Uterine cancer facts medical author: Charles Patrick Davis, MD, PhD
Uterine cancer facts
- The uterus is a hollow organ in females located in the pelvis, commonly called the womb. The uterus functions to support fetal development until birth. The uterus is shaped like an upside-down pear; the top is the fundus, the middle is the corpus, and bottom is the cervix; the inner layer of the uterus is the endometrium, and the outer layer is muscle (myometrium).
- Uterine cancer is the abnormal (malignant) growth of any cells that comprise uterine tissue. The buildup of cancer cells may form a mass (malignant tumor). Non-cancer cells that form a mass are termed benign tumors.
- Although the exact causes of uterine cancers are not known, risk factors include women with endometrial overgrowth (hyperplasia), obesity, women who have never had children, menses beginning before age 12, menopause after age 55, estrogen therapy, taking tamoxifen, radiation to the pelvis, family history of uterine cancer, and Lynch syndrome (most commonly seen as a form of inherited colorectal cancer).
- Common signs and symptoms of uterine cancer are
- abnormal vaginal bleeding (most common symptom),
- vaginal discharge,
- pain with urination and/or sex, and
- pelvic pains.
- Uterine cancer is diagnosed usually with a pelvic exam, Pap test, ultrasound, and biopsy. Occasionally, CT or MRI may be done to help confirm the diagnosis.
- Uterine cancer stages (0 to IV) are determined by biopsy, chest X-ray, and/or CT or MRI scans.
- Treatment options may include one or more of the following: surgery, radiation, hormone therapy, and chemotherapy. Treatment depends on the uterine cancer stage, your age, and general health with uterine cancer stage IV as the most extensive and usually caused by the most aggressive type of cancer cells. You and your doctors can decide what treatment plan is best for you.
- Surgical therapy usually involves removal of the uterus, ovaries, fallopian tubes, adjacent lymph nodes, and part of the vagina.
- Radiation therapy may be by external radiation or by internal radiation (brachytherapy).
- Chemotherapy usually requires IV administration of drugs designed to kill cancer cells. Most chemotherapy treatments need to be done in repeated cycles of drug administration followed by a rest period.
- Hormone therapy (usually progesterone) is used on uterine cancer cells that require another hormone (estrogen) for growth.
- Second opinions can be obtained by referrals made by your doctor to others in the local medical society or to other doctors elsewhere.
- Follow-up care is important. Complications can be treated early, and possible cancer recurrence can be diagnosed early.
- Support groups are varied and many are local. The National Cancer Institute (NCI) can help locate support groups and possible clinical trials that test the newest treatments.
Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.
The endometrium is the lining of the uterus, a hollow, muscular organ in a woman's pelvis. The uterus is where a fetus grows. In most nonpregnant women, the uterus is about 3 inches long. The lower, narrow end of the uterus is the cervix, which leads to the vagina.
Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called sarcoma of the uterus.
Obesity, high blood pressure, and diabetes mellitus may increase the risk of endometrial cancer.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for endometrial cancer include the following:
- Being obese.
- Having high blood pressure.
- Having diabetes mellitus.
Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can increase the risk of endometrial cancer.
Endometrial cancer may develop in breast cancer patients who have been treated with tamoxifen. A patient taking this drug should have a pelvic exam every year and report any vaginal bleeding (other than menstrual bleeding) as soon as possible. Women taking estrogen (a hormone that can affect the growth of some cancers) alone have an increased risk of endometrial cancer. Taking estrogen combined with progesterone (another hormone) does not increase a woman's risk of this cancer.
Signs and symptoms of endometrial cancer include unusual vaginal discharge or pain in the pelvis.
These and other signs and symptoms may be caused by endometrial cancer or by other conditions. Check with your doctor if you have any of the following:
- Bleeding or discharge not related to menstruation (periods).
- Difficult or painful urination.
- Pain during sexual intercourse.
- Pain in the pelvic area.
Tests that examine the endometrium are used to detect (find) and diagnose endometrial cancer.
Because endometrial cancer begins inside the uterus, it does not usually show up in the results of a Pap test. For this reason, a sample of endometrial tissue must be removed and checked under a microscope to look for cancer cells. One of the following procedures may be used:
- Endometrial biopsy: The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells.
- Dilatation and curettage: A procedure to remove samples of tissue from the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. The tissue samples are checked under a microscope for signs of disease. This procedure is also called a D&C.
Other tests and procedures used to diagnose endometrial cancer include the following:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
- Transvaginal ultrasound exam: A procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An ultrasound transducer (probe) is inserted into the vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumors by looking at the sonogram.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.