Uterine cancer is the fourth-most-common cancer in women in the United States. The two most common types of uterine cancer are endometrial cancer and uterine sarcoma, although cases of uterine sarcoma are rare. Endometrial cancer forms in the uterine lining (endometrium); uterine sarcoma forms in uterine muscle and supporting tissue. There are no reliable screening tests or exams for either type of uterine cancer.
Risk Factors for Uterine Cancer
Risk factors for uterine cancer differ depending on the type. Endometrial cancer usually affects woman who are postmenopausal, and is also more common in those who meet the following criteria:
- Are 50 years of age or older
- Have never been pregnant
- Are obese
- Have irregular ovulation
- Began menstruating at an early age
- Have diabetes
- Have used hormones or had hormone treatment
- Have had breast or ovarian cancer
- Have a family history of colon cancer
There are only a few risk factors for uterine sarcoma; they include having undergone pelvic radiation treatment, being African American, and having had retinoblastoma that was caused by being born with an abnormal copy of a particular gene (RB gene).
Symptoms of Uterine Cancer
Symptoms of both endometrial cancer and uterine sarcoma include the following:
- Abnormal bleeding (even post-menopause)
- Abnormal vaginal discharge
- Pain or pressure in the pelvis
If uterine sarcoma is present, it may be possible for a mass to be felt when a physical exam is performed.
Diagnosis of Uterine Cancer
If uterine cancer is suspected, a series of tests is performed to confirm its presence, and to rule out other conditions. Tests include the following:
- Endometrial biopsy (small amount of tissue is removed from the lining of the uterus)
- Transvaginal ultrasound (sound waves check size of the uterus and thickness of its lining)
- Hysteroscopy (slender, light-transmitting scope is used to view the inside of the uterus)
- Dilation and curettage (D&C) (tissue is scraped or suctioned from inside of uterus)
If uterine cancer is diagnosed, CT and MRI scans may be performed to see if the cancer has metastasized.
Treatment of Uterine Cancer
Treatment for both endometrial cancer and uterine sarcoma includes surgery, radiation therapy, chemotherapy and hormone therapy. Types of surgery include total hysterectomy, in which both the uterus and cervix are removed; total hysterectomy with unilateral salpingo-oophorectomy, in which the uterus, one ovary and one fallopian tube are removed; total hysterectomy with bilateral salpingo-oophorectomy, in which the uterus, both ovaries and both fallopian tubes are removed; and radical hysterectomy, in which the uterus, cervix, both ovaries, both fallopian tubes and nearby tissue are removed. Which type of surgery is performed depends on the extent of the cancer.
Radiation therapy, chemotherapy and hormone therapy are often given postsurgery to keep the cancer from returning, or as primary treatments in cases in which the cancer cannot be removed surgically, or the woman has other health problems that make surgery inadvisable.