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Chemo (chemotherapy) is the use of drugs to treat cancer. These drugs are usually given into a vein (IV) or taken by mouth and can reach and destroy cancer cells anywhere in the body. This makes chemo a useful treatment for cancer that has spread outside the uterus.

When is chemo used for uterine sarcoma?

Not everyone with uterine sarcoma will need chemo, but there are a few situations in which chemo might be recommended:

• Instead of surgery, as the main treatment if surgery is not an option. It can be used alone or with radiation.
• After surgery (adjuvant therapy), to lower the chance of cancer coming back.
• To manage cancer spread, recurrence, and symptoms, for uterine sarcoma that has spread to other parts of the body or come back after surgery.

Chemo might not work for all types of uterine sarcoma. Some uterine sarcomas might respond better to certain drugs and drug combinations.

Which chemo drugs are used to treat uterine sarcoma?

The role of chemo, as well as which chemo drugs best treat uterine sarcomas, is not clear. Some of the drugs that might be used include:

• Doxorubicin (Adriamycin)
• Docetaxel
• Gemcitabine
• Ifosfamide
• Dacarbazine (DTIC)
• Cisplatin
• Vinorelbine
• Liposomal doxorubicin
• Epirubicin
• Temozolomide
• Trabectedin

Sometimes, more than one drug is used. For example, gemcitabine and docetaxel might be used together to treat leiomyosarcoma.

Possible side effects of chemo

Chemo drugs affect cells that grow fast. Cancer cells multiply quickly, but so do other healthy cells in the body, including the blood-forming cells, hair cells, and cells that make up the lining of your gut. When chemo damages these fast-growing healthy cells, it can lead to side effects.

These side effects vary depending on the type of chemo drugs, the dose, and the length of time they are given.

Your cancer care team will watch you closely for side effects. Don’t hesitate to ask questions.

Short-term side effects

Some common short-term side effects of chemo drugs include:

• Nausea and vomiting
• Loss of appetite
• Diarrhea or constipation
• Hair loss
• Mouth sores
• Fatigue

Chemo can damage your bone marrow, where new blood cells are made. This can lower your blood cell counts, leading to:

• Increased chance of infection from having too few white blood cells
• Easy bleeding or bruising from low platelets
• Fatigue or shortness of breath from low red blood cells

Controlling short-term side effects

Most short-term side effects go away after treatment is finished.

During treatment, there are ways to make these side effects less severe. For example, you can take medicines to help prevent and reduce nausea and vomiting or have a transfusion if your red blood cell or platelet count drops  too low. Tell your cancer care team about any side effects you have so they can help you control them.

Late effects

Late effects of chemo can take months or years to develop after treatment.

For example, some drugs can increase the risk of developing another type of cancer, such as leukemia, although this is rare. This small increase in risk should be weighed against the potential benefit of chemotherapy.

For more on the possible long-term effects of treatment, see After Treatment for Uterine Sarcoma.

Side effects of specific chemo drugs

Some chemo drugs have specific side effects.