Uterine Cancer

Definition

Uterine cancer is the growth of cancer cells that start in the uterus. The walls of the uterus are made of an inner and outer lining. The endometrium is the inner lining. This is where the most common type of uterine cancer begins.

This fact sheet will focus on endometrial cancer.

Uterine Cancer

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Causes

Cancer is the out of control growth of cells. The cells form a clump of tissue called a growth or tumor. Cancer cells can invade nearby tissues. It can then spread to other parts of the body.

The exact cause of uterine cancer is not known. It may be linked to exposure to the hormone estrogen. Genes and the environment may also play a role.

Risk Factors

Uterine cancer is more common in women over 40 years of age. Other things that may raise the risk are:

• Long term use of estrogens or tamoxifen—in high doses
• Early start of menstrual periods
• Late menopause
• History of abnormal cells or polyps in the uterus
• Health problems such as:
  • Polycystic ovary syndrome
  • Obesity
  • High blood pressure
  • Diabetes
  • Thyroid disease
  • Gallbladder disease
  • Breast cancer
• Infertility, or never having a pregnancy
• A family history of:
  • Uterine cancer
  • Cowden syndrome or Lynch syndrome

Symptoms

Problems may be:

• Bleeding between menstrual periods
• Vaginal bleeding or spotting in postmenopausal women
• Belly bloating or fullness
• Pelvic pain

Diagnosis

The doctor will ask about symptoms and health history. A pelvic exam will be done. Tests may include:

• Blood tests to look for cancer markers
• Ultrasound to view the pelvic area
• Biopsy—a small tissue sample is taken from the uterus and sent for testing
• Pap test—to look for problems with the lining of the uterus
• Dilation and curettage (D&C)—to remove samples of uterine tissue for testing
• Hysteroscopy—to view the uterus using a lighted scope

Uterine cancer is staged from 1 to 4. Stage 1 is a cancer that has stayed in one area. Stage 4 is a cancer that has spread to other parts of the body.

Treatment

Treatments for uterine cancer depend on the stage of the cancer. Surgery will be done to remove as much of the cancer as possible. Surgery to remove the uterus is called hysterectomy. Nearby tissue, such as ovaries or lymph tissue, may also need to be removed. Other treatment may include:

• Radiation therapy— to kill cancer cells and shrink tumors
• Hormone therapy—to stop or slow cancer growth and spread by changing how cancer cells work
• Chemotherapy by mouth, catheter, or injection—to kill cancer cells in cancer that has or may have spread to other areas of the body

Prevention

The risk of this health problem may be lowered by:

• Exercising regularly
• Reaching or maintaining a healthy weight
• Eating a healthful diet that is rich in fruits, vegetables, and whole grains

References

• Endometrial cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/endometrial-cancer.html.
• Endometrial cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/endometrial-cancer.
• Endometrial cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/endometrial-cancer.
• General information about endometrial cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq. Accessed March 8, 2021.
• 1/11/2018 DynaMed Systematic Literature Surveillance https://www.dynamed.com/management/breastfeeding: Jordan SJ, Na R, Johnatty SE, et al. Breastfeeding and endometrial cancer risk: an analysis from the epidemiology of cancer consortium. Obstet Gynecol. 2017;129(6):10599-1067.