Uterine Cancer

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Uterine cancer, or cancer of the uterus (womb), also may be called endometrial cancer. It is the:

  • Fourth most common cancer in women
  • Most common cancer of women’s reproductive organs

Each year, more than 40,000 women in the United States are diagnosed with uterine cancer. The average age for diagnosis of uterine cancer is 60. However, the number of younger women with uterine cancer is going up. Of uterine cancers, about:

  • 25 percent are found before women go through menopause
  • 5 percent are found before women are 40 years old

Early diagnosis is key. Most uterine cancers develop over a period of years. They may start as less serious problems such as endometrial hyperplasia, which is an overgrowth of cells in the lining of the uterus.

Fortunately, many uterine cancers are found early because of warning signs such as abnormal or postmenopausal bleeding. There are four stages of uterine cancer, but uterine cancer is found in the earliest stages, it often can be treated successfully.

At Banner MD Anderson Cancer Center, uterine cancer is treated with a multidisciplinary approach in which a team of experts including gynecologic oncologists and radiation oncologists work together to develop an individual treatment plan based on each patient’s unique needs. Clinical nurse navigators work closely with patients, guiding them through their journey and serving as a single point of contact throughout their care.

Learn More About Uterine Cancer

Risk factors for uterine cancer include:

  • Weight: Obesity is a strong risk factor for endometrial cancer.
  • Genetics: Women with a family history of colorectal and/or endometrial cancer may have Lynch Syndrome, or Hereditary Non-Polyposis Colorectal Syndrome, which significantly increases the risk of endometrial cancer. Inherited genes associated with Lynch Syndrome account for five percent of endometrial cancer cases.
  • Tamoxifen: Women who take tamoxifen are at an increased risk.
  • Infertility: Women who have a history of infertility or polycystic Ovarian Syndrome are at increased risk.
  • Diabetes: Women with diabetes are at higher risk.

Reducing Your Risk

Although most cases cannot be prevented, there are certain things a woman can do to lower her risks of developing endometrial cancer:

  • Maintain a healthy weight
  • Talk to a physician about ways to regulate irregular menstrual periods
  • Participating in prevention or early detection research studies

See a physician immediately if you experience any post-menopausal or irregular bleeding.

Signs Symptoms of Uterine Cancer

Uterine cancer symptoms vary from woman to woman. If you have gone through menopause, see your doctor if you have any vaginal bleeding, spotting or unusual discharge.

If you have not gone through menopause, see your doctor if you have any of the following symptoms for more than two weeks:

  • Unusual bleeding, such as between periods or heavier flow
  • Abnormal vaginal discharge
  • Pelvic pain or pressure
  • Weight loss

These symptoms do not always mean you have uterine cancer. However, it is important to discuss any symptoms with your doctor, since they may signal other health problems.

Uterine cancer (endometrial cancer) screening is only recommended for women at increased risk. That’s because they have a higher chance of getting the disease.

Being at increased risk doesn’t mean you’ll definitely get endometrial cancer, but you may need to start regular uterine cancer screening exams. So if you do get cancer, your doctor can find it at its earliest stage. When found early, the chances for successfully treating the disease are greatest.

Along with regular exams, practice awareness. This means you should be familiar with your body. That way you’ll notice changes, like irregular bleeding or discharge. Then, report them to your doctor without delay.

You’re at increased risk if you’ve been diagnosed with or have a family history of Lynch syndrome (hereditary non-polyposis colorectal cancer). If so, you should follow the screening schedule below.

  • Transvaginal ultrasound every year
  • Endometrial biopsy every year

Check with your insurance provider before scheduling an exam. Not all insurance providers cover the cost of these exams.

Surgery

The primary surgery for uterine cancer is a total hysterectomy with bilateral salpingo-oophorectomy. The uterus is removed along with both ovaries and fallopian tubes and sometimes the pelvic and para-aortic lymph nodes. Traditionally, a hysterectomy is done through an up and down incision in the abdomen. Minimally invasive techniques such as laparoscopy and robotic surgery have recently become options for this surgery.

Some uterine cancer patients may undergo a lymphadenectomy, or lymph node dissection. Lymph nodes are removed from the pelvic area and examined for the presence of cancerous cells, helping doctors determine the exact stage and grade of the cancer.

Radiation Therapy

Radiation therapy may be used to treat uterine cancer after a hysterectomy or in rare situations as the primary treatment when surgery is not an option. Depending on the stage and grade of the cancer, radiation therapy may also be used at different points of treatment. There are two types of radiation therapy and in some uterine cancer cases, both types are given.

External beam radiation involves a series of radioactive beams precisely aimed at the tumor from outside the body. Intensity-modulated radiation therapy and proton therapy are examples of external beam radiation. Patients generally undergo daily outpatient treatments five days a week for four to six weeks, depending on the treatment plan.

Brachytherapy involves tiny radioactive seeds that are inserted through the vagina into the uterus wherever cancer cells are located. The seeds remain in place for two to three days and then removed. Depending on your cancer, several treatments may be needed. Because brachytherapy delivers radiation to a localized area, there is little effect on nearby structures such as the bladder or rectum.

Chemotherapy

Chemotherapy may be used as a cancer treatment after surgery for some uterine cancers. Chemotherapy uses drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Chemotherapy can be given by mouth or injected into a vein or muscle. In most cases, it is given to a patient through a vein during an outpatient visit using systemic chemotherapy. The drugs enter the bloodstream and can reach cancer cells throughout the body. Chemotherapy is often used if the uterine cancer recurs or has spread.

Hormone Therapy

The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have receptors where hormones can attach, drugs can be used to reduce the production of hormones or block them from working. Uterine cancers often grow in the presence of estrogen. This is why obesity is a risk factor for uterine cancer. Fat turns cholesterol into an estrogen, thus the more fat in the body the more estrogen that can cause uterine cancer to grow. In hormone treatment for uterine cancer, progesterone-like drugs known as progestins, which block the effect of estrogen, can be used to slow the growth of cancer cells.