What is Uterine Cancer?

Uterine cancer happens when abnormal cells grow together and form masses called tumors in the uterus (womb) in a woman’s pelvis. There are two types of uterine cancer. Endometrial is the most common type. Uterine sarcoma is the second type, which develops in tissue and muscle that support the uterus. Uterine sarcomas are rare.

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of uterine cancers. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Signs and symptoms of uterine cancer can include:

• A mass (tumor) that can be felt
• Abnormal vaginal bleeding and discharge or spotting
• Pain during sex
• Pain or difficulty urinating
• Pain or pressure in the pelvic area

Diagnosis

To diagnose uterine cancer, a physical examination that includes a pelvic exam is performed. A physician will also ask about symptoms and family medical history. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition, including:

Blood tests: Substances released into the blood can be checked to determine if cancer is present.

D&C (dilation and curettage): This procedure may be done if a biopsy does not provide enough tissue for examination. The cervix will be enlarged to remove tissue samples from the uterus.

Endometrial biopsy: In this procedure, a thin, flexible tube is inserted through the cervix and into the uterus to remove a small amount of tissue that will be studied under a microscope to look for cancer cells.

Hysteroscopy: During this procedure, a thin tube with a camera and light on the end is inserted into the vagina to the uterus. A physician will look at the uterus and may remove small pieces of tissue to be studied under a microscope to see if cancer is present. A D&C may be done with this procedure.

Imaging tests: A computerized tomography (CT) scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) allows a physician to view organs in the pelvis area to see if cancer is present and determine the size of the tumor.

Pap smear: In this procedure, the uterus is swabbed and the sample is studied under a microscope to look for cancer cells.

Transvaginal ultrasound: An ultrasound device allows physicians to see scans of the uterus to look for cancerous tumors. 

Causes

The cause of uterine cancer is unknown. Lifestyle factors that can contribute to the development of uterine sarcoma include: 

• Obesity
• Sedentary lifestyle

Risk Factors

Risk factors for developing uterine cancer include:

Age: Most uterine cancers occur in women who have entered or passed menopause.

Breast cancer drug: Taking tamoxifen to treat breast cancer increases the risk of developing uterine cancer.

Diabetes: There is close association of diabetes with uterine cancer.

Endometrial hyperplasia: This condition, which causes a thickening of the uterus, can increase the risk for uterine cancer. 

Prolonged exposure to estrogen on the lining of the uterus: Certain risk factors increase the exposure of the uterus lining to estrogen, which increases the risk of developing uterine cancer. Those factors include taking estrogen for five or more years without progesterone (male hormone); early menstruation or late menopause; never being pregnant; and obesity.

Genetics: Women with known or suspected Lynch syndrome have a higher risk for uterine cancer. An annual screening with endometrial biopsy and/or transvaginal ultrasound beginning at age 35 is recommended for these women.

Polycystic ovarian syndrome: This condition creates an imbalance of hormones and increases the risk of uterine cancer.

Pregnancy: Pregnancy seems to reduce the risk of uterine cancer, so women who have not been pregnant have a higher risk for developing the disease.

Radiation: Previous radiation therapy to treat a condition in the pelvic area increases the risk of getting uterine cancer.

Prevention

In most cases, uterine cancer cannot be prevented, but risks may be lowered with lifestyle changes, including:

Eat healthy foods and exercise: Eating lower-fat foods and exercising can reduce the risk of developing uterine cancer. 

Get a medical diagnosis: If symptoms of uterine cancer occur, see a physician immediately to determine the cause.

Maintain a healthy weight or lose weight: Aim for a body mass index no higher than 25 to avoid development of uterine cancer. 

Prognosis

The prognosis for uterine cancer depends upon how early the disease is diagnosed, the size of the tumor, and if it has spread. When found early, uterine cancer has a high survival rate.

Treatment and Recovery

Uterine cancer treatment depends upon the stage of cancer, size of the tumor, age and health of the woman.

Surgery

Surgery is the most common treatment for uterine cancer. Surgery options can include:

• Salpingo-oophorectomy: During a hysterectomy, there are two options for the salpingo-oophorectomy procedure: either remove the uterus, one ovary and fallopian tube; or remove the uterus and both ovaries and fallopian tubes.
• Hysterectomy: In this procedure, the uterus is removed, and sometimes, the cervix. For an abdominal hysterectomy, an incision is made through the abdominal wall to remove the uterus. During a vaginal hysterectomy, the uterus is removed through an incision in the vagina.
• Lymph node dissection: During a hysterectomy, a surgeon may remove lymph nodes by the tumor to see if cancer has spread beyond the uterus. 
• Radical hysterectomy: In this procedure, the uterus, cervix and part of the vagina are removed. The ovaries, fallopian tubes and pelvic lymph nodes may also be removed.
• Sentinel lymph node biopsy: During this procedure, a small sample from a sentinel lymph node (the first lymph node that cancer spreads to from a primary tumor) is removed to be studied under a microscope to determine if cancer has spread into the lymph nodes.

Recovery After Surgery

Recovery from surgery varies by the type performed. Hospital stays can last from one to seven days and recovery at home takes four to six weeks.

Hormone Therapy

In some cases, hormone therapy can treat uterine cancer by slowing the growth of cancer cells.

Radiation Therapy

Radiation may be used after surgery to kill any remaining cancer cells. Most often, radiation treatments are given five days a week for several weeks, and can include radiation directed precisely to the tumor or to the whole pelvic area.

Chemotherapy

If uterine cancer has spread outside of the uterus, chemotherapy is used, often in combination with radiation for treatment. Special drugs designed to kill cancer cells can be given as a pill, injected into the bloodstream or applied directly to the uterus.

Complications

Uterine cancer can return after treatment or spread to other parts of the body.