Uterine cancer facts and risks

When you are diagnosed with uterine cancer, also called endometrial cancer, you may feel shocked and frightened. It can turn your life upside down as you try to cope with your own feelings and your family's needs and fears.

About 43,000 women in the US are diagnosed with uterine cancer each year-it is the fourth most common cancer in women. There are two major types of uterine cancer, adenocarcinoma, commonly called endometrial cancer, and sarcoma, which develops in the outer layer of muscle. About 95% of uterine cancers are endometrial cancers.

What is it?
Cancer of the uterus begins in the womb or uterus, a hollow, pear-shaped organ that is part of a woman's reproductive system. Sometimes the cells of the uterus grow abnormally, forming a mass of tissue called a tumor. The tumor may be benign or malignant-uterine cancer is caused by malignant tumors. The cells in these tumors grow rapidly and can spread to other parts of the body. The most frequently diagnosed type of uterine cancer begins in the lining, which is called the endometrium. This is why uterine cancer is frequently called endometrial cancer.

Symptoms
This type of cancer usually takes years to develop and occurs after menopause. There are currently no standard screening tests, so you should see your doctor if you have the following symptoms:

• Unusual vaginal bleeding or discharge
• Vaginal bleeding after you have gone through menopause
• Painful urination
• Pain during sexual intercourse
• Pain in the pelvic area

There are many other reasons for these symptoms caused by conditions not related to this cancer. Your physician can help to determine your particular medical condition.

Risk factors
No one knows for sure the exact causes of uterine cancer, but studies show the following risk factors:

• Age. This cancer is usually seen in women over 50.
• Endometrial hyperplasia, an increased number of cells in the uterine lining (endometrium).
• Hormone replacement therapy. Women who use estrogen without progesterone have an increased risk.
• Obesity and related conditions. Because the body makes estrogen in fatty tissue, obese women are at higher risk. This is also true of women with diabetes and high blood pressure.
• Tamoxifen. This drug is used by women to prevent or treat breast cancer.
• Race. White women are more likely than African American women to get uterine cancer.
• Family history. If several family members have had uterine or colon cancer, the risk is higher for uterine cancer.

Diagnosis and treatment
To accurately diagnose uterine cancer, your physician may perform several tests, including a pelvic exam, transvaginal ultrasound, and a biopsy. Your doctor may also order chest x-rays, CT scan, MRI, and other procedures to determine the stage or extent of the disease.

The most common treatment is surgery to remove the uterus-this is a hysterectomy. It may be the only treatment necessary. Surgery is sometimes combined with radiation, hormone therapy, and/or chemotherapy if the cancer has spread to lymph nodes. Radiation may be external or internal. You should discuss any and all treatments with your physician before you begin.

There are clinical trials in progress today to learn more about this disease and ways to treat it. Talk with your physician to find out more.

Support and resources
Mission Hospital offers support and encouragement throughout your treatment process, and there are many support groups online. Some Internet resources you might find helpful include:

American Cancer Society
National Institutes of Health/uterine cancer
National Cancer Institute
Women's Cancer Network
Cancer.net/uterine