Types and Stages of Uterine Cancer
Cancer of the uterus is the fourth most common cancer among women in the United States. It is diagnosed in more women than ever before and the numbers continue to rise. Experts estimate that more than 65,000 women will be diagnosed with uterine cancer in 2020. The most common type of uterine cancer is endometrial cancer, cancer that affects the uterine lining. Learn more about the different types of uterine cancer and how it is staged.
Uterine Cancer Types
Endometrial cancer, or endometrial adenocarcinoma, is the most common type of uterine cancer. It is diagnosed in 80 to 90% of women with uterine cancer. It is called endometrial cancer because it affects the cells that make the innermost uterine lining, the endometrium.
There are three rarer forms of uterine cancer:
- Adenosquamous carcinoma
- Papillary serous carcinoma, also called uterine serous adenocarcinoma
- Uterine sarcoma
Adenosquamous carcinoma occurs in about 10% of cases. The cancer starts in the squamous cells, which line the outside of the uterus. Papillary serous carcinoma affects about 5% of women with uterine cancer. Uterine sarcoma accounts for another 5% of uterine cancers. This tumor starts in the uterine wall itself.
Determining Uterine Cancer Stages
All cases of uterine cancer are assigned a stage depending on how far they progressed. The stage determines the type of treatment women receive.
Here is the description of each stage:
- Stage I (1): The cancer is confined to the uterus. It has not spread anywhere in the body.
- Stage II (2): The cancer has spread to the cervix but nowhere else.
- Stage III (3): The cancer has spread beyond the cervix and uterus. Stage 3 cancer is divided into subgroups: 3A has spread to the tissue that covers the uterus, the fallopian tubes, and/or the ovaries; 3B has spread to the vagina; 3C has spread to the pelvic lymph nodes.
- Stage IVA (4A): The cancer has spread to the bladder or bowel. Stage IV is metastatic uterine cancer.
- Stage IVB (4B): The cancer has spread beyond the pelvic lymph nodes to other lymph nodes and may have spread to other organs like the liver or lungs.
- Recurrent: Recurrent uterine cancer is cancer that has returned after treatment.
Getting a Uterine Cancer Diagnosis
Uterine cancer can be difficult to diagnose. Often, women may think their symptoms are caused by something else, so diagnosis is delayed. The most common uterine cancer symptoms are:
- Irregular vaginal bleeding
- Heavier or longer than normal menstrual periods
- Vaginal bleeding after menopause
- Pain or discomfort in the pelvic area
Women who experience these signs should see their doctor for testing, to rule out uterine cancer or to diagnose it as early as possible.
Diagnostic tests include:
- Pelvic exam: Your doctor feels your uterus and other reproductive organs for any abnormalities.
- Pap smear: Although Pap smears are done to detect cervical cancer, sometimes they can show signs of uterine cancer.
- Biopsy: Your doctor may take a sample of tissue from your uterine wall for testing. A pathologist examines it for abnormal cells. For the biopsy, your doctor will insert a long narrow tube through the vagina, cervix and into the uterus. The doctor uses a suctioning tool to remove a bit of tissue.
- Dilation and curettage: A ‘D&C’ is a minor surgical procedure. Your doctor “cleans out” your uterus, removing endometrial tissue, which she sends to the pathology lab for testing.
- Ultrasound: A transvaginal ultrasound is done with a special wand (transducer) inserted in your vagina. When it’s in place, sound waves are sent through the wand creating pictures of your uterus on a monitor. This allows your doctor to see how thick your uterine wall is.
- Computed tomography scan (CT or CAT scan): Similar to an X-ray but more detailed, a CT scan captures images of your uterine wall from different angles. If there is a tumor, your doctor can determine its size.
- Magnetic resonance imaging (MRI): An MRI produces images similar to a CT scan, but uses a different technology without radiation.
The stage of uterine cancer is an important piece of information in treatment decisions. Surgery (hysterectomy or removal of more organs) is part of uterine cancer treatment in most cases. Women with stage III or stage IV cancer, or women who cannot undergo surgery, may be candidates for hormone therapy, targeted therapy, and clinical trials. Women with early stage uterine cancer may be candidates for a trial as well.
Before making treatment decisions, make sure you understand your type and stage of cancer and the benefits and risks of specific treatments for that type and stage (also based on your age and pre-existing conditions).