Uterine Cancer

What is the uterus?
The uterus, also called the womb, is a hollow, pear-shaped organ located in a woman's lower abdomen, between the bladder and the rectum.

What are parts of the uterus?

• cervix - the narrow, lower portion of the uterus

• corpus - the broader, upper part of the uterus

• myometrium - the outer layer of the corpus; the muscle that expands during pregnancy to hold the growing fetus

• endometrium - the inner lining of the uterus

What is uterine cancer?
Cancers that occur in each part of the uterus have their own names, such as cervical cancer or endometrial cancer, but are sometimes broadly defined as uterine cancer because the structure is part of the uterus. Cancer of the uterus spreads through the bloodstream or lymphatic system, and is the most common cancer of the female reproductive tract.

What are non-cancerous conditions of the uterus?
Some conditions in the uterus, caused by abnormal, rapid, and uncontrolled division of cells, are not cancer. Three of these benign conditions include:

• Fibroid tumors are common benign tumors of the uterine muscle that do not develop into cancer. Fibroid tumors of the uterus are very often found in women in their forties. And, although single fibroid tumors do occur, multiple tumors are more common.

Symptoms of fibroid tumors, which depend on size and location, include irregular bleeding, vaginal discharge, and frequent urination. For fibroids that press against nearby organs and cause pain, surgery may be necessary. Many times, however, fibroids do not cause symptoms and do not need to be treated. After menstrual periods cease, fibroid tumors may become smaller and may disappear altogether.

• Endometriosis is a benign condition of the uterus that is common among women in their thirties and forties, especially women who have never been pregnant. Tissue that looks and acts like endometrial tissue begins to grow in unusual places, such as on the surface of the ovaries, on the outside of the uterus, and in other tissues in the abdomen.

• Hyperplasia is an increase in the number of normal cells lining the uterus. Although it is not cancer, it may develop into cancer in some women. The most common symptoms are heavy menstrual periods, bleeding between periods, and bleeding after menopause.

• age 50 or over
• history of endometrial hyperplasia
• estrogen replacement therapy (ERT)
• being overweight
• diabetes
• hypertension (high blood pressure)
• history of other cancers
• history of taking tamoxifen for breast cancer treatment or prevention
• Caucasian women

What are the symptoms of uterine cancer?
According to the National Cancer Institute, abnormal bleeding after menopause is the most common symptom of cancer of the uterus. Other symptoms, according to the National Cancer Institute, may include:

• unusual vaginal bleeding or discharge
• difficult or painful urination
• pain during sexual intercourse
• pain in the pelvic area

Cancer of the uterus often does not occur before menopause. It usually occurs around the time menopause begins. The occasional reappearance of bleeding should not be considered simply part of menopause. It should always be checked by a physician.

How is uterine cancer diagnosed?
When symptoms suggest uterine cancer, the following may be used to make a positive diagnosis:

• a detailed medical history -- family and personal

• a thorough physical exam

One or more of the following:

• pelvic examination of the uterus, vagina, ovaries, bladder, and rectum (may include a Pap test)

• biopsy -- surgically removing a small amount of uterine tissue to be examined under a microscope by a pathologist

• dilation and curettage (D and C) -- surgery in which the cervix is dilated (widened) and a curette (a small spoon-shaped instrument) is inserted to remove (by applying suction through a slender tube, called suction curettage) pieces of the lining of the uterus. The pieces are then examined for evidence of cancer.

When cancer cells are found, other tests are used to determine if the disease has spread from the uterus to other parts of the body. These procedures may include:

• blood tests

• chest x-rays

• computed tomography (CT or CAT) scans of various sections of the abdomen

• an ultrasound to view organs inside the body

• special exams of the bladder, colon, and rectum

How may uterine cancer be treated?
Specific treatment for uterine cancer will be determined by your physician(s) based on:

• your overall health and medical history
• extent of the disease
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disease
• your opinion or preference

Methods of treatment may include:

• hysterectomy
• bilateral salpingo-oophorectomy
• radiation therapy
• hormone therapy
• chemotherapy
• other