Uterine Cancer

Definition

Uterine cancer is a disease in which cancer cells grow in the uterus (womb).

The lower portion of the uterus, which is closest to the vagina, is called the cervix. When cancer develops in this portion, it is called cervical cancer; this is discussed in the cervical cancer fact sheet.


The walls of the uterus (excluding the cervical portion) are made up of the endometrium, the inner lining, and the myometrium, the muscular, outer lining. The most common type of uterine cancer—adenocarcinoma--begins in the endometrium. Endometrial cancer is another term for uterine cancer. Less common cancers called sarcomas begin in the myometrium. This fact sheet will focus on endometrial cancer.

Cancer occurs when cells in the body (in this case uterus cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The term cancer refers to malignant tumors, which can invade nearby tissues and spread to other parts of the body. A benign tumor does not invade or spread.

Causes

The exact cause of uterine cancer is unknown. Exposure to the hormone estrogen seems to be strongly related to the development of this cancer.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
• Age: between 50 and 60 years old
• Obesity
• High blood pressure
• Polycystic ovary syndrome
• Endometrial polyps
• Infertility
• No history of pregnancy
• Early start of menstrual periods
• Late menopause
• Diabetes

Symptoms

Symptoms include:
• Abnormal bleeding between menstrual periods
• Vaginal bleeding or spotting in postmenopausal women
• Pain in the pelvic area
• Pain during urination
• Pain during intercourse
Note: These symptoms may also be caused by other, less serious health conditions. A woman experiencing these symptoms should see her doctor.

Diagnosis

The doctor will ask about your symptoms and medical history.
Tests may include:
• Blood and urine tests
• Pelvic exam – examination of the vagina, uterus, ovaries, bladder, and rectum
• Pap test – scraping and testing tissue from the inside of the cervix and upper vagina
• Biopsy of the uterine lining – removing a sample of tissue from the uterine lining for testing
• Dilation and curettage (D & C) – to get a sample of tissue from the uterine lining

Treatment

Once uterine cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what parts of the body. Treatments for uterine cancer depend on the stage of the cancer.

Treatments include:
Surgery – surgical removal of the uterus (hysterectomy) and the fallopian tubes and ovaries, and possibly nearby lymph nodes
Radiation Therapy – the use of radiation to kill cancer cells and shrink tumors. Radiation may be:
External Radiation Therapy – radiation directed at the tumor from a source outside the body
Internal Radiation Therapy – radioactive materials placed into the body near the cancer cells
Hormone Therapy – use of drugs to control cancer cells outside the uterus. This treatment is recommended for women unable to have surgery, or who have recurrent cancer, or cancer that has spread (metastasized).
Chemotherapy – use of drugs to kill cancer cells. Chemotherapy may be given in many forms including: pill, injection, and via a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy has not yet been shown to be of benefit in uterine cancer, whether it is local or advanced in nature. There are some current studies looking at the possible benefits of chemotherapy when it is added to radiation therapy after the appropriate surgery has been performed.

Prevention

All women should have yearly pelvic exams to monitor any changes that may signal cancer development. Use of oral contraceptives may provide some protection against uterine cancer.