Endometrial Cancer

In Switzerland, around 900 women are newly diagnosed with endometrial cancer every year, and just over 200 women die as a result of the disease. Most women are over 70 years of age when the diagnosis is made, and it is often noticeable at an early stage by vaginal bleeding. Overall, endometrial cancer has a rather good prognosis. The therapy is usually not very aggressive, often removing the uterus alone together with the ovaries is sufficient. In some cases, however, more extensive surgery is required, sometimes additional radiation is required, and rarely chemotherapy. There are different types of endometrial cancer.

The much more common variant are less aggressive growths of the uterine lining as an expression of hormonal overstimulation (well to moderately differentiated endometroid carcinomas), which occurs e.g. through fatty tissue. In this respect, many women with endometrial cancer tend to be overweight and therefore also have other diseases such as diabetes mellitus and high blood pressure. If women are younger and develop endometrial cancer, it should be checked whether there is a hereditary colon cancer syndrome in the family (Lynch syndrome or HNPCC mutation). Much rarer are very aggressive tumors (poorly differentiated endometroid, serous or clear cell carcinomas, as well as Müllerian mixed tumors), which often already have settlements (metastases) in the lymph nodes when the diagnosis is made and must be treated more aggressively. Your prognosis is less favorable.


The goal of the operation is to remove the uterus and ovaries. It has recently become established that, similar to other tumor diseases, metastasis in lymph nodes occurs through the analysis of the sentinel lymph nodes during the operation. If there are no metastases in these, then other lymph nodes are very unlikely to be involved. This process is very gentle and rarely has lasting consequences. If the sentinel lymph nodes are affected, more extensive surgery on the pelvic and abdominal lymph nodes is necessary, which often leads to permanent lymphatic congestion in the legs. Being overweight is also unfavorable.
Surgery for endometrial cancer should almost always be performed by a laparoscopy; an abdominal incision is rarely necessary.

Radiation treatment

Wenn ein Endometriumkarzinom wiederkommt, dann meistens als Rezidiv in der Vagina. Dem kann vorgebeugt werden, sodass durch eine Kontaktbestrahlung der Vagina ab einem bestimmten Stadium diese Rezidive deutlich vermindert werden können. Diese Therapie hat kaum Nebenwirkungen, allerdings kann die Vagina im Verlauf trocken sein und verkleben, sodass bestrahlte Frauen ihre Vagina regelmässig mit Cremes und Dilatatoren pflegen sollten.

When endometrial cancer comes back, it usually occurs as a recurrence in the vagina. This can be prevented so that these recurrences can be significantly reduced by contact irradiation of the vagina from a certain stage onwards. This therapy has hardly any side effects, but the vagina can be dry and sticky over time, so that irradiated women should regularly care for their vagina with creams and dilators.
In the case of aggressive tumors that have already spread beyond the uterus, radiation from the outside should also be carried out (percutaneous radiotherapy). This has significantly more side effects, as the skin, the intestines and the urinary bladder are also partially irradiated.


Chemotherapy is increasingly rarely recommended for endometrial cancer, only for very aggressive tumors or if there are already metastases in lymph nodes or other organs. The preparations carboplatin and paclitaxel are mainly used.

Advanced disease

In the case of advanced disease, the therapy depends very much on the individual needs of the patient and the way in which the disease has spread. Special tests can be used to determine whether the tumor is growing in a hormone-dependent manner, for example. If this is the case, then an attempt can be made to stabilize the disease with hormone preparations (e.g. progestins). Otherwise, radiation therapy, chemotherapy and, in individual cases, complex operations are used, although specific tumor therapy is not always desired or absolutely necessary. It is important to support those affected with palliative care in such a situation.


We now know that genetics play a much bigger role in endometrial cancer than we thought. Hereditary endometrial cancer is more common than we thought, even if there are no obvious cancers in the family. That is why we are increasingly concentrating on looking for changes that indicate this. It has also been shown that the very old-fashioned classification of the different variants of endometrial cancer is not so reliable. Apparently less aggressive tumors suddenly develop metastases. Supposedly aggressive tumors are overestimated and treated too aggressively. This can soon be determined more precisely, as a molecular biological analysis enables a more precise allocation and can therefore be treated in a much more targeted manner. Unfortunately, this cannot yet be implemented in routine; clinical studies must first confirm these methods of classification and their reliability.