Uterine Cancer

Uterine cancers originate in either the uterine lining or the uterine muscle. Endometrial cancer, or cancer of the uterine lining, is the most common type of gynecologic cancer. Uterine muscle cancer, called a uterine sarcoma, is much rarer and tends to be more aggressive than most endometrial cancers.

Currently, medical science has identified two types of endometrial cancer. Type I endometrial cancer, the most common type, appears related to estrogen exposure, grows more slowly, and is usually curable with surgery alone. These cancers typically occur in women who suffer from “metabolic syndrome,” a constellation of high-risk conditions such as obesity, diabetes, elevated cholesterol, and hypertension related to an unhealthy American lifestyle. Type II endometrial cancers are genetically distinct from Type I cancers. We find them more commonly in older, thinner women. They have a more aggressive behavior pattern and grow in an other- wise normal or even dormant uterine lining. In general, treatment for Type II cancers involves a combination of surgery, chemotherapy, and radiation.

Uterine cancers are staged based on the findings at the time of uterine cancer surgery. Therefore, the stage of any woman’s uterine cancer is not known until the surgery is performed and all the removed tissue is analyzed by the pathology laboratory. It can take several days to a week to receive a final report. A total hysterectomy (uterus and cervix) and removal of the ovaries/tubes is the minimum surgery in all cases. In many situations, additional removal of surrounding lymph nodes is necessary to look for spread of abnormal cells. In a smaller number of cases, usually for the more aggressive Type II cancers, removal of other abdominal tissues can help identify other areas of spread.

Uterine sarcomas evolve from the muscular wall of the uterus. Uterine fibroids also arise from the uterine muscle but are benign. Many women with fibroids are afraid their fibroids will “turn to cancer,” but this just doesn’t happen. However, the symptoms of fibroids and sarcomas overlap. In both cases, the uterus becomes enlarged from a mass, and abnormal bleeding is common.