Learning more about Uterine Cancer

From prevention to cure

If you have been diagnosed with uterine cancer or if you face an increased risk, it's common to feel overwhelmed and afraid. But many types of uterine cancer can be cured if treated early. Our mission is to help you overcome your fears and conquer cancer, by understanding how this disease is detected, diagnosed and treated.

What is uterine cancer?

The uterus is the pear-shaped organ where a baby grows. The inner lining, which is shed during a woman's monthly menstrual cycle, is called the endometrium. The outer layer of the uterus, called the myometrium, is made of muscle tissue.

Cancer occurs when abnormal cells grow out of control. These cells can create a mass of tissue, called a tumor.

The three main types of uterine cancer are:


Endometrial carcinoma: Cancer that begins in the cells of the endometrium is the most common type of uterine cancer. It's often detected early, and has a high cure rate.

Uterine sarcoma : Uterine sarcomas begin in the myometrium or the tissues of the uterine muscles. This is a rare type of cancer. Depending on the type of cells, the tumor can grow slowly or quickly.

Uterine carcinosarcoma: This rare type of uterine cancer begins in the endometrium, but has features of both carcinomas and sarcomas.

Non-cancerous tumors

It's important to know that not all uterine tumors are malignant (cancerous). Benign (non-cancerous) conditions include:

Polyps: It is common for women to have these small, localized growths on the endometrium.

Fibroids: These are common growths in the myometrium. As a woman reaches menopause, they often become smaller and disappear.

Endometrial hyperplasia: This occurs when too many endometrial cells are produced, and the lining of the uterus becomes too thick. If the cells are abnormal, hyperplasia can develop into cancer.

Accessing Your risk

Your risk for developing uterine cancer is higher if you:
• Are 50 pounds or more overweight
• Are 50 or older
• Have endometrial hyperplasia
• Began menstruating before age 12 or entered menopause late, after age 52
• Have never given birth
• Have an ovarian disease that can cause you to have higher than normal levels of the hormone estrogen and lower levels of the hormone progesterone
• Have taken hormones after menopause that contain estrogen but not progesterone
• Have taken tamoxifen to prevent or treat breast cancer
• Are Caucasian
• Have a personal or family history of colorectal cancer
• Have diabetes or high blood pressure
• Have a family history of endometrial cancer

Symptoms

Abnormal vaginal bleeding is the most common symptom of uterine cancer. This includes bleeding after menopause and bleeding or spotting between periods. Other symptoms are:
• Unusual vaginal discharge
• Persistent pelvic pain and weight loss
• Pain during sexual intercourse

Prevention

While you can't control some risk factors for uterine cancer, you can take precautions to lower your risk and increase your chance of detecting cancer early:
• Get annual pelvic exams.
• See your doctor right away if you experience any symptoms of uterine cancer.
• Stay at a healthy weight.
• Keep your blood pressure and blood glucose level in a healthy range.
• Treat endometrial hyperplasia.
• Before beginning hormone replacement therapy, talk to your doctor about your risk for uterine cancer.

Diagnosis

To check for uterine cancer, your doctor may perform pelvic or imaging exams, or take a sample of tissue (called a biopsy). If the biopsy results aren't clear, a procedure called dilation and curettage (D&C) might be done. Through this outpatient procedure, tissue is scraped from the lining of your uterus and examined under a microscope to look for cancer cells.

Staging

If cancer is found, your doctor will perform tests to determine the "stage" of the disease. This is based on the size of the tumor, if it has affected nearby organs or tissue, and if the cancer has spread to other areas in the body, including the lymph nodes. Blood tests, X-rays and other imaging exams may be used, but surgery typically is required to confidently determine the stage of endometrial cancer.

Stages include:
Stage I: Cancer is limited to the uterus
Stage II: Cancer is limited to the uterus and cervix
Stage III: Cancer has spread beyond the uterus, possibly to lymph nodes in the pelvic area, but hasn't reached the rectum and bladder
Stage IV: Cancer has spread past the pelvic region, to the bladder, rectum or other parts of the body

Treatment

Treatment options for uterine cancer depend on several factors, including:
• The type of cancer - sarcoma or carcinoma
• The stage of the disease
• Your overall health and age
• Your personal preferences
• The four basic types of treatment for uterine cancer are surgery, radiation therapy, hormone therapy and chemotherapy. Surgery Removing the uterus through surgery is recommended for most women with endometrial cancer. This procedure, called a hysterectomy, often cures the cancer if it is detected and treated early. But, a hysterectomy makes it impossible to become pregnant. In addition, many women also have their ovaries removed. This causes them to stop producing estrogen and progesterone and experience symptoms related to menopause.

Radiation

Radiation therapy uses X-rays and other highly focused energy beams to kill cancer cells. This may be recommended to:
• Lower the risk of cancer returning after surgery
• Shrink a tumor before surgery
• Reduce cancer-related pain
• Treat the tumor if you aren't healthy enough for surgery
• Hormone therapy

If you have advanced endometrial cancer that has spread beyond the uterus, your doctor may recommend taking a medication to kill the cancer cells or stop them from growing. Some medications do this by increasing the amount of progesterone in your body, while others lower the amount of estrogen.

Chemotherapy

If the cancer is advanced or keeps coming back, chemotherapy might be used. Sometimes the cancer-killing chemicals are taken in pill form, and other times they are injected directly into a vein through an IV.

Mercy Health — Gynecological Oncology
2409 Cherry St., Suite 307
Toledo, OH 43608
419-251-4873