Uterine Cancer: The Facts

What is it?

Uterine cancer begins in the Uterus, or womb, located in the pelvic area, which is part of the female reproductive system. The uterus is a hollow pear shaped organ that protects and nurtures the growing fetus during pregnancy, and is involved in menstruation and menopause. There are two linings of the uterus. The first is called the Endometrium, which grows and recedes every month. The time during which the endometrium is receding is your period; the shedded endometrium is the bloody discharge. The second lining of the uterus is the Myometrium, which is made of muscle tissue. The uterus has Fallopian Tubes attached on both sides, connecting it to the Ovaries, where the eggs (ovas) are formed. The bottom section of the uterus, called the Cervix, connects the uterus to the Vagina. (Cervical Cancer is not being discussed here.)

Endometrial Cancer is cancer of the endometrium. This is the most common uterine cancer. The development of Endometrial Cancer may be described in four stages:

• Stage I: The cancer is only in the body of the uterus; it is not in the cervix.
  
• Stage II: The cancer has spread from the body of the uterus to the cervix.
  
• Stage III: The cancer has spread outside the uterus, but not outside the pelvis. Lymph nodes in the pelvis may contain cancer cells.
  
• Stage IV: The cancer has spread into the bladder or rectum, or it has spread beyond the pelvis to other body parts.
  

Sarcoma of the Uterus begins in the muscle wall of the uterus (called the myometrium) or supporting tissues of the uterus. This form of uterine cancer occurs less frequently than Endometrial Cancer. The development of Uterine Sarcoma may be described in four stages:

• Stage I: Cancer is found only in the main part of the uterus, it is not found in the cervix.
  
• Stage II: Cancer cells have spread to the cervix.
  
• Stage III: The cancer has spread outside the Uterus, but remains within the pelvic area.
  
• Stage IV: The cancer has spread to other parts of the body beyond the pelvic area to the lining of the bladder, the bowel, lymph nodes or other parts of the body beyond the pelvis.
  

Who gets it?

Uterine Cancer is the most common cancer of the female reproductive system. It is the fourth most common cancer in women, behind lung, breast, and colon cancer. There are certain factors that may increase a woman's chance of getting Uterine Cancer. Some of these factors cannot be controlled (your age), however others may be controlled by lifestyle habits (obesity). Those risk factors that cannot be controlled should be told to your doctor who will make this part of your health record.

The following risk factors for Endometrial Cancer may increase your risk for developing uterine sarcomas, however they do not always cause uterine sarcomas:

• Many years of Menstruation, a woman starting menstruation before age 12 and continuing into her 50s.
  
• Obesity.
  
• Infertility.
  
• Diabetes and High Blood Pressure
  
• Estrogen Replacement Therapy without Progesterone.
  
• Tamoxifen (a treatment for Breast Cancer).
  
• An inherited form of colorectal cancer.
  

Most women who have Uterine Sarcoma are between the ages of 55 and 70. Women who are white have a higher chance of developing uterine sarcoma than do non-white women. Also, women who have received prior pelvic radiation treatment are at an increased risk for Uterine Sarcoma than women who did not.

How is it detected?

If you have any of the symptoms of Uterine Cancer, you should speak with your physician. If he/she suspects Uterine Cancer, you may undergo any of the following procedures:

• Endometrial Biopsy: A sample of endometrial tissue is removed from the inner uterine lining or endometrium. This procedure can be done in the doctor's office. This is the only way to definitively know if a woman has Uterine Cancer.
  
  
• Dilation and Curettage (D&C): A more invasive type of biopsy, it is performed under anesthesia and is usually done as an outpatient procedure. The doctor first dilates the cervix and then scrapes a sample of tissue from different parts of the inner lining of the uterus. These cells will be checked for cancer. After a D&C, women may experience cramps and vaginal bleeding.
  
  
• Transvaginal Ultrasound: The doctor inserts a probe into the vagina that emits high-frequency sound waves that echo off the tissues of the organs in the pelvis. The echoes create a picture that is analyzed by a computer.
  
  
• Computed Tomography (CT) Scans: A series of x-rays that are combined to form a cross-sectional image of the region of the tumor.
  
  
• Physical Exam
  
  
• Pelvic Exam: The doctor feels the vagina, uterus, ovaries, bladder, and rectum to check for lumps or changes in the shapes of the organs in the pelvis.
  
  
• Pap Smear: The doctor uses a small brush to take a sample of cells from the cervix and upper vagina. These cells are examined under a microscope to look for cancer. The Pap test is not a reliable method to detect Uterine Cancer because it does not test cells from inside the uterus, however it is part of a routine gynecological exam.
  

Symptoms:

The symptoms of Uterine Cancer may be associated with less severe medical problems such as benign tumors or urinary tract infections. However, these symptoms should be discussed with your physician. These symptoms include:

• Any abnormal vaginal discharge without visible blood.
  
• Unusual vaginal bleeding after menopause or bleeding that is not part of the menstrual cycle.
  
• Pain in the pelvic area or lower abdomen.
  
• A feeling of fullness in the pelvic area.
  

Is it curable?

The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed. The overall 5-year survival rate for patients with Endometrial Cancer is 84%. The prognosis for individual patients depends on the stage, health, and circumstances of each patient. While Uterine Sarcoma has a significantly lower survival rate (stage I 5-year survival rate of 50%), it occurs much less frequently.

It's easier to prevent cancer than to cure it....

Although many of the risk factors for Uterine Cancer cannot be prevented, there are certain lifestyle changes and habits can help to reduce your chances of getting other cancers and improve your general health. These include:

• See your gynecologist each year for a complete exam.
  
• Reducing weight.
  
• Eat a well balanced diet, less fatty foods.
  
• See your physician for a regular physical, including blood and urine tests.
  
• Don't Smoke.
  
• Regular exercise.
  
• Moderate, if any, consumption of alcohol.
  
• Low fat, high fiber diet.
  

If you found this information helpful, please consider making a donation to the Rhode Island Cancer Council so we may continue adding content to our website and providing valuable services to Rhode Island residents. Please click the Donate icon to the left to make a donation via credit card or your PayPal account.

See also: