Uterine Cancer

Uterine cancer -- also called sarcoma of the uterus -- is a very rare kind of cancer in
women. It is a disease in which cancer (malignant) cells start growing in the muscles or other
supporting tissues of the uterus. Cancer of the uterus is different from cancer of the
endometrium, a disease in which cancer cells start growing in the lining of the uterus. You
should see your doctor if you have bleeding after menopause (the time when you no longer
have menstrual periods) or bleeding that is not part of your menstrual cycle. Cancer of the
uterus usually occurs after menopause. Most Uterine CA are endometrioid (originating in the
lining of the uterus). After breast, colorectal, and the lung cancer, endometrial cancer is the
fourth most common cancer in women and the most common pelvic neoplasm. Cumulative
exposure to estrogen is considered the major risk factor. This exposure occurs with the use of
estrogen replacement therapy without the use of progestin, early menarche, late menopause,
nulliparity, and anovulation.

Risk factor/ Cause

 Age: at least 55 yrs; median age, 61 yrs.

 Postmenopausal bleeding
 Obesity
 Unopposed estrogen therapy(estrogen use without progesterone, which offsets
the risk of unopposed estrogen)
 Other: nulliparity, truncal obesity, late menopause (after 52 yrs of age) and
possibly, use of Tamoxifen

Symptoms

Abnormal vaginal bleeding

 Vaginal discharge
 Vaginal discharge with mucus and blood - in post-menopausal women
 Difficult urination
 Painful urination
 Pain during intercourse
 Pelvic pain

Assessment and Diagnostic Findings

 Physical exam
 Pelvic exam
 Pap smear
 Transvaginal ultrasound
 Biopsy
Management

• Surgery - the most common treatment choice.

• Hysterectomy
• Total abdominal hysterectomy
• Bilateral salpingo-oophorectomy
• Lymphadenectomy

Types

• Area that is affected:

o Endometrial Carcinoma - affects the endometrial lining layer of the uterus.
o Uterus Sarcoma - affects the muscle cells of the uterus.
o Cervical cancer
• Stage of cancer:
o Stage I Uterine cancer - only affects uterus and not cervix.
o Stage II Uterine cancer - spread from uterus to cervix.
o Stage III Uterine cancer - spread beyond uterus and cervix to local pelvis
area (e.g. pelvic lymph nodes) but not to bladder or rectum.
o Stage IV Uterine cancer - spread to rectum or bladder, or further
metastatic cancer.