Uterine Cancer

Uterine Cancer

Most cases of uterine cancer develop in the lining of the uterus. Common symptoms of this disease include bleeding or discharge not related to menstruation, pain during urination, pain during sex, and pain in the pelvic area. Treatment for cancer of the uterus can include surgery, radiation therapy, hormone therapy, or a combination of treatments. In many cases, this form of cancer is highly curable.

What Is Uterine Cancer?

Uterine cancer is a disease in which cancer cells first form in the tissues of the uterus. Most cases of this disease occur in the lining (endometrium) of the uterus. This article uses the term "uterine cancer" to refer to this type of cancer, also known as endometrial cancer. This article does not discuss a rare type of uterine cancer that can occur in the muscles or other tissues that support the uterus. Click Uterine Sarcoma for more information on this topic.

Understanding the Uterus
The uterus is part of a woman's reproductive system that is located in the pelvis between the bladder and the rectum. The uterus is the hollow, pear-shaped organ where a baby grows. The narrow, lower portion of the uterus is called the cervix. The broad, middle part of the uterus is called the body, or the corpus. The dome-shaped top of the uterus is called the fundus. The fallopian tubes extend from either side of the top of the uterus to the ovaries.

The Uterus and Other Reproductive Organs
The wall of the uterus has two layers of tissue. The inner layer, or lining, is the endometrium and the outer layer is muscle tissue called the myometrium. In women of childbearing age, the lining of the uterus grows and thickens each month to prepare for pregnancy. If a woman does not become pregnant, the thick, bloody lining flows out of the body through the vagina. This flow is called menstruation.

Understanding Cancer of the Uterus
Cancer is a group of many related diseases. All cancers begin in cells, which are the body's basic unit of life. Cells make up tissues, and tissues make up the organs of the body. Normally, cells grow and divide to form new cells as the body needs them, and when cells grow old and die, new cells take their place. However, sometimes this orderly process goes wrong. New cells form when the body does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Tumors can be benign or malignant. Benign tumors are not cancer, and doctors can usually remove them. Cells from benign tumors do not spread to other parts of the body, and in most cases benign tumors do not come back after they are removed. It is important to note that benign tumors are rarely a threat to life. Benign conditions of the uterus include:

* Fibroids
* Endometriosis
* Endometrial hyperplasia.

On the other hand, malignant tumors are cancer. Malignant tumors tend to be more serious and may be life-threatening. Cancer cells can:

* Invade and damage nearby tissues and organs
* Break away from a malignant tumor
* Enter the bloodstream or lymphatic system.

That is how cancer cells spread from the original (primary) tumor to form new tumors in other organs. The spread of cancer is called metastasis.

When uterine cancer spreads (metastasizes) outside of the uterus, cancer cells are often found in nearby lymph nodes, nerves, or blood vessels. If the cancer has reached the lymph nodes, cancer cells may have spread to other lymph nodes and other organs, such as the lungs, liver, and bones. When cancer spreads from where it has originally developed to another part of the body, the new tumor will have the same kind of abnormal cells and the same name as the primary tumor. For example, if cancer of the uterus spreads to the lungs, the cancer cells in the lungs are uterine cancer cells. The disease is metastatic uterine cancer, not lung cancer and it is treated as uterine cancer, not lung cancer. Doctors may call the new tumor "distant" disease.

Causes and Risk Factors for Uterine Cancer
No one knows the exact cause or causes of uterine cancer, and doctors can seldom explain why one person will get it and another person will not. However, research has shown that people with certain risk factors are more likely than others to develop uterine cancer. A risk factor is anything that increases a person's chances of developing a disease.

Specific risk factors for uterine cancer include:

* Being over the age of 50
* Having endometrial hyperplasia
* Taking hormone replacement therapy (HRT)
* Being obese (or having conditions such as diabetes)
* Being Caucasian
* Taking tamoxifen for breast cancer
* Having an inherited form of colorectal cancer
* Prolonged exposure to estrogen.

Symptoms of Uterine Cancer
Common uterine cancer symptoms include:

* Bleeding or discharge not related to menstruation (periods)
* Difficult or painful urination
* Pain during sexual intercourse
* Pain in the pelvic area.

These possible symptoms of uterine cancer are not sure signs of the disease. Other health problems can also cause these symptoms. People with symptoms should see a doctor as soon as possible, because only a doctor can diagnose and treat the problem.

Diagnosing Uterine Cancer
If a person has possible uterine cancer symptoms, the doctor will need to perform a physical exam, ask about the patient's personal and family medical history, and recommend additional tests and procedures that examine the cervix and uterus.

Exams and tests that are used to make a uterine cancer diagnosis may include:

* Pap test (Pap smear)
* Transvaginal ultrasound
* Biopsy
* Dilatation and curettage (D&C).

Staging Uterine Cancer
If a diagnosis of uterine cancer is made, the doctor will need to determine the stage, or extent, of the disease in order to plan the best treatment. Uterine cancer staging is an attempt to find out the size of the tumor, whether the disease has spread, and if so, to what parts of the body.

The following stages are used to describe uterine cancer:

* Stage I
* Stage II
* Stage III
* Stage IV
* Recurrent.

Treating Uterine Cancer
Treatment options for cancer of the uterus will vary based on:

* The size of the tumor.

* The stage of the cancer (see Uterine Cancer Stage).

* Whether female hormones affect tumor growth.

* The tumor grade. The grade tells how closely the cancer cells resemble normal cells and suggests how fast the cancer is likely to grow. Low-grade cancers are likely to grow and spread more slowly than high-grade cancers.

* The woman's age and general health.

In general, uterine cancer treatment can include:

* Surgery (see Uterine Cancer Surgery)
* Radiation therapy (see Radiation for Uterine Cancer)
* Hormone therapy (see Uterine Cancer Hormone Therapy)
* A combination of any of the above treatments.

Doctors can describe the treatment choices and the expected results of each treatment option. Patients should work with their doctors to develop a treatment plan that meets their medical needs and personal values. Choosing the most appropriate treatment for uterine cancer is a decision that ideally involves the patient, the family, and the healthcare team.

What's the Prognosis?
The American Cancer Society estimates that 41,200 women will be diagnosed with uterine cancer in 2006 and that 7,350 women would die as a result of the disease during the year.

The uterine cancer prognosis will depend on:

* The stage of uterine cancer (whether it is in the endometrium only, involves the whole uterus, or has spread to other places in the body)

* How the uterine cancer cells look under a microscope

* Whether the cancer cells are affected by progesterone

* Whether the cancer has just been diagnosed or has recurred (come back).

It is important to note that uterine cancer is highly curable.

Summary of Uterine Cancer
Key information about uterine cancer includes the following:

* Uterine cancer is a disease in which cancer cells form in the tissues of the uterus.

* While the cause of uterine cancer is unknown, researchers have identified certain factors that increase the risk of developing the disease. Examples of these risk factors include taking tamoxifen for breast cancer, taking hormone replacement therapy (HRT), and being obese.

* Possible symptoms of uterine cancer include unusual vaginal discharge and pain in the pelvis.

* Some of the tests used to detect and diagnose uterine cancer include Pap tests, transvaginal ultrasounds, and biopsies.

* Factors that may affect the uterine cancer prognosis and treatment options include such things as the stage of the disease and how the cancer cells appear under a microscope. Uterine cancer is often curable.