Uterine Cancer

Abnormal vaginal bleeding, bleeding after menopause, and pelvic pain are common symptoms of uterine cancer. Menopausal women may notice a clear or whitish vaginal discharge. As uterine cancers increase in size or spread to other organs, they can create a sensation of pelvic fullness or interfere with urination or bowel movements.

Common symptoms of uterine cancer include:

• Clear or whitish vaginal discharge after menopause
• Difficult or painful urination or bowel movements
• Heavy vaginal bleeding
• Pain during sexual intercourse
• Pelvic or abdominal pain, pressure or fullness
• Unintended weight loss
• Vaginal bleeding between periods
• Vaginal bleeding for more than seven days
• Vaginal spotting or bleeding after menopause

In some cases, uterine cancer can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

• Inability to urinate or have bowel movements

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing

• Severe pelvic or abdominal pain

• Uncontrolled or heavy bleeding, (hemorrhage)

The cause of uterine cancer is not known, but excess estrogen seems to increase the risk. During a woman’s reproductive years, the uterine lining, or endometrium, is in a continual cycle of growth and maturation. Estrogen encourages growth of the endometrium, while progesterone encourages maturation. When pregnancy does not occur, the resulting decrease in progesterone levels causes endometrial shedding and menstruation. High estrogen levels can lead to excessive growth (hyperplasia) of the endometrium, which can develop into cancer.

Uterine cancer occasionally runs in families, and individuals who have syndromes that increase the general risk of cancer may develop endometrial cancer.

A number of factors increase the risk of developing uterine cancer. Not all women with risk factors will get uterine cancer. Risk factors for uterine cancer include:

• Diabetes

• Endometrial hyperplasia

• Estrogen therapy without progesterone therapy

• Family history of endometrial cancer or familial cancer syndromes

• First menstrual period at a young age

• Infertility

• Late onset of menopause

• Nulliparity (having had no children)

• Obesity

• Pelvic radiation therapy history

• Polycystic ovarian syndrome (condition associated with multiple small ovarian cysts and menstrual irregularities)

• Tamoxifen (drug used in breast cancer treatment)

The goal of uterine cancer treatment is to permanently cure the cancer or to bring about a complete remission of the disease. Remission means that there is no longer any sign of the disease in your body, although it may recur later.

When identified in an early stage, uterine cancer may be curable with surgery alone or in combination with radiation therapy. Your doctor may add chemotherapy to your treatment plan if your cancer is more advanced. Women who, for various reasons, are not eligible for surgery may be treated with radiation therapy alone. After your treatment is complete, continued regular follow-up with your doctor is recommended.

It is important to follow your treatment plan carefully to ensure the best possible chance for a cure and to detect any possible recurrence early.

Common treatments for uterine cancer include:

• Chemotherapy to attack cancer cells

• Hormonal therapy to reduce estrogen production or help counteract the effects of estrogen

• Participation in a clinical trial test promising new therapies and treatments for uterine cancer

• Radiation therapy to attack cancer cells

• Surgery to remove the cancer and determine the extent of any spread

Other therapies may be added to enhance your general state of health and help offset any side effects of treatment:

• Antinausea medications

• Blood cell growth factors to increase the number of healthy blood cells

• Blood transfusions to temporarily replace blood components, such as red blood cells, that have been reduced or lost

• Dietary counseling to help maintain strength and nutritional status

• Pain medications as needed

Some complementary treatments may help some women to better deal with uterine cancer and its treatments. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for full medical care.

Complementary treatments may include:

• Acupuncture
• Massage therapy
• Yoga

In cases in which uterine cancer has progressed to an advanced stage and has become unresponsive to treatment, the goal of your treatment may shift from curing the disease to focusing on measures to keep you comfortable and maximize quality of life. Hospice care involves medically controlling pain and other symptoms while providing psychological and spiritual support, as well as services to support your family members.

Complications of untreated uterine cancer can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of uterine cancer include:

• Anemia (low red blood cell count)
• Bowel obstruction
• Hemorrhage
• Spread of cancer