investigational Approaches
At Memorial Sloan-Kettering, we are currently engaged in a program of active research in endometrial cancer. This includes investigations into the epidemiology and molecular genetics of endometrial cancer, the use of new imaging techniques, and novel ways to identify and combat the spread of cancer, or metastases.
Through our own research programs and those of the Gynecologic Oncology Group (a multi-institutional clinical research group supported by the National Cancer Institute), we are committed to clinical research that will improve both the survival and quality of life for women with gynecologic cancers. We also are actively engaged in the development of new drugs for treatment of endometrial cancer when other treatments have not been effective.
Tamoxifen
One known risk factor for endometrial cancer is taking tamoxifen. Memorial Sloan-Kettering investigators have completed studies to evaluate screening methods for endometrial cancer in women receiving tamoxifen as adjuvant therapy for breast cancer. (Adjuvant therapy refers to secondary treatment given after the primary treatment to increase the chances of a cure.) The findings indicated that women who take tamoxifen should receive yearly gynecologic examinations and immediately report any signs of nonmenstrual vaginal bleeding to their doctor. They also found that a special type of ultrasound called sonohysterography was more sensitive at detecting endometrial cancers in women treated with tamoxifen than was the traditional method used for diagnosis, endometrial biopsy. The use of sonohysterography as a screening method may spare countless women from unnecessary biopsies and other invasive procedures.
Uterine Sarcoma Program
Although the majority of endometrial cancers are carcinomas, some women develop a rare kind of cancer called uterine sarcoma. Unlike carcinomas, which begin in the lining of the uterus, sarcomas originate in the muscle or other connective tissues of the uterus. Because uterine sarcomas are so rare, expert pathological review is critical; and because the behavior of these tumors can be highly variable, it is important for women diagnosed with these cancers to receive treatment at a center that has experience caring for such patients. Memorial Sloan-Kettering has experts who diagnose and treat uterine sarcomas, and we also have an active research program aimed at developing more-effective therapies for these diseases.
Leiomyosarcoma
To treat leiomyosarcoma, a type of sarcoma that occurs within the uterine muscle wall, we have developed a novel chemotherapy regimen that has demonstrated excellent efficacy in women whose sarcoma has metastasized and cannot be removed surgically. The success of this regimen in leiomyosarcomas has led to additional research efforts, including two larger studies of our treatment regimen by the Gynecologic Oncology Group and the acceptance of this treatment regimen as a standard treatment for advanced sarcoma by the National Comprehensive Cancer Network. We also led the clinical trial that showed this regimen to be effective in patients with other types of soft tissue sarcoma. We are actively investigating new treatments for uterine sarcomas.
