Uterine cancer is a serious illness but it’s treatable. The five-year survival rate for uterine cancer is 81%. But it is important to remember that survival rates are only estimates and no two people with cancer are the same.
Uterine cancer starts in cells that grow abnormally in the lining of the uterus or in the muscle tissue (the myometrium). There is no preventive screening for this cancer.
Endometrial cancer
Uterine cancer is a disease that develops when abnormal cells in the uterus begin to grow and multiply out of control. These cancer cells can spread to other parts of the body and cause other health problems, such as pelvic pain or infertility. The exact causes of uterine cancer are not fully understood, but certain risk factors can increase the chances that a woman will get it. These risk factors include a family history of the disease, aging, and taking hormones, such as estrogen and progesterone.
The most common symptom of endometrial cancer is unusual vaginal bleeding or spotting. Other symptoms include abdominal pain and a feeling that there is something stuck in your lower abdomen. If you have these symptoms, talk to your doctor about them. Your doctor will examine you and may order blood tests and a pelvic ultrasound test.
If your doctor thinks you have endometrial cancer, they will probably ask you to have a hysteroscopy. This is a procedure that uses a tiny telescope to see inside your uterus. The doctor will put a tube into your vagina and fill it with salt water to make it easier to see the lining of the uterus. Then, they will remove some tissue from the lining of your uterus to check for cancer cells.
Your doctor will use these tissue samples to find out if your cancer has spread within your uterus or to other parts of your body. The process used to find out how far your cancer has spread is called staging.
The most common treatment for uterine cancer is surgery to remove the uterus, cervix, fallopian tubes and ovaries. Your doctor might also give you chemotherapy or hormonal therapy after surgery to help prevent the cancer from returning. Chemotherapy involves giving you drugs that block the growth of cancer cells or kill them. Hormonal therapy uses drugs to stop the hormones oestrogen and progesterone from helping the cancer to grow. You might take this as tablets or, if you have had a hysterectomy, through a hormone-releasing intrauterine device (IUD).
Uterine sarcoma
Uterine sarcoma is rare and aggressive and has a poor prognosis. Surgery is the cornerstone of treatment. Currently, total abdominal hysterectomy with bilateral salpingo-oophorectomy is the standard of care. Surgical management depends on several clinical and histopathologic factors including tumor histology, oophorectomy status, menopausal state, and desire for fertility preservation. Recent advances in the classification of uterine sarcoma and improved imaging modalities should allow better differentiation of benign leiomyomas from malignant tumours preoperatively. However, a definitive diagnosis can only be made after biopsy of the lesion.
Treatment may include radiation therapy, chemotherapy, and/or hormone blockade. The use of multiple modalities has been shown to improve survival. Hormone blockade is used to decrease the production of estrogen and testosterone, which encourage cancer cells to grow.
Chemotherapy is a drug that kills cancer cells or slows their growth. The type of chemotherapy your doctor prescribes will depend on the type of uterine sarcoma you have. Some types of uterine sarcoma are resistant to certain chemotherapy drugs, so your doctor will prescribe a different medication.
The most common symptoms of uterine sarcoma include pain in your pelvic area and bleeding from the uterus. If you experience these symptoms, see your healthcare provider right away. Your doctor will also check for signs of cancer spread to other parts of your body. These tests include blood chemistry studies, CT scans, and ultrasounds.
Cancer that has spread to other parts of your body is called metastatic disease. There are three ways that cancer can spread to other parts of your body: through the blood, through lymph nodes, or by forming a new tumor in another part of your body. If your uterine sarcoma has spread to other areas of the body, you will need additional treatments.
If you have a uterine sarcoma, your doctor will likely recommend that you participate in a clinical trial. These trials test new methods of treating uterine cancer. The clinical trials are conducted at hospitals, universities, and other medical centers. Patients can volunteer to participate in a clinical trial. You can learn more about clinical trials from your healthcare provider or from online resources.
Uterine carcinosarcoma
Uterine carcinosarcoma (UCS) is a rare cancer that starts in the muscle wall of the uterus. It looks like a mix of endometrial adenocarcinoma cells and sarcoma cells. It usually develops in people who are 60 or older. It rarely affects men. In the United States, about two out of 100,000 people get this type of cancer each year. It is harder to treat than other types of uterine cancer.
The main treatment for uterine cancer is surgery to remove the tumor and some of the tissue around it. Radiation therapy may also be used. This can be directed to the whole pelvis or only to the area where the tumor is. It can be given after surgery or before surgery to kill any remaining cancer cells. It is sometimes given with chemotherapy or hormone therapy.
Some people with uterine cancer need radiation to other areas of the body to control their symptoms or prevent the cancer from spreading. For example, if the cancer has spread to the lung, doctors might treat it with radiation to the chest and abdomen. They might also give the patient medicine to help prevent bone pain.
After a person has surgery, they can have hormone therapy or chemotherapy to kill any remaining cancer cells. Some people with uterine cancer get this type of medicine by mouth, while others have it injected into the veins. People with uterine cancer often feel tired and weak after treatment. They might need help with daily tasks, such as cooking or cleaning. They might also need emotional support to cope with their illness and treatment.
A person with uterine cancer can get support from groups for people who have this disease and their families. They can also find out more about treatment options by talking to their doctor or getting a referral to a specialist. They can also try a complementary or alternative medicine (CAM) approach to health care, such as acupuncture.
People with uterine cancer can participate in clinical trials of new treatments. These studies are done to see if the treatments are safe and work. The National Cancer Institute has information about clinical trials for uterine cancer.
Treatment
Cancer of the uterus usually starts in cells that line the uterus (the small, pear-shaped organ in your pelvis where a baby grows). But it can also start in muscle tissue or the connective tissues surrounding the uterus. There are two types of uterine cancer: endometrial cancer and uterine sarcoma.
Uterine cancer often doesn’t cause any symptoms until it has spread to other parts of the body. But it can be diagnosed with a pelvic exam, blood tests and imaging tests such as X-rays and CT scans. A biopsy may be needed to confirm the diagnosis.
The first treatment option is surgery to remove your uterus, sometimes with the ovaries and fallopian tubes removed. A surgeon will also remove any tissues that have cancer. Your doctor might recommend hormone therapy after surgery to help prevent the cancer from returning. You might have chemotherapy or targeted therapy with or without radiation to destroy any remaining cancer cells.
Women with uterine cancer are most likely to be diagnosed when they are over 50 and have stopped having periods (postmenopausal). But anyone who has abnormal vaginal bleeding should see a doctor right away, especially if the bleeding is very heavy or happens between your regular periods.
Researchers aren’t sure what causes uterine cancer, but it seems to develop when cells mutate and grow out of control, forming a tumor. Some things might raise a person’s risk of getting the disease, including:
The most common type of uterine cancer is endometrial carcinoma. This starts in the cells that line the uterus and sometimes forms a thick layer of tissue. The most common symptoms are bleeding that is heavier or longer than normal, pain or pressure in the pelvis and abdominal area and vaginal discharge that changes from white to brown or black.
A less common but still serious type of uterine cancer is uterine sarcoma, which starts in the muscles of the uterus or its surrounding tissues. It makes up fewer than 5 percent of uterine cancer cases. Uterine sarcoma is often more aggressive than endometrial carcinoma.
