Uterine cancer

Uterine [YOU-tuhr-in] cancer is cancer of the womb or uterus. It usually begins in the lining of the uterus, called the endometrium [ehn-doh-MEE-tree-UM], and is sometimes referred to as endometrial [ehn-doh-MEE-tree-UHL] cancer. Sometimes, cells in the uterus (womb) grow too quickly, clumping together to form a mass called a tumor. When this tumor starts to grow or spread, it is called cancer.

There are two basic types of uterine cancer. Type 1 is the most common and it is slow growing. Type 2 uterine cancer, which is rare, is more aggressive. The stages of uterine cancer are identified by the location of the cancer cells or tumor and how far it has spread in the uterus and the rest of the body. Each of the following stages of uterine cancer also has sub-stages that help determine treatment.

• Stage I. Cancer cells or growth can be found in the uterus but has not spread beyond it.
• Stage II. Cancer has spread outside the uterus but not beyond the pelvis.
• Stage III. Cancer has spread beyond the pelvis but not yet to distant areas of the body. It may or may not be in the lymph [LIMF] nodes.
• Stage IV. Cancer has spread to the bladder, rectum [REK-tum] or other distant organs such as the bones and lungs.

Early detection is key to improving the outcome of uterine cancer. It is the most common type of cancer found in the female reproductive system and the fourth most common cancer diagnosed in women. Uterine cancer is typically diagnosed after menopause [MEN-uh-pawz].

While uterine cancer can’t always be prevented, you can practice some basic lifestyle changes to reduce your risk of developing cancer.

These include:

• Maintaining a healthy weight
• Exercise regularly
• Eat a healthy diet

There is some evidence that taking birth control pills or having an IUD can reduce the risk of growths in the lining of the uterus. Hormone therapy is also a risk factor for developing uterine cancer, so it’s recommended that you talk with your doctor or gynecologist before undergoing this treatment for menopause.

Symptoms

The symptoms of uterine cancer can be easy to spot in post-menopausal [MEN-uh-paw-zuh l] women but may be confused with irregular periods in younger women. These include:

• Unusual bleeding or discharge
• Pain during intercourse
• Pain in the pelvic area
• Trouble urinating
• Bloating
• Changes in bowel or bladder habits
• Feeling of fullness

Causes

Like most cancers, doctors aren’t sure exactly what causes uterine cancer, but there are some known risk factors that place you at a greater risk of developing it. These risk factors include:

• Age. Women are much more likely to develop uterine cancer after menopause
• Obesity. Unhealthy lifestyle and diets can increase the risk of all cancers, including uterine cancer.
• Hormone levels. Women who have undergone estrogen-only hormone therapy for menopause treatment have a greater risk of developing uterine cancer.
• Genetics. Some women carry an inherited risk because of a family history of uterine cancer.

If you have these risk factors, talk with your doctor or gynecologist about whether they would recommend additional testing or screening for uterine cancer.

Diagnosis and Tests

Uterine cancer screening is not a part of the standard Pap test and gynecological [jin-i-kuh-LOJ-ik-al] exams that women receive. If you or your doctor suspect uterine cancer, some additional testing may be recommended including the following:

• Transvaginal [TRANS-vaj-uh-nl] ultrasound
• Endometrial biopsy [BY-op-see]
• Blood tests
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan
• Chest x-ray
• Positron emission tomography (PET) scan

The tests your doctor or gynecologist recommend will depend on your age, overall health, symptoms, and other risk factors.

Treatments

The goals of treatment for uterine cancer are to remove not only the primary cancer growth or tumor but also to prevent cancer from returning. The secondary goal of treatment is to alleviate the symptoms of cancer. Your doctor or gynecologist will work together with a treatment team that may include an oncologist [on-CALL-oh-jist] and a surgeon. This team will develop a treatment plan that works best for your situation.

Treatment for uterine cancer can fall into two types: local and systemic.

Local treatments are designed to remove cancer and tumors and may include the following:

• Surgery. Hysterectomy [HISS-tuhr-EKT-uh-mee] is the most common treatment for cancer, which may involve removing the uterus as well as the ovaries [oh-VUH-rees] and fallopian tubes, especially if the cancer has spread to these areas.
• Radiation. High-energy radiation targeting the pelvic area can kill cancer cells or slow down their growth.
• Systemic treatments are meant to stop the spread of cancer to other parts of the body and may include:
• Hormone therapy
• Chemotherapy

If you are experiencing any of the symptoms of uterine cancer, you should schedule an appointment with your doctor or gynecologist [gahy-ni-KOL-uh-jist. Pap tests can screen for cervical cancer but not uterine cancer, so it’s important to talk with your doctor if you have irregular bleeding and pain, especially if you have already gone through menopause.