The Basics of Uterine Cancer

Cancer of the inner lining of the uterus, called the endometrium, is the most common cancer of the female reproductive tract. Cancer of the uterus, or uterus cancer, is commonly referred to as uterine cancer. According to the American Cancer Society, an estimated 39,300 new cases of uterine cancer, most of which are endometrial cancers, will be detected in the United States in 2002. The good news is that, if uterine cancer is detected and treated early, the prognosis for survival of uterine cancer is excellent.

The vast majority of women who are diagnosed with uterine cancer are menopausal; it is rare in women under the age of 30, and uncommon in women under 40. Unlike ovarian cancer, uterine cancer has a major, identifiable symptom in its early stages: abnormal vaginal bleeding. This is a symptom of the disease in over 95 percent of uterine cancer cases. Pelvic pressure is another common symptom, as is difficulty and pain during urination and pain during intercourse. If your cycles have become abnormal in any way — no matter what your age — contact your health care professional.


Abnormal bleeding as a symptom of uterine cancer

A woman's bleeding pattern changes as she approaches menopause. Typically, the amount of bleeding decreases and the time between bleeding increases. Some women may experience short periods with heavy bleeding.

One of the most common and annoying symptoms you may notice during your 40s is that your periods become irregular. They may be heavier one month and then very light the next. They may get shorter or last longer. You may even begin to skip your period every few months or lose track of when your periods should start and end. These symptoms are caused by irregular estrogen and progesterone levels. For example, if you don’t ovulate one month — which is common for women in their late 40s — progesterone isn’t produced to allow for effective shedding of the endometrium.

One note of caution: although irregular menstrual periods are common as you get closer to menopause, they can also be a symptom of uterine abnormalities or uterine cancer. If your periods stop for several months and then start again with heavy bleeding or if you start bleeding after menopause, consult with a gynecologist as soon as possible for an evaluation. Be sure to mention any menstrual irregularities during regular checkups. Most of the time, irregular bleeding is normal prior to menopause.

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)


The Basics of Uterine Cancer (<i>cont'd</i>)

In addition to menopause, other hormonal causes may include thyroid and adrenal gland imbalance. Another cause of excessive bleeding falls under the heading of structural causes, including fibroids, polyps, scar tissue, infection and precancerous conditions.

One more note on abnormal bleeding patterns: if your cycles have become abnormal in any way, contact your health care professional. If you have gone through menopause and are not taking hormones, any uterine bleeding is abnormal. There are a myriad of conditions your health care professional might consider, depending on your symptoms.


Stages of the disease

If you are diagnosed with uterine cancer, you should know that the cure rates for this disease depend on whether or not the cancer has spread to other parts of the body. In order to know how far the disease has spread, surgical evaluation is required for evidence of metastasis.

To plan treatment, a health care professional needs to know the stage of the disease. The following stages are used to assess cancer of the endometrium:

  • Stage I: Cancer is found only in the main part of the uterus.
  • Stage II: Cancer cells have spread to the cervix.
  • Stage III: Cancer cells have spread outside the uterus but have not spread outside the pelvis.
  • Stage IV: Cancer cells have spread beyond the pelvis, to other body parts, or into the lining of the bladder (the sac which holds urine) or rectum.
  • Recurrent: Recurrent disease means the cancer has come back (recurred) after it has been treated.

Sarcoma of the Uterus

Sarcoma of the uterus, a very rare kind of cancer in women, is a disease in which cancer cells start growing in the muscles or other supporting tissues of the uterus. Women who have received therapy with high-dose X-rays to their pelvis are at high risk for this disease.

Sarcoma of the uterus usually begins after menopause. The prognosis and choice of treatment depend on the stage of the sarcoma, how fast the cancer cells are growing and the woman's general health. The stages of sarcoma are basically the same as those for uterine cancer.

Copyright 2003 National Women's Health Resource Center Inc. (NWHRC)