Uterine Cancer Overview

According to the National Cancer Institute, more than 43,000 cases of uterine cancer (also referred to as endometrial cancer) will be diagnosed this year. Women’s Specialists of Plano offers uterine cancer treatment in the Plano, Frisco and Dallas, Texas communities. They recently compiled the following Q & A on this serious form of cancer. Early screening is important in order to prevent uterine cancer from starting or spreading.

What is the Uterus?

The uterus is the hollow, pear-shaped organ that resides in the pelvic region of a female.  The uterus is a part of the reproductive system and is the place where a baby grows during pregnancy.  The uterus holds the cervix, which is the lower, narrow area of the uterus, and the fallopian tubes that extend from both sides of the organ.  The uterus contains two layers of tissue: the inner layer is known as the endometrium; the outer layer is called the myometrium. It is within this lining that a woman’s body prepares itself for menstruation as the walls within the uterus are lined and thickened with blood and then released monthly through the vagina.

What Conditions Can Exist in the Uterus?

Fibroids (benign tumors), endometriosis (endometrial tissue that grows inside the body, outside of the uterus) and endometrial hyperplasia (an increase of cells in the lining of the uterus) are all benign conditions that can affect the uterus. Another condition that can exist within the uterus is Adenomysis—in which the endometrium exists in the muscle of the uterus. Endometrial polyps can also exist in the uterus and is another source of abnormal bleeding. These conditions should be monitored and treatment for each condition is available.

What is Uterine Cancer?

Uterine cancer is a type of cancer that affects the uterus; it most often occurs when abnormal or cancerous cells begin to develop and multiply in the endometrium lining of the uterus.  When cancer occurs within the lining of the uterus, it is known as endometrial cancer.  Endometrial cancer is the most common type of uterine cancer. If the cancer develops in the tissue and muscles that make up the uterus, the cancer is known as a sarcoma.  Sarcomas are the most rare of uterine cancers.

What Causes Uterine Cancer?

The exact cause of uterine cancer is not known; however, studies have shown that there are some risk factors:

  • Age.  Uterine cancer, endometrial cancer and sarcomas of the uterus most often affect women over the age of 50
  • Obesity.   Obese women have higher levels of estrogen in their bodies because the body makes some of its estrogen naturally in fatty tissues.  Higher levels of estrogen create a higher risk for uterine cancer.
  • Untreated Conditions.  Certain uterine conditions, if left untreated, could increase the chances of a woman getting uterine cancer. Chronically irregular periods, especially going more than three months between periods will increase the risk.
  • Race.  White woman are more likely to get uterine cancer than African-American women.
  • Diabetes and hypertension.
  • Certain hormone-related therapies. Women who are on estrogen replacement therapy and unbalanced hormonal therapy should be monitored closely. These specific therapies, as well as “natural” therapies such as estrogen cream, if not balanced by progesterone, can increase the risk of uterine cancer.
  • Starting menstruation early (before age 12)
  • Never being pregnant

What are the Symptoms of Endometrial Cancer?

It is important to note that the majority of diagnosed uterine cancers (including endometrial cancer and sarcomas) occur near or after menopause.  Abnormal and ongoing vaginal bleeding is typically the first symptom of uterine cancer. Other symptoms may include heavy discharge, painful urination, and pain in the pelvic area or pain during intercourse.

How is Uterine Cancer Diagnosed?

If a woman has unusual symptoms, a pelvic exam, pap test or biopsy may be administered. Once uterine cancer is in fact diagnosed, your doctor will work to determine the stage.

What are the Stages of Uterine Cancer?

In most cases, a hysterectomy is the first step and the most reliable way to stage uterine cancer. It allows the surgeon and the pathologist the opportunity to look closely at where the cancer has invaded and spread.  Staging uterine cancer occurs in 4 ways:

  • Stage 1:  The cancer is isolated in the uterus and has not spread to the cervix
  • Stage 2:  The cancer has spread to the cervix
  • Stage 3: The cancer has spread outside the uterus; however it has not spread outside of the pelvic region. Lymph nodes in and around the pelvic may or may not contain cancer cells.
  • Stage 4:  The cancer has spread to other organs in the body

What Treatment Options are Available for Endometrial Cancer?

Most women who have been diagnosed with uterine cancer will have surgery.  A hysterectomy (removal of the uterus) is generally the first course of treatment; during this procedure the ovaries are typically removed as well. During the hysterectomy, lymph nodes will most likely also be removed so that tests can be administered to see if and where the cancer has spread. Depending on the stage of the cancer, radiation therapy, chemotherapy and/or hormonal therapy will be recommended.

What is the Prognosis for Uterine Cancer?  Can it be Prevented?

Prognosis is first related to the depth of cancer invasion into the myometrium—the less the invasion, the better the prognosis.  The cervix and surrounding tissues are then screened and tested for cancer. If uterine cancer is found early, the prognosis is excellent.  The 1-year survival rate is about 92% if the cancer has not spread.  That number does drop significantly if the cancer has spread to nearby organs. Women should have annual and routine physical examinations including pelvic exams, Pap smears and blood work. If you are experiencing any abnormal bleeding, pain in the pelvic area, bleeding lasting longer than a full week and bleeding that occurs every 21 days or more, please consult with your doctor.

If you live in the communities of Plano, Frisco and Dallas, Texas and would like additional information on uterine cancer, otherwise known as endometrial cancer, please contact the office of Women’s Specialists of Plano today.