Endometrial Cancer (Cancer of the Uterus)

What is endometrial cancer?

Endometrial cancer is a growth of abnormal cells in the lining of the uterus. It is the most common type of cancer in the uterus. The uterus (womb) is the muscular organ at the top of the vagina. Babies grow in the uterus, and menstrual blood comes from the uterus.

Uterine cancer is one of the most common cancers among women. It occurs most often in women between the ages of 50 and 70.

How does it occur?

The cause of cancer of the uterus is not known. However, you are at greater risk of having this type of cancer if there is extra estrogen in your body. Your risk is also greater if your body is exposed to estrogen for too long a time.

Examples of things that may cause you to be exposed to more estrogen are:

• never having been pregnant
• menstruating for more years than most women because you started having periods at a very young age or you stopped having periods later than most women
• being overweight
• hormone imbalance that can lead to problems with the ovaries
• some types of ovarian tumors
• a history of polycystic ovary syndrome
• use of estrogen for hormone replacement therapy without progesterone

Some of the other things that may increase the risk of endometrial cancer are:

• age over 50
• tamoxifen treatment for breast cancer
• a history of breast, ovarian, or colon cancer
• a history of diabetes, hypertension, gallbladder disease, or thyroid disease.

What are the symptoms?

Symptoms may include:

• abnormal vaginal bleeding
• difficult or painful urination
• pain during sex
• pain in the pelvic area.

In most cases of endometrial cancer, abnormal bleeding is the first symptom. Many women ignore this bleeding or blame it on menopause. If you have unusual bleeding or any of the other symptoms listed above, contact your healthcare provider.

How is it diagnosed?

Endometrial cancer begins inside the uterus rather than in the opening of the uterus (the cervix). For this reason, it is not usually found with a Pap test, which checks for cancer in the cervix. To check for cancer in the uterus, a sample of endometrial tissue must be removed and examined under a microscope. One of the following procedures may be used to get a sample of tissue:

• Endometrial biopsy: Your healthcare provider removes a small sample of the endometrium with a tiny strawlike tube put into your vagina and then into the uterus through the cervix.
• D&C (dilation and curettage): The cervix is widened and a sharp tool called a curette is used to scrape the walls of the uterus. The tissue scrapings are checked for cancer cells.

If you have cancer, you may have other tests to see if the cancer has spread to other parts of your body. Tests you may have include:

• blood tests
• urine test
• CT scan
• X-rays.

How is it treated?

The treatment depends on the type of cancer cells and if the cancer has spread. If the cancer is diagnosed early, the uterus is usually removed. The ovaries, fallopian tubes (tubes from the ovaries to the uterus), part of the vagina, and some lymph nodes may also be removed.

Other treatments are:

• chemotherapy, which uses drugs to try to stop the growth of cancer cells
• radiation therapy, which uses high-energy X-rays or other types of radiation to try to kill cancer cells
• hormone therapy, which uses medicine to remove hormones or block their action to try to stop cancer cells from growing.

Any of these treatments may be used alone or in combination.

If your uterus is removed, you will no longer be able to get pregnant. If the cancer is at a very early stage and you want to still be able to have children, it may be possible to treat the cancer with the hormone progesterone instead of with removal of the uterus.

How long will the effects last?

With early treatment, there is a good chance of cure. The longer the cancer goes untreated, the lower the survival rate. For this reason, regular pelvic exams are important for all women. If you develop unusual spotting or bleeding not related to menstrual periods, see your healthcare provider.

How can I prevent it?

Because the cause of uterine cancer is not known, there is no way to prevent it. However, there are some things you can do that may help lower your risk:

• Eat a diet low in animal fat.
• Control your weight by eating healthy foods and exercising.
• Control your blood pressure by decreasing stress and eating a diet low in salt.
• Report abnormal vaginal bleeding right away to your healthcare provider.
• Have an annual pelvic exam.
• If you still have your uterus and are taking estrogen hormone therapy, you should take progesterone with the estrogen and follow your healthcare provider's advice for regular exams.
• If you have diabetes, keep it under good control.

For more information, contact your local chapter of the American Cancer Society or call 800-ACS-2345. The National Cancer Institute (800-4-CANCER) is another resource. You may also visit their Web sites at http://www.cancer.org or http://www.cancer.gov.