Uterine Sarcoma: Chemotherapy 

What is chemotherapy?

Chemotherapy uses strong medicines to kill cancer cells. The medicines are made to attack and kill cells that grow quickly. Some normal cells also grow quickly. Because of this, chemotherapy can also harm those cells. This can cause side effects.

When might chemotherapy be used to treat uterine sarcoma?

Your healthcare provider may advise chemotherapy in any of these cases: 

• You've had surgery to remove uterine sarcoma (chemotherapy can help kill any cancer cells left in your body)

• To shrink the cancer before surgery, so it's easier to remove

• If you can't have surgery

• The cancer doesn’t appear to have spread outside the uterus, but you have risk factors that indicate a high likelihood that it will spread

• You’re being treated with a combination of radiation and chemotherapy

• You’re being treated with a combination of hormone therapy and chemotherapy

• The cancer has spread and can’t be controlled with other treatments

• The cancer has returned after you have been treated

How is chemotherapy given for uterine sarcoma?

Chemotherapy is most often given into your blood through an IV (intravenous) line that's put into a vein. It may also be taken by mouth as a pill, or as an injection (shot). Treatment is most often given in an outpatient hospital infusion center. You can usually go home the same day. Or it may be done at your healthcare provider’s office or a chemotherapy clinic. In some cases, you may stay in the hospital during treatment.

If you need to have an IV for each cycle of chemotherapy, it can be helpful to have a central venous (vein) access device. A port is one example of a central venous access device. A catheter is a thin, flexible tube that's put into a vein. It stays in place between cycles. This is done so that you don't need a new IV each time you get treatment. One end of the catheter is placed into a big vein near your heart. The other end is just under the skin or comes out through your skin. The medicine can then be connected to it when you have treatment. Your healthcare team will talk with you about the risks and benefits of a venous access device.

You get chemotherapy in cycles over a period of time. That means you get the medicine for a set amount of time and then you have a rest period. Each period of treatment and rest is one cycle. You will get several cycles. Having treatment in cycles helps by: 

• Killing more cancer cells. The medicine can kill more cancer cells over time because cells aren't all dividing at the same time. Cycles allow the medicine to fight more cells.

• Giving your body a rest.  Treatment is hard on other cells in your body that divide quickly. This includes cells in the lining of the mouth and stomach. Damaging these cells causes side effects, like mouth sores and nausea. It also causes drops in your blood counts. Between cycles, your body can get a rest and healthy cells can recover.

• Giving your mind a rest. Having chemotherapy can be stressful. Taking breaks between cycles gives you an emotional break between treatments.

What types of medicines are used to treat uterine sarcoma?

In most cases, two or more medicines are used together. This is called combination therapy. The chemotherapy medicines most often used for uterine sarcoma include: 

• Doxorubicin hydrochloride

• Liposomal doxorubicin

• Ifosfamide 

• Gemcitabine

• Paclitaxel

• Docetaxel

• Dacarbazine

• Epirubicin

• Vinorelbine

Which medicines you get and how often you get them depend on many factors. If you get chemotherapy, you get it along with another type of cancer treatment. 

What are common side effects of chemotherapy?

Side effects are common with chemotherapy, but it's important to know that they can often be controlled and even prevented. Most side effects go away after treatment ends. Side effects depend on the type and amount of medicines you’re taking. They vary from person to person. 

Some common side effects include: 

• Nausea and vomiting

• Mouth sores

• Constipation or diarrhea

• Hair loss

• Hearing loss

• Infections from low white blood cell levels

• Easy bruising or bleeding from low blood platelet levels

• Tiredness from low red blood cell levels

• Loss of appetite

• Dizziness

• Skin problems, such as dryness, rash, or blistering or darkening skin

• Tingling, numbness, or swelling in hands or feet

• Kidney damage

Most side effects will go away or get better between treatments and after treatment ends, but some may be long lasting or even permanent. There may be things you can do to help control some side effects. Tell your healthcare providers about any side effects you have. They can help you cope with the side effects and try to keep them from getting worse. 

Working with your healthcare provider

It's important to know which medicines you're taking. Write the names of your medicines down. Ask your healthcare team how they work and what side effects they might have.

You will have blood tests done regularly while you're getting chemotherapy to make sure you aren't having harmful reactions. Make sure you ask which problems mean you should call your healthcare provider right away. For instance, chemotherapy can make you more likely to get infections. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

Your healthcare provider may advise you to call if you have any of these symptoms: 

• Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

• Sore throat

• Shaking chills

• Redness, swelling, and warmth at the site of an injury or IV catheter

• New cough or shortness of breath

• Nasal congestion

• Burning during urination

• Bleeding or bruising

• Uncontrolled diarrhea or vomiting

• Uncontrolled pain

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.