What is uterine cancer?
Uterine cancer is a general term that is used to describe a cancer of the uterus (or womb). A uterine cancer that develops in the endometrium (inner lining of the uterus) is called an endometrial cancer. A uterine cancer that develops in the myometrium (muscle wall of the uterus) is called a uterine sarcoma. Uterine sarcomas are very rare.
What are the risk factors for uterine cancer?
The exact cause of uterine cancer is not known, but there are certain risk factors related to the disease. Most of the known risk factors are linked to the balance between the hormones estrogen and progesterone. Some risk factors include:
- Obesity (being very overweight): Fat tissue in the body can change some other hormones into estrogens. Having more fat tissue can increase a woman's estrogen levels and her risk for developing uterine cancer.
- History of not being able to become pregnant or having never given birth: Women who have not been pregnant have a higher risk because of the increased exposure to estrogen.
- Use of tamoxifen: This drug, which is used to treat women with breast cancer, acts like estrogen in the uterus and can increase the risk of uterine cancer.
- Estrogen replacement therapy (ERT): This therapy (the use of the female hormone estrogen to counteract the effects of menopause) can increase uterine cancer risk if progesterone is not used to protect against precancerous changes in the endometrium.
- Ovarian diseases: Women who have certain ovarian tumors have higher-than-normal estrogen levels and lower levels of progestins, which can increase a woman's chance of getting uterine cancer.
- A diet high in animal fat: A high-fat diet can increase the risk of several cancers, including uterine cancer. Because fatty foods are also high-calorie foods, a high-fat diet can lead to obesity, which is a definite uterine cancer risk factor.
- Diabetes: Diabetes has been linked to weight, but some studies suggest that diabetes by itself could be a risk factor for uterine cancer.
- Age: As women get older, the likelihood of uterine cancer increases. Most uterine cancers occur in women age 50 or older.
- Early menstruation: If monthly periods begin before age 12, the risk for this cancer might increase as the uterus might be exposed to estrogen for more years.
- Late menopause: If menopause occurs after age 50, the risk for this cancer might increase as the uterus might be exposed to estrogen for more years.
- Total length (years) of menstruation span: The span (length in years) of menstruation might be a more important factor than the age at which periods started or ended.
- Family history: Uterine cancer risk is increased in some families who are also at risk to develop a certain type of colon cancer.
- Earlier pelvic radiation therapy: Radiation used to treat some other cancers can damage the DNA of cells, increasing the risk of a second type of cancer.
What are the symptoms of uterine cancer?
The following symptoms might occur with uterine cancer or other conditions:
- Vaginal bleeding between normal periods in pre-menopausal women.
- Vaginal bleeding or spotting in post-menopausal women, even a small amount.
- Lower abdominal pain or cramping in the pelvis area.
- Thin white or clear discharge in post-menopausal women.
- Extremely long, heavy, or frequent vaginal bleeding episodes in women over 40.
Diagnosis and Tests
How is uterine cancer diagnosed?
If a woman has any of the symptoms of uterine cancer described above, she should visit her doctor. The doctor will ask her about her symptoms, risk factors, and family medical history. The doctor will also perform a general physical exam and an exam of the pelvis.
These are some of the procedures that might be used in diagnosing uterine cancer:
- Endometrial biopsy: During this procedure, a sample of endometrial tissue is obtained through a very thin flexible tube inserted into the uterus through the cervix. The tube removes a small amount of the endometrium using suction.
- Transvaginal ultrasound or sonography: A transvaginal sonogram uses sound waves to create pictures of the uterus.
- Dilation and curettage (D & C): This procedure is done in the operating room. A special surgical instrument is used to scrape tissue from inside the uterus. Increasingly, in-office hysteroscopy is used to evaluate the endometrium.
- Testing of endometrial tissue: Endometrial tissue samples removed by biopsy or D & C are examined under the microscope to determine whether cancer is present.
- CT or CAT scan (also called computed tomography, computerized tomography, or computerized axial tomography): This is a scan that involves taking a series of detailed pictures of areas inside the body. The pictures are created by a computer linked to an X-ray machine.
- MRI (also called magnetic resonance imaging): This is a procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body.
- CA-125 assay: This blood test can measure the level of CA-125, a substance that is sometimes found in an increased amount in the blood, other body fluids, or tissues. A particular level of CA-125 might suggest the presence of some types of cancer.
Management and Treatment
How is uterine cancer treated?
Surgery is the main treatment for most women with uterine cancer. Radiation therapy, hormone therapy, and chemotherapy may be used, depending on the stage and the specific type of uterine cancer cell found. In certain situations, a combination of treatments might be used. The choice of treatment or treatments will depend on the type and stage of the cancer and the overall medical condition of the patient.
Can uterine cancer be prevented?
Most cases of uterine cancer cannot be prevented, but women can take some measures to reduce their risks by:
- Maintaining a healthy weight.
- Using oral contraceptives.
- Controlling diabetes.
In addition, women who are considering estrogen replacement therapy should talk to their doctors to evaluate their risk of uterine cancer.
The American Cancer Society encourages women to discuss any unexpected bleeding or spotting with their doctors. Women who have or are at high risk for hereditary nonpolyposis colon cancer (HNPCC) should receive annual screenings for uterine cancer with an endometrial biopsy starting at age 35.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
This document was last reviewed on: 12/14/2016