Uterine cancer is a general term that describes cancer in your uterus:
Endometrial cancer develops in the endometrium, the inner lining of your uterus. It’s one of the most common gynecologic cancers — cancers affecting your reproductive system.
Uterine sarcoma develops in the myometrium, the muscle wall of your uterus. Uterine sarcomas are very rare.
What are the symptoms of uterine cancer?
Signs of uterine cancer can resemble those of many conditions. That’s especially true of other conditions affecting reproductive organs. If you notice unusual pain or irregular vaginal bleeding, talk to your healthcare provider. An accurate diagnosis is important so you can get the proper treatment.
Symptoms of endometrial cancer or uterine sarcoma include:
Extremely prolonged, heavy or frequent vaginal bleeding if you’re older than 40.
What causes uterine cancer?
Researchers aren’t sure of the exact cause of uterine cancer. Something happens to create changes in cells in your uterus. The mutated cells grow and multiply out of control, which can form a mass called a tumor.
Certain risk factors can increase the chances you’ll develop uterine cancer. If you’re at high risk, talk to your healthcare provider about steps you can take to protect your health.
What are risk factors for uterine cancer?
There are several risk factors for endometrial cancer. Many of them relate to the balance between estrogen and progesterone. These risk factors include having obesity, a condition called polycystic ovarian syndrome (PCOS) or taking unopposed estrogen (taking estrogen without taking progesterone, too). The genetic disorder Lynch syndrome is another risk factor unrelated to hormones.
Risk factors include:
Age, lifestyle and family history
Age: As you get older, your likelihood of developing uterine cancer increases. Most uterine cancers occur after age 50.
Diet high in animal fat: A high-fat diet can increase your risk of several cancers, including uterine cancer. Fatty foods are also high in calories, which can lead to obesity.
Family history: Some people inherit genetic disorders that increase cancer risk. People with Lynch syndrome, or hereditary nonpolyposis colorectal cancer (HNPCC), have increased risk of endometrial cancer, along with other kinds of cancer.
Other conditions
Diabetes: This disease is often related to obesity, a risk factor for cancer. But some studies suggest a more direct tie between diabetes and uterine cancer as well.
Obesity (having excess body weight): Some hormones get changed to estrogen by fat tissue, raising uterine cancer risk. The higher the amount of fat tissue, the greater the effect on estrogen levels.
Ovarian diseases: People who have certain ovarian tumors have high estrogen levels and low progesterone levels. These hormone changes can increase uterine cancer risk.
Menstrual and reproductive history
Early menstruation: If your period started before age 12, your risk for uterine cancer might increase. That’s because your uterus gets exposed to estrogen for more years.
Late menopause: Similarly, if menopause occurs after age 50, the risk also increases. Your uterus gets exposed to estrogen longer.
Long menstruation span: The number of years menstruating might be more important than your age when periods started or ended.
Not getting pregnant: People who haven’t been pregnant have a higher risk.
Previous treatments for other conditions
Earlier radiation therapy to your pelvis: Radiation therapy to the pelvis to treat other cancers can damage cell DNA. This damage may increase your risk of developing a second type of cancer.
Estrogen replacement therapy (ERT): Some people receive estrogen therapy to help relieve menopause symptoms. Getting ERT without progesterone places you at a higher risk for uterine cancer.
Use of tamoxifen: People may receive this drug for breast cancer treatment. It acts like estrogen in the uterus and can increase the risk of uterine cancer.
What are complications of endometrial cancer?
The most serious complication of endometrial cancer is death. However, when your healthcare provider diagnoses endometrial cancer at an early stage, the prognosis is usually very good.
Other complications of endometrial cancer include:
The cancer spreading to other parts of your body (metastasizing).
Your body doesn’t respond well to treatment.
How is uterine cancer treated?
Most people with endometrial cancer need surgery. Your particular treatment plan depends on the type of cancer and your overall health. Other treatments you may have include:
Chemotherapy, which uses powerful drugs to destroy cancer cells.
Radiation therapy, which sends targeted radiation beams to destroy cancer cells.
Hormone therapy, which gives hormones or blocks them to treat cancer.
Immunotherapy, which helps your immune system fight cancer.
Targeted therapy, which uses medications to target specific cancer cells to stop them from multiplying.
Researchers continue to study more ways to treat endometrial cancer.
What type of uterine cancer surgery will I need?
Surgery is usually the primary treatment for endometrial cancer. You’ll most likely have a hysterectomy, with the surgeon removing your uterus and cervix. There are four types of hysterectomy procedures:
Total abdominal hysterectomy: The surgeon makes an incision (cut) in your abdomen to access and remove your uterus.
Vaginal hysterectomy: The surgeon removes your uterus through your vagina.
Radical hysterectomy: If cancer has spread to your cervix, you may need a radical hysterectomy. The surgeon removes your uterus and the tissues next to your uterus. The surgeon also removes the top part of your vagina, next to your cervix.
Minimally invasive hysterectomy: The surgeon makes multiple small incisions (cuts) to remove your uterus. This may be done laparoscopically or robotically.
During a hysterectomy, surgeons often perform two other procedures, as well:
Bilateral salpingo-oophorectomy (BSO) to remove your ovaries and fallopian tubes. Most people need this extra step to make sure all cancer gets removed.
Many people who have uterine cancer need their ovaries removed. But removing the ovaries means you’ll go through menopause if you haven’t already. If you’re younger than 45 and premenopausal, talk to your care team to see if you should keep your ovaries.
Menopause (if you were premenopausal and ovaries were removed) and its symptoms, including vaginal dryness and night sweats.
How is a uterine sarcoma treated?
Often, surgeons use a single procedure to diagnose, stage (describe severity) and treat uterine sarcoma. Treatment options are like those for endometrial cancer. You may have a hysterectomy, as well as a BSO to remove your ovaries and fallopian tubes.
Talk to your healthcare provider if you notice possible signs of uterine cancer. Your provider will:
Ask about your symptoms, risk factors and family history.
What tests will I need to diagnose uterine cancer?
Your provider may perform one or more tests to confirm a diagnosis of uterine cancer:
Blood tests:
CA-125 assay measures CA-125, a protein. A certain amount of CA-125 can point to cancer in your body.
Imaging tests:
CT scans take a series of detailed pictures of the inside of your body.
MRI scans use radio waves and a powerful magnet to create images.
Transvaginal ultrasound inserts a special probe (smooth, rounded device) into your vagina to get pictures of your uterus.
Other tests:
Endometrial biopsy inserts a thin, flexible tube through your cervix (opening of your uterus) and into your uterus. Your provider removes a small amount of the endometrium.
Hysteroscopy inserts a hysteroscope, a long thin tube, through your vagina and cervix to reach your uterus. This narrow instrument with a light and camera provides detailed images of your uterus.
Dilation and curettage (D&C) is a more complex procedure to remove uterine tissue. It takes place in the operating room.
If you had a D&C or biopsy to remove tissue samples, your provider then sends the sample to a lab. There, a pathologist looks at the tissue to confirm if there’s cancer.
Can a Pap test diagnose uterine cancer?
No. The Pap test (Pap smear) doesn’t screen for or diagnose uterine cancer. It checks for cervical cancer.
What else does an endometrial cancer diagnosis show?
If your healthcare provider diagnoses endometrial cancer, they also need to determine the type. Knowing the cancer type helps your care team figure out the best treatment:
Type 1 endometrial cancers are less aggressive. They usually don’t spread to other tissues quickly.
Type 2 endometrial cancers are more aggressive. They’re more likely to spread outside of the uterus and need stronger treatment.
Your provider will also determine cancer stage. Uterine cancers are staged on a scale that ranges from I to IV.
Stage I cancer hasn’t spread beyond your uterus.
Stage II cancer has spread to your cervix.
Stage III cancer has spread to your vagina, ovaries and/or lymph nodes.
Stage IV cancer has spread to your bladder or other organs far away from your uterus.
In some cases, your provider may not be able to determine what stage of cancer you have until you’ve had surgery to remove it.
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