Uterine cancer begins in the uterus also known as the womb, which is the pear-shaped organ in a woman's pelvis where a baby grows during pregnancy. Uterine cancer is also known as endometrial cancer because it forms in the lining or endometrium of the uterus. Most uterine cancers begin in cells that make and release mucus and other fluids. Uterine cancer is the fourth most common cancer in women in the United States, and it is the most commonly diagnosed gynecologic cancer.
Uterine cancer may cause vaginal discharge or bleeding, or cause pain or pressure in your pelvis in the lower abdomen area that is not normal for you. Please see your doctor if you experience these symptoms.
All women are at risk for uterine cancer, but the risk increases with age. Most uterine cancers occur in women who are post-menopausal the time of life when menstrual periods stop. There is no way to know for sure if you will get uterine cancer. Your doctor will advise you about how often to be checked for uterine cancer, especially if you have factors that increase your chance of getting it. Some women get it without being at high risk.
Several Factors that May Increase Your Risk
The chance that you will develop uterine cancer may increase if you:
- Are older than 50
- Are obese with an abnormally high, unhealthy amount of body fat
- Take estrogen by itself (without progesterone) for hormone replacement during menopause
- Have had trouble getting pregnant, or have had fewer than five periods in a year before starting menopause
- Take tamoxifen, a drug used to treat certain types of breast cancer
- Have close family members who have had uterine, colon, or ovarian cancer
- Early menstruation increases the number of years the body is exposed to estrogen, increasing the risk of endometrial cancer
- Late menopause: Women who reach menopause at an older age are exposed to estrogen for a longer time and have an increased risk of endometrial cancer
- Never being pregnant: Because estrogen levels are lower during pregnancy, women who have never been pregnant are exposed to estrogen for a longer time than women who have been pregnant
Protective Factors that May Decrease Your Risk
The following factors may decrease your risk for uterine or endometrial cancer if you:
- Take a combination oral contraceptives with estrogen and progestin has a protective effect that can last for many years beyond oral contraceptive use
- Are pregnant or breastfeeding, lowering a woman's estrogen levels
- Have a diet low in saturated fats and high in fruits and vegetables
While there is no simple, reliable way to screen for uterine or endometrial cancer in women who do not have any signs or symptoms, there are diagnostic tests to detect uterine or endometrial cancer once you begin experiencing symptoms, or if you are a high-risk patient who has not yet demonstrated symptoms:
- Transvaginal ultrasound (TVU) examines the vagina, uterus, fallopian tubes, and bladder through a probe inserted into the vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumors by looking at the sonogram.
- Endometrial sampling is the removal of tissue from the endometrium by inserting a thin, flexible tube through the cervix and into the uterus. The tool gently scrapes a small amount of tissue from the endometrium that is viewed under a microscope to look for cancer cells.
If you have been diagnosed with uterine cancer, ask to be referred to a gynecologic oncologist—a doctor who has been trained to treat cancers of the female reproductive system. Most patients have surgery to remove as much of the uterine tumor as possible. Even if the doctor removes all the cancer that can be seen at the time of the surgery, the doctor may give some patients radiation therapy or hormone treatment after surgery to kill any cancer cells that remain. Your doctor will work with you to create a treatment plan that may include surgery, hormone therapy, radiation therapy, chemotherapy or a combination of these treatments.
The different types of surgery to remove uterine cancer include:
- Hysterectomy: A surgical procedure to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
- Unilateral Salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.
- Bilateral Salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes. Different types of treatment are available for patients with endometrial cancer including surgery to remove as much of the tumor as possible.
- Laparoscopic, Robotic Hysterectomy: A minimally invasive surgical procedure treats endometrial cancer using the Da Vinci Robot to augment the laparoscopic removal of the uterus and lymph nodes. The robot enables our surgeons to do more complex operations laparoscopically than would otherwise be possible.
Hormone therapy is a cancer treatment that removes hormones which are substances made by glands in your body and circulated into the bloodstream, and stops cancer cells from growing. Some hormones can cause certain cancers to grow.