About cancer of the uterus (uterine cancer or endometrial cancer)

What is cancer of the uterus (uterine cancer or endometrial cancer)?

Endometrial cancer begins in the lining (endometrium) of the uterus.

Endometrial cancer is a type of cancer that begins in the uterus. The uterus is the hollow, pear-shaped pelvic organ where fetal development occurs.

Endometrial cancer begins in the layer of cells that form the lining (endometrium) of the uterus. Endometrial cancer is sometimes called uterine cancer. Other types of cancer can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer.

Endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding. If endometrial cancer is discovered early, removing the uterus surgically often cures endometrial cancer.

What are the symptoms for cancer of the uterus (uterine cancer or endometrial cancer)?

Signs and symptoms of endometrial cancer may include:

  • Vaginal bleeding after menopause
  • Bleeding between periods
  • Pelvic pain

What are the causes for cancer of the uterus (uterine cancer or endometrial cancer)?

Doctors don't know what causes endometrial cancer. What's known is that something occurs to create changes (mutations) in the DNA of cells in the endometrium — the lining of the uterus.

The mutation turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Abnormal cells grow and multiply out of control, and they don't die at a set time. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).

What are the treatments for cancer of the uterus (uterine cancer or endometrial cancer)?

Stage I

Treatments. The standard treatment is surgery called a total hysterectomy to remove the uterus and cervix, as well as the fallopian tubes and ovaries.

The surgeon may also do a pelvic washing. That's when a saltwater solution flushes your abdomen. Then it's checked for cancer cells.

For some women, surgery may be enough. But if you have bigger tumors or a fast-spreading cancer, you may need more treatment. Tiny cancer cells may have spread outside the uterus. To avoid a return of your cancer, you may need treatments like radiation therapy, chemotherapy, or vaginal brachytherapy, which delivers radioactive material to cancer cells.

If you have stage 1A endometrial cancer and still want to have children, you may be able to use progestin therapy. These hormones may help the cancer shrink or go away for a period so you can become pregnant. This option can be dangerous if you aren't watched closely. There's a risk that the hormones don't work and the cancer will spread.

Stage II

Treatment. In most cases, you'll get surgery called radical hysterectomy to remove your uterus, the tissues next to it, and the upper part of your vagina. The surgeon may also remove your fallopian tubes and ovaries. You may also need radiation therapy or vaginal brachytherapy.

Stage III

Treatment. If your doctor thinks that the cancer can be taken out with surgery, a surgeon may do a total or radical hysterectomy and remove your fallopian tubes and ovaries. They may also do a pelvic washing. This is followed by chemotherapy or radiation.

If the surgeon thinks that your cancer is too widespread, you may get radiation. This may help shrink the tumor enough for surgery.

Stage IV

Treatment. For most people with stage IV endometrial cancer, the cancer has spread too far for a surgeon to remove it all, but you may still get surgery similar to the kind in earlier stages, as well as radiation, to keep you from bleeding too much.

Hormone therapy, targeted therapy, chemotherapy, and immunotherapy may also help. Talk to your doctor about whether it's a good idea for you to join clinical trial, where researchers are studying new treatments that aren't yet available to everyone.

What are the risk factors for cancer of the uterus (uterine cancer or endometrial cancer)?

Female reproductive system Open pop-up dialog box Close Female reproductive system Female reproductive system

The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system.

Factors that increase the risk of endometrial cancer include:

  • Changes in the balance of female hormones in the body. The ovaries make two main female hormones — estrogen and progesterone. Fluctuations in the balance of these hormones cause changes in the endometrium.

    A disease or condition that increases the amount of estrogen, but not the level of progesterone, in your body can increase your risk of endometrial cancer. Examples include irregular ovulation patterns, which might happen in polycystic ovary syndrome, obesity and diabetes. Taking hormones after menopause that contain estrogen but not progesterone increases the risk of endometrial cancer.

    A rare type of ovarian tumor that secretes estrogen also can increase the risk of endometrial cancer.

  • More years of menstruation. Starting menstruation at an early age — before age 12 — or beginning menopause later increases the risk of endometrial cancer. The more periods you've had, the more exposure your endometrium has had to estrogen.
  • Never having been pregnant. If you've never been pregnant, you have a higher risk of endometrial cancer than someone who has had at least one pregnancy.
  • Older age. As you get older, your risk of endometrial cancer increases. Endometrial cancer occurs most often after menopause.
  • Obesity. Being obese increases your risk of endometrial cancer. This may occur because excess body fat alters your body's balance of hormones.
  • Hormone therapy for breast cancer. Taking the hormone therapy drug tamoxifen for breast cancer can increase the risk of developing endometrial cancer. If you're taking tamoxifen, discuss this risk with your doctor. For most, the benefits of tamoxifen outweigh the small risk of endometrial cancer.
  • An inherited colon cancer syndrome. Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC), is a syndrome that increases the risk of colon cancer and other cancers, including endometrial cancer. Lynch syndrome is caused by a gene mutation passed from parents to children. If a family member has been diagnosed with Lynch syndrome, discuss your risk of the genetic syndrome with your doctor. If you've been diagnosed with Lynch syndrome, ask your doctor what cancer screening tests you should undergo.

Is there a cure/medications for cancer of the uterus (uterine cancer or endometrial cancer)?

Cancer of the uterus (uterine cancer or endometrial cancer) is treated in several ways. It depends on the kind of uterine cancer and how far it has spread. Treatments include surgery, chemotherapy, and/or radiation.

1. Surgery: Doctors remove cancer tissue in operation.
2. Radiation: Using high-energy rays (similar to X-rays) to kill cancer.
3. Chemotherapy: Using special medicines to shrink or kill cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both. Chemo is often given in cycles: a period of treatment followed by a rest period. The chemo drugs may be given on one or more days in each cycle.
Chemo drugs used to treat endometrial cancer may include:
• Paclitaxel (Taxol®)
• Carboplatin
• Doxorubicin (Adriamycin®) or liposomal doxorubicin (Doxil®)
4. Radiation therapy uses powerful energy beams, such as X-rays and protons, to kill cancer cells. In some instances, your doctor may recommend radiation to reduce your risk of cancer recurrence after surgery. In certain situations, radiation therapy may also be recommended before surgery to shrink a tumor and make it easier to remove.
If you aren't healthy enough to undergo surgery, you may opt for radiation therapy only.
Radiation therapy can involve:
• Radiation from a machine outside your body. During external beam radiation, you lie on a table while a machine directs radiation to specific points on your body.
• Radiation placed inside your body. Internal radiation (brachytherapy) involves placing a radiation-filled device, such as small seeds, wires or a cylinder, inside your vagina for a short period of time

Bloody or watery discharge, which might have a bad smell,Bleeding between periods or after menopause,Discomfort or pain in the abdomen
Bleeding or discharge not related to your periods (menstruation) — over 90 percent of women diagnosed with endometrial cancer have abnormal vaginal bleeding,Postmenopausal bleeding,Difficult or painful urination,Pain during intercourse,Pain and/or mass in the pelvic area
Paclitaxel (Taxol®),Carboplatin,Doxorubicin (Adriamycin®) or liposomal doxorubicin

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