What is uterine cancer?
Cancer that starts in the uterus is called uterine cancer. Most uterine cancers are endometrial cancers, which originate in the lining of the uterus. Uterine cancer is the most common gynecologic cancer, affecting more than 43,000 women annually in the United States (Source: NCI).
Common symptoms of uterine cancer are abnormal vaginal bleeding and bleeding after menopause. You may also have a vaginal discharge. The tumor may cause pelvic pain and may make it difficult or painful to urinate.
The cause of uterine cancer is not known, but high estrogen levels may play a role in its development. The risk is increased in women who menstruate longer than average, women who began puberty early, women who have never given birth, and women who start menopause late. Risk is also increased in women who have diabetes, are obese, have infertility problems, or have polycystic ovarian syndrome (PCOS). Medications such as tamoxifen and estrogen, when not combined with progesterone, may also increase the risk of ovarian cancer.
When uterine cancer is suspected, a biopsy is typically done to confirm the diagnosis. Caught early, uterine cancer has an excellent prognosis and can be successfully treated with surgery. Radiation therapy is often recommended after surgery, or it may be used to treat women who, for various reasons, are not candidates for surgery. Chemotherapy may also be used in the treatment of more advanced uterine cancers.
To minimize complications and ensure that you have the best opportunity for a cure, seek prompt medical care if you develop symptoms suggestive of uterine cancer. Some complications of uterine cancer can be serious or even life threatening. Seek immediate medical care (call 911) if you, or someone you are with, experience severe symptoms such as the inability to have a bowel movement or urinate, uncontrollable or severe vaginal bleeding, or severe pelvic or abdominal pain.
What are the symptoms of 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
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
Serious symptoms that might indicate a life-threatening condition
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)
What causes uterine cancer?
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.
What are the risk factors for uterine 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:
Estrogen therapy without progesterone therapy
Family history of endometrial cancer or familial cancer syndromes
First menstrual period at a young age
Late onset of menopause
Nulliparity (having had no children)
Pelvic radiation therapy history
Tamoxifen (drug used in breast cancer treatment)
How is uterine cancer treated?
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
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:
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:
- Massage therapy
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.
What are the potential complications of uterine cancer?
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: