Uterine cancer at a glance
- Uterine cancer is uncontrolled malignant cell growth in or on a woman’s uterus.
- The most common type of uterine cancer is endometrial cancer, which accounts for over 90 percent of diagnoses.
- Symptoms of uterine cancer include abnormal vaginal bleeding, chronic pelvic pain and unintentional weight loss.
- Treatment for uterine cancer usually involves surgery and may also include chemotherapy, radiation and hormone therapy.
What is uterine cancer?
Uterine cancer is the uncontrolled growth of cells originating from a woman’s uterus, the organ in which a fetus develops during pregnancy. According to the American Cancer Society, there are just over 61,000 new cases of uterine cancer diagnosed each year in the United States. Of these cases, over 92 percent are endometrial cancer, or cancer that originates from the endometrium, which is the inner lining of the uterus.
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Types of uterine cancer
Uterine cancers are broadly divided into two distinct types.
Endometrial cancer. The endometrium is the innermost layer of the uterus and it plays an important role during a woman’s reproductive years in maintaining an environment that can support a fertilized egg and pregnancy. If a woman does not get pregnant during ovulation, a layer of the endometrium is shed in the process of menstruation.
Most endometrial cancers occur after menopause, when a woman is no longer experiencing menstruation. It is most frequently diagnosed in women between the ages of 60 and 70 and is rarely seen in women under the age of 45.
Uterine sarcomas account for a small minority of uterine cancer diagnoses. This type of cancer is the uncontrolled growth of cells originating from the muscles and connective tissues of the uterus.
Uterine cancers are typically classified separately from cervical cancer, although the cervix is technically the lowermost portion of the uterus.
Uterine cancer symptoms
Symptoms of uterine cancer may include the following:
- Abnormal vaginal bleeding (bleeding or spotting after menopause or between periods in premenopausal women)
- Abnormal vaginal discharge, including nonbloody fluid
- Unintentional weight loss
- Pelvic pressure
- Chronic pelvic pain.
These symptoms do not necessarily indicate a woman has uterine cancer. They can often be signs of a less serious, noncancerous condition. However, a woman experiencing any of the symptoms listed should promptly discuss them with her doctor.
Detection and diagnosis of uterine cancer
A diagnosis of endometrial cancer is most commonly made by a gynecologist. The first step in checking for the presence of endometrial cancer may be an ultrasound exam. The doctor might use other imaging techniques such as hysteroscopy, in which a small lighted tube is inserted through the vagina and into the uterus. If cancer is suspected during the exam, a small tissue sample may be collected for biopsy.
Endometrial biopsy, grading and staging
Once a tissue sample is collected it is sent to a laboratory to be examined under a microscope. If cancerous cells are present in the endometrial tissue, the cancer will then be assigned a grade. Lower grade tumors are usually less aggressive and more treatable than higher grade tumors. Endometrial cancers are classified into three grades.
- Grade 1 – most of the cells in the tumor(s) resemble normal cells that would be found in a healthy endometrium.
- Grade 2 – more of the tumor cells appear abnormal and disorganized and have a greater chance of spreading.
- Grade 3 – the tumor cells appear abnormal and highly disorganized with a high chance of spreading aggressively.
In addition to grading, endometrial cancer is also described in stages. Stages indicate how far the cancer has spread on and beyond the uterus. The stages of endometrial cancer are:
- Stage 1 – cancer is only in the uterus
- Stage 2 – cancer is in the uterus and has spread to the cervix
- Stage 3 – cancer has spread beyond the uterus but not beyond the pelvic region
- Stage 4 – cancer has spread beyond the uterus and pelvic region into other organs and/or lymph nodes throughout the body.
Detection of uterine sarcoma
Uterine sarcomas are sometimes identified during surgery to remove what appear to be benign uterine fibroids. But it is more commonly diagnosed after it has started to cause symptoms.
Sometimes uterine sarcomas are more difficult to detect than endometrial cancer because they originate within the muscle and connective tissues of the uterus. A doctor may use a series of advanced imaging techniques to effectively view and biopsy the uterine tissue if uterine sarcoma is suspected.
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Causes and risk factors
The exact causes of uterine cancer are unknown, but certain risk factors have been identified. Many cases are linked with hormonal imbalances relating to estrogen and progesterone, but precisely how the imbalance leads to cancer is still a topic of active research.
The following are known risk factors for the development of uterine cancer:
- Age – once a woman goes through menopause she is at increased risk for developing uterine cancer
- Obesity – women with a body mass index (BMI) over 30 are at higher risk
- Using estrogen hormone therapy without progesterone during or after menopause
- Current or past use of tamoxifen, a medication used to treat breast cancer
- Family history of uterine, ovarian or colon cancers
- History of infertility or difficulty getting pregnant
- Infrequent or irregular periods prior to menopause.
Uterine cancer treatment
The most common treatment method for uterine cancer is surgery. During surgery the doctor will locate and remove the tumors on the uterus and surrounding areas. Often this involves a hysterectomy (the total surgical removal of the uterus). Surgery may also play an important role in allowing the doctor to see how far the cancer has spread, which is an aspect of staging.
Depending on the grade and stage of the cancer, the doctor may utilize chemotherapy, radiation and/or hormone therapy in conjunction with surgery. Certain cancers may also qualify for experimental treatment methods in clinical trials.