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Formerly known as California Oncology of the Central Valley Request an Appointment
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Formerly known as California Oncology of the Central Valley Request an Appointment

Uterine Cancer

What is Uterine Cancer?

Uterine cancer is cancer that forms in the lining of the uterus. It is the most common gynecologic cancer in the U.S. There are three layers in the uterus: the endometrium, the myometrium, and the serosa. Most uterine cancers are found in the endometrium, but some can be found in the myometrium.

Female reproductive system

Three Layers of the Uterine Wall

  • Endometrium: inner layer
  • Myometrium: middle muscle layer
  • Serosa: smooth outer layer

Types of Uterine Cancer

Uterine cancers are categorized by the layer of the uterus in which they form. Cancers that originate in a certain layer of the uterus can spread to other layers.

Endometrial Cancer

Most uterine cancers are endometrial cancers, meaning it forms from the cells in the innermost lining of the uterus. Most of these are endometrioid adenocarcinomas, meaning they develop from glandular cells in the endometrial layer growing out of control. Papillary serous adenocarcinomas and clear cell adenocarcinomas make up a small percentage of this type of uterine cancer, but are notably more aggressive than adenocarcinomas. Other types include mixed adenocarcinomas, mucinous adenocarcinomas, and squamous cell adenocarcinomas.

Uterine Sarcoma

A soft tissue sarcoma, uterine sarcoma develops in the myometrium, the layer of muscle in between the inner and outer layers of the uterus. These make up less than 4% of uterine cancers. Types of uterine sarcoma include low grade endometrial stromal sarcoma (ESS), high-grade ESS, undifferentiated uterine sarcoma, and uterine leiomyosarcoma.

Diagnosis

Not much is known about the causes of uterine cancer, but some known risk factors are older age, high blood pressure, diabetes, obesity, hormone replacement therapy after menopause, and family history of uterine or colon cancer. Lynch Syndrome (HNPCC) is an inherited genetic mutation associated with a higher risk for colon and endometrial cancers.

Symptoms

  • Pelvic or back pain
  • Unintentional weight loss or gain
  • Urgent, frequent, or painful urination
  • Diarrhea or constipation
  • Blood in the stool or urine
  • Abnormal vaginal bleeding
  • Abnormal vaginal discharge
  • Pain during intercourse

Tests & Exams

Some tests are performed by primary care providers or OB/GYNs as part of routine screenings, while others are done after receiving abnormal results to learn more.

  • Pap test
  • Pelvic exam
  • Transvaginal ultrasound
  • Biopsy
  • Dilation and curettage (D&C)
  • Hysteroscopy
  • CT scan
  • PET scan

Stages

Staging is a measurement system based on the size of the tumor and how far it has spread in the body. Using the TNM system, all of the information from tests and examinations is then combined and assessed to determine the stage, from I (one) to IV (four). Generally, the higher the stage, the more serious the cancer.

TNM System

(Tumor – node – metastasis system)

  • T: shows how far the main tumor has spread into nearby tissue
  • N: shows whether or not the nearby lymph nodes have cancer in them
  • M: shows if the cancer has spread (or metastasized) to distant organs in the body
Stage I
Stage II
Stage III
Stage IV

Stage I

Cancer cells have formed and can be found in the endometrium or myometrium of the uterus.

Stage I Uterine Cancer

Stage II

Cancer cells have spread from the uterus to the stromal connective tissue of the cervix.

Stage II Uterine Cancer

Stage III

Cancer cells have spread to the serosa, adnexa, vagina, parametrium, and/or nearby lymph nodes.

Stage III Uterine Cancer

Stage IV

Cancer has spread to the bladder mucosa and/or bowel, or has metastasized beyond the pelvic area.

Stage IV Uterine Cancer

Grades

The grade of an illness refers to how the cancer cells look when compared to normal cells. The lower the number, the more cancer cells look like the normal cells. This means the cancer is less likely to spread and may be easier to treat. Grade 3 looks very different from normal cells and is likely to grow and spread faster.

Comparison of the grades of cancer

Uterine Cancer Treatment

Surgery is usually necessary to learn how far the uterine cancer has progressed and to remove cancerous cells. Other treatments help to increase the effectiveness of surgery and prevent recurrence.

In-Office Therapies

Other Courses of Treatment

Radiation Therapy

This type of treatment uses radiation to kill cancer cells or stop them from growing. The method and dosage of radiation therapy are dependent on the extent of the cancer.

Surgery

Sometimes, surgeons can stage and treat the cancer during one procedure. If the cancer is more advanced, the surgery may be a type of hysterectomy, which removes the cancerous cells, the uterus, and other affected organs in the pelvic area.