July 27, 2022

New research and forward-looking physicians are changing the future for those diagnosed with the most common female reproductive cancer.

Uterine cancer is the most common female reproductive cancer, with nearly 66,000 women — mainly postmenopausal women — receiving a uterine cancer diagnosis each year. Roughly 90% of these diagnoses involve cancer of the uterine lining, or endometrium.

When Catherine Watson, M.D., a gynecologic oncologist at Vanderbilt Health, was in medical school, treatment for endometrial cancer was largely one-size-fits all: surgery, possible radiation and perhaps some chemotherapy. But change was coming, in the form of what’s now commonly known as personalized medicine.

How personalized medicine improves endometrial cancer treatment

In a personalized medicine approach, the patient’s medical team seeks to better understand his or her specific cancer by analyzing the the tumor’s genetic makeup. In doing so, the team is better able to identify the best treatment for that particular patient.

“Personalized medicine is a hot topic in every field, especially in oncology right now, but I think endometrial cancer really demonstrates the potential benefit of it,” Watson said. “It’s still early, but I think in the next decade we’ll see huge changes in how we’re treating this disease.”

Testing and classifying tumors

“For the last few decades, endometrial cancer was simply classified as high or low risk,” Watson said. “We used to have limited tools to treat endometrial cancers, but now that we understand more about them on a molecular level, we can start to treat them more uniquely with drugs that target the unique genomic signatures of the tumor.”

Endometrial tumors, or carcinomas, are now grouped into four distinct molecular subgroups. Understanding the characteristics of each is helping oncologists like Watson recommend more specific treatments.

An example of this personalized approach is immunotherapy in the form of checkpoint inhibitors, which provide a huge advantage to patients with advanced or recurrent disease. Immunotherapy works by blocking the mechanisms that cancer uses to escape detection by your immune system.

Advancements in surgical treatment for endometrial cancer

“It’s an exciting time in the field of gynecologic oncology, and I hope to see significant advancements in the upcoming years for our patients with endometrial cancer.”

It’s not just progress in personalized medicine that’s helping Watson and other gynecologic oncologists feel optimistic about the near future of endometrial cancer care. There have also been several advancements in surgery that are bringing big changes to endometrial cancer treatment.

The first change relates to surgical evaluation of the lymph nodes. For years, sentinel lymph node biopsy — a surgical procedure that helps determine whether a cancer has spread beyond a tumor and into the body’s lymphatic system — has been used for evaluating breast cancer and melanoma. Research now shows that sentinel lymph node biopsy can also be used for endometrial cancer, which potentially prevents complications of more extensive lymph node dissection.

Together with gene sequencing, she expects surgical developments to dramatically improve prognoses for her patients. “It’s an exciting time in the field of gynecologic oncology, and I hope to see significant advancements in the upcoming years for our patients with endometrial cancer.”

Vanderbilt Gynecologic Oncology provides expert care for women with cancers affecting the female reproductive system. These experts offer sophisticated, compassionate care with the latest treatments, for even the most complicated diagnoses. The Vanderbilt Gynecologic Oncology care team can be reached at 615-936-8422.

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