Uterine Sarcoma
Overview
What is uterine sarcoma?
Uterine sarcoma is a type of cancer that forms in the muscles or tissues of the uterus, or womb. Uterine sarcoma is different from endometrial cancer, which is cancer of the endometrium (the lining of the uterus). Uterine sarcoma is very rare.
Who is at risk for having uterine sarcoma?
Women who have had radiation therapy in the pelvis area, or who have been treated with the drug tamoxifen for breast cancer, have a greater risk of developing uterine sarcoma.
What is cancer staging?
One of the biggest concerns about a cancer diagnosis is whether the cancer has metastasized (spread) beyond its original location. To determine this, the doctor assigns a number (I through IV) to the diagnosis. The higher the number, the more the cancer has spread throughout the body. This is called "staging." The doctor needs this information in order to plan the treatment.
What are the stages of uterine sarcoma?
The stages of uterine sarcoma are:
- Stage I: the cancer is in the uterus only.
- Stage II: the cancer has spread to the cervix.
- Stage III: the cancer has spread beyond the uterus and cervix but is still contained within the pelvis.
- Stage IV: the cancer has spread to areas outside the pelvis, including the bladder, abdomen, and groin.
Symptoms and Causes
What are the signs and symptoms of uterine sarcoma?
The main signs and symptoms of uterine sarcoma are:
- Unusual bleeding from the vagina that is not related to menstrual periods, or that happens after menopause
- A mass (lump or growth) in the vagina
- Pain in the abdomen
- Feeling full at all times
- Having to urinate often
Diagnosis and Tests
How is uterine sarcoma diagnosed?
If your doctor thinks you might have uterine sarcoma, he or she will perform a physical examination and take your medical history. Your doctor will also conduct a pelvic examination of the vagina, cervix, uterus, Fallopian tubes, ovaries, and rectum. To examine these organs, the doctor inserts a gloved hand into the vagina and rectum to feel for anything unusual.
Your doctor may also perform the following procedures:
- Pap test: a screening test in which a sample of cells is taken from the cervix and vagina with a speculum (a device used to widen the vagina). The cells are examined under a microscope to look for cancer.
- Transvaginal ultrasound: Ultrasound is used to create images of soft tissue structures, including female reproductive organs. During this approach, a specialized transducer is inserted in the vaginal canal about 2 to 3 inches to examine the uterus and ovaries.
- Endometerial biopsy: a tissue sample is taken from the endometrium (the lining of the uterus) for examination.
- Dilation and curettage (D&C): a minor surgical procedure to remove tissue from the uterus. The name refers to the dilation (widening) of the cervix, into which a thin instrument called a curette is inserted. The doctor then uses a suction device or a scraping instrument, called a curette, to clean out tissue from the uterus.
Management and Treatment
How is uterine sarcoma treated?
Uterine sarcoma is treated with one or more of these therapies: surgery, radiation therapy, chemotherapy, and hormone therapy.
Surgery
Surgery to remove the cancer or a part of the body is the most commonly used treatment for uterine sarcoma. The surgeon may take out the mass itself, or may perform one of these procedures:
- Hysterectomy: removal of the uterus and cervix.
- Total hysterectomy with salpingo-oophorectomy: removal of the uterus and one or both ovaries and one or both Fallopian tubes.
- Radical hysterectomy: removal of the uterus, cervix, both ovaries, both Fallopian tubes, and some surrounding tissue.
- Lymphadenectomy: removal of the lymph nodes to check them for cancer.
- Laparotomy: an incision is made in the abdomen, which is examined for cancer. In some cases, an organ may be removed.
Radiation therapy
Radiation therapy is a form of cancer treatment that uses high energy X-rays to kill cancer cells while minimizing damage to healthy cells. Radiation therapy can either be internal (placed in the body) or external (delivered by a machine outside the body). In the treatment of uterine sarcoma, some women receive both internal and external radiation.
Side effects of radiation therapy include:
- Fatigue (feeling tired)
- Diarrhea
- Nausea and vomiting
- Changes to the skin
- Irritations in the bladder
- Edema (swelling) in the legs
Chemotherapy
Chemotherapy is the use of medications to kill or to slow the growth of rapidly multiplying cancer cells. These medications are often given intravenously (through a needle into a blood vessel) and can have major side effects. For some patients who have uterine sarcoma, radiation therapy and chemotherapy are given together.
Side effects of chemotherapy include:
- Nausea and vomiting
- Hair loss
- Loss of appetite
- Low blood count
- Fatigue
Hormone therapy
Hormones are substances that the body produces to regulate certain functions. Examples include testosterone and estrogen. In some cases, hormones may help a cancer to grow.
Hormone therapy is used to stop the growth of a cancer by blocking the action of the hormones. Hormones used in treating uterine sarcoma include progestins, gonadotropin-releasing hormone agonists, and aromatase inhibitors.
Outlook / Prognosis
What is the prognosis (outlook) for women who have been treated for uterine sarcoma?
After treatment, patients must see their doctors on a regular basis for follow-up. Women who have been successfully treated for uterine sarcoma have a greater risk for certain other types of cancer, including breast cancer, colon cancer, bladder cancer, vaginal cancer, and rectal cancer.
If you are diagnosed with cancer, it's important to realize that you are not alone. You have your family and friends, and there are support groups. Ask your doctor for information about these groups. You can also contact your local chapter of the American Cancer Society for more information.
In addition, your doctor can refer you to a social worker or a mental health professional to help you deal with the emotional aspects of your disease.
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