Uterine Cancer Diagnosis

The uterus is a pear-shaped organ in a woman's body, and this is where the fetus develops during pregnancy. There are two types of uterine cancer; endometrial cancer, and more rarely, uterine sarcoma. The National Cancer Institute estimates that in 2009, over 42,000 women in the United States will be newly diagnosed with endometrial cancer, and 7,780 women will die from the disease. Uterine sarcoma is a much rarer diagnosis, with the American Cancer Society estimating that in 2009, approximately 1,200 new cases of this cancer will be diagnosed in the United States.

Types

• Endometrial cancer is the more prevalent uterine cancer. The lining of the uterus is called the endometrium, which is where this cancer begins.

  Uterine sarcoma is cancer that starts in the muscles of the uterus, or in tissues that support the uterus.

Risk Factors

• Women over the age of 50 are more at risk for developing uterine cancer, and those who use hormone replacement therapy also have a higher risk of uterine cancer than women who do not use this medication. Tamoxifen has also been shown to increase a woman's risk of both endometrial cancer and uterine sarcoma. If a woman has previously been diagnosed with endometrial hyperplasia, the risk of uterine cancer increases. Endometrial hyperplasia is a proliferation of cells that make up the lining of the uterus. It is not cancer. Obese women are also at higher risk of this cancer due to the higher levels of estrogen from an abundance of fatty tissue.

Symptoms

• Because uterine cancer is commonly diagnosed after menopause, abnormal vaginal bleeding is the most common symptom. Pelvic pain, pain during intercourse and difficult urination are also symptoms of uterine cancer. Uterine sarcoma has these same symptoms, and also has the symptoms of a feeling of abdominal fullness, or a vaginal mass.

Diagnosis

• One of the first things a doctor will do to look for uterine cancer is a physical exam, including a health history, along with a pelvic exam and Pap test. A dilatation and curretage (D&C) is a small surgery that removes small pieces of tissue of the uterus to check for cancer. An in-office procedure somewhat similar to this is an endometrial biopsy. Transvaginal ultrasound may also be performed.

Staging

• Removing the uterus is the best way to stage uterine cancer, in order to get an in-depth look at the uterus, lymph nodes and muscles. In Stage I, cancer is only found in the uterus and the cervix is not affected. In Stage II, the cancer is found in the uterus and cervix. In Stage III, cancer is outside of the uterus, but is confined to the pelvis. It is not in the bladder or rectum, but pelvic lymph nodes may be cancerous. In Stage IV, the cancer has spread to the bladder or rectum, or to body parts other than the pelvis.

  The stages of uterine sarcoma are similar, but have sub-stages within each stage.

Treatment

• Uterine sarcoma has four kinds of standard treatments: surgery, radiation, chemotherapy or hormone therapy. One or more of these may be used, depending on the extent of the cancer.

  Endometrial cancer is commonly treated with one or more of the following: surgery, radiation or hormonal therapy. Chemotherapy for endometrial cancer is currently being studied in clinical trials. Again, as with uterine sarcoma, treatment is dependent on the stage and extent of disease.