Uterine cancer care

Uterine cancer, or cancer of the uterus, is the most common cancer of the female reproductive system. Also called endometrial cancer, almost all cases start in the lining of the uterus, called the endometrium. The cells of the endometrium are shed during a woman’s monthly menstrual cycle. Types of uterine or endometrial cancer include:

• adenocarcinoma
• serous carcinoma
• small cell carcinoma
• squamous cell carcinoma
• transitional carcinoma
• uterine carcinosarcoma

You may be at greater risk for uterine or endometrial cancer if you:

• are obese
• are age 40 or older
• eat a high-fat diet
• have a close family member who has had uterine, colon or ovarian cancer, which may be a sign of Lynch syndrome (hereditary nonpolyposis colorectal cancer or HNPCC)
• have diabetes
• have had breast or ovarian cancer, complex atypical endometrial hyperplasia, a precancerous condition, or ovarian diseases such as polycystic ovarian syndrome (PCOS)
• have had pelvic radiation to treat other kinds of cancer
• have never been pregnant, have had trouble getting pregnant or have had fewer than five periods in a year before starting menopause
• have taken estrogen without progesterone for hormone replacement during menopause
• have taken tamoxifen as a treatment for breast cancer
• started your period before age 12 or went through menopause late

If you have two or more risk factors, it doesn’t mean you’ll develop uterine or endometrial cancer, but you may want to talk to your doctor to see if you should have more frequent exams.

If you have gone through menopause, see your doctor if you have vaginal bleeding, spotting or unusual discharge.

If you have not gone through menopause, see your doctor id you have experienced any of the following for more than two weeks:

• abnormal vaginal discharge
• pelvic pain or pressure
• unusual bleeding between periods or heavier flow
• unintentional weight loss

There is no reliable screening for uterine cancer. If you have symptoms or are at high risk for uterine cancer, your doctor may perform an endometrial biopsy or transvaginal ultrasound.

Genetic counseling may be recommended if you:

• have a relative who has tested positive for a Lynch syndrome gene mutation (MLH1, MSH2, MSH6, PMS2) 
• have close relatives with colon, rectal or endometrial cancer
• have had colon or rectal cancer
• were diagnosed with endometrial cancer before age 50

We use a variety of tests to diagnose or rule out uterine cancer:

• biopsy
• blood tests
• CT scan
• D&C (dilation and curettage)
• hysteroscopy
• MRI
• PET scan
• Physical exam or pelvic exam
• transvaginal ultrasound
• ultrasound

Treatment options for uterine cancer include:

• surgery, including a total hysterectomy (removal of your uterus), bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes) or removal of lymph nodes in your pelvis and lower abdomen
• chemotherapy
• radiation therapy
  • brachytherapy
  • 3D conformal radiation therapy
  • Intensity-modulated radiotherapy (IMRT)
• hormone therapy with aromatase inhibitors, progestins or tamoxifen
• immunotherapy