What is Uterine Cancer

Uterine cancer is an abnormal growth of cancer tissue (malignant tumor) in the uterus. Unlike noncancerous (benign) tumors, malignant tumors can spread to other parts of the body. Uterine cancer usually occurs after menopause. However, it may also occur around the time that menopause begins.

The wall of the uterus has an inner layer of tissue (endometrium) and an outer layer of muscle tissue (myometrium). The most common type of uterine cancer begins in the endometrium (endometrial cancer). Cancer that begins in the myometrium (uterine sarcoma) is very rare.

What are the causes?

The exact cause of this condition is not known.

What increases the risk?

You are more likely to develop this condition if you:

• Are older than 50.
• Have an enlarged endometrium (endometrial hyperplasia).
• Use hormone therapy.
• Are severely overweight (obese).
• Use the medicine tamoxifen.
• You are white (Caucasian).
• Cannot bear children (are infertile).
• Have never been pregnant.
• Started menstruating at an age younger than 12 years.
• Are older than 52 and are still having menstrual periods.
• Have a history of cancer of the ovaries, intestines, or colon or rectum (colorectal cancer).
• Have a history of enlarged ovaries with small cysts (polycystic ovarian syndrome).
• Have a family history of:
  • Uterine cancer.
  • Hereditary nonpolyposis colon cancer (HNPCC).
• Have diabetes, high blood pressure, thyroid disease, or gallbladder disease.
• Use long-term, high-dose birth control pills.
• Have been exposed to radiation.
• Smoke.

What are the signs or symptoms?

Symptoms of this condition include:

• Abnormal vaginal bleeding or discharge. Bleeding may start as a watery, blood-streaked flow that gradually contains more blood. This is the most common symptom. If you experience abnormal vaginal bleeding, do not assume that it is part of menopause.
• Vaginal bleeding after menopause.
• Unexplained weight loss.
• Bleeding between periods.
• Urination that is difficult, painful, or more frequent than usual.
• A lump (mass) in the vagina.
• Pain, bloating, or fullness in the abdomen.
• Pain in the pelvic area.
• Pain during sex.

How is this diagnosed?

This condition may be diagnosed based on:

• Your medical history and your symptoms.
• A physical and pelvic exam. Your health care provider will feel your pelvis for any growths or enlarged lymph nodes.
• Blood and urine tests.
• Imaging tests, such as X-rays, CT scans, ultrasound, or MRIs.
• A procedure in which a thin, flexible tube with a light and camera on the end is inserted through the vagina and used to look inside the uterus (hysteroscopy).
• A Pap test to check for abnormal cells in the lower part of the uterus (cervix) and the upper vagina.
• Removing a tissue sample (biopsy) from the uterine lining to check for cancer cells.
• Dilation and curettage (D&C). This is a procedure that involves stretching (dilation) the cervix and scraping (curettage) the inside lining of the uterus to get a biopsy and check for cancer cells.

Your cancer will be staged to determine its severity and extent. Staging is an assessment of:

• The size of the tumor.
• Whether the cancer has spread.
• Where the cancer has spread.

The stages of uterine cancer are as follows:

• Stage I. The cancer is only found in the uterus.
• Stage II. The cancer has spread to the cervix.
• Stage III. The cancer has spread outside the uterus, but not outside the pelvis. The cancer may have spread to the lymph nodes in the pelvis. Lymph nodes are part of your body’s disease-fighting (immune) system. Lymph nodes are found in many locations in your body, including the neck, underarm, and groin.
• Stage IV. The cancer has spread to other parts of the body, such as the bladder or rectum.

How is this treated?

This condition is often treated with surgery to remove:

• The uterus, cervix, fallopian tubes, and ovaries (total hysterectomy).
• The uterus and cervix (simple hysterectomy).

The type of hysterectomy you will have depends on the extent of your cancer. Lymph nodes near the uterus may also be removed in some cases. Treatment may also include one or more of the following:

• Chemotherapy. This uses medicines to kill the cancer cells and prevent their spread.
• Radiation therapy. This uses high-energy rays to kill the cancer cells and prevent the spread of cancer.
• Chemoradiation. This is a combination treatment that alternates chemotherapy with radiation treatments to enhance the way radiation works.
• Brachytherapy. This involves placing radioactive materials inside the body where the cancer was removed.
• Hormone therapy. This includes taking medicines that lower the levels of estrogen in the body.

Follow these instructions at home:

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Exercise regularly as told by your health care provider.
• Do not drive or use heavy machinery while taking prescription pain medicine.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Maintain a healthy diet.
• Work with your health care provider to:
  • Manage any long-term (chronic) conditions you have, such as diabetes, high blood pressure, thyroid disease, or gallbladder disease.
  • Manage any side effects of your treatment.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Consider joining a support group to help you cope with stress. Your health care provider may be able to recommend a local or online support group.
• Keep all follow-up visits as told by your health care provider. This is important.

Where to find more information

• American Cancer Society: https://www.cancer.org  
• National Cancer Institute (NCI): https://www.cancer.gov  

Contact a health care provider if:

• You have pain in your pelvis or abdomen that gets worse.
• You cannot urinate.
• You have abnormal bleeding.
• You have a fever.

Get help right away if:

• You develop sudden or new severe symptoms, such as:
  • Heavy bleeding.
  • Severe weakness.
  • Pain that is severe or does not get better with medicine.

Summary

• Uterine cancer is an abnormal growth of cancer tissue (malignant tumor) in the uterus. The most common type of uterine cancer begins in the endometrium (endometrial cancer).
• This condition is often treated with surgery to remove the uterus, cervix, fallopian tubes, and ovaries (total hysterectomy) or the uterus and cervix (simple hysterectomy).
• Work with your health care provider to manage any long-term (chronic) conditions you have, such as diabetes, high blood pressure, thyroid disease, or gallbladder disease.
• Consider joining a support group to help you cope with stress. Your health care provider may be able to recommend a local or online support group.