** Uterine (Endometrial) cancer originates in the female reproductive system and generally affects postmenopausal women between ages 50 and 60;. It develops in the body of the uterus or womb whose wall has an inner lining (called the endometrium) and an outer layer of muscle tissue (called the myometrium).
** Endometrial cancer (Uterine Cancer) is often detected at an early stage because it frequently produces vaginal bleeding between menstrual periods or after menopause. If discovered early, this slow-growing cancer is likely to be confined to the uterus. Removing the uterus surgically (Hysterectomy) successfully eliminates endometrial cancer, if detected and carried out in the initial stages.
** Such extensive surgeries usually require additional training and experience compared to general gynecology. In addition, management of cancer today follows a multimodality approach, and integration of surgery with non-surgical treatments such as, chemotherapy and radiation therapy is essential to improve outcome. Gynecological oncologists are best suited for this as they are focusing only on gynecological cancers.
Types of Uterine(Endometrial) Cancer
There are three types of uterine cancer.
Endometrial cancer: Almost all uterine cancers start in the lining of the uterus (endometrium). The two main types of endometrial cancer are:
Endometroid adenocarcinoma: This accounts for most cases of endometrium cancer.
Uterine carcinosarcoma: The cancer cells look like endometrium cancer and sarcoma.
Uterine sarcomas: These are less common types of uterine cancer and start in the muscle wall of the uterus.
Stages of Uterine(Endometrial) Cancer
Stage IA:Cancer is in the endometrium (uterine lining) only, the inner half of the myometrium (muscle wall), or the glands in the cervix
Stage IB: Cancer has spread to outer half of the myometrium
Stage II: Cancer has spread to cervix connective tissue
Stage IIIA:Cancer has spread to:
The outer layer of uterus
Other pelvic organs including the fallopian tubes or ovaries
Stage IIIB:Cancer has spread to the vagina
Stage IIIC: Cancer has spread to lymph nodes near the uterus
Stage IVA: Cancer has spread the bladder and/or bowel wall
Stage IVB: Cancer has spread beyond the pelvis, including lymph nodes in the abdomen or groin.
Prevention of Uterine(Endometrial) Cancer
If you are diagnosed with uterine cancer, your doctor will discuss the best options to treat it. This depends on several factors, including the type and stage of the cancer and your general health. One or more of the following therapies may be recommended to treat uterine cancer or help relieve symptoms.
Surgery
** Surgery is the main treatment for uterine cancer. Usually surgery for uterine cancer includes:
- Total hysterectomy (surgical removal of the uterus)
- Bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes)
- Biopsy of the omentum, a fat pad in the pelvis
- Removal of lymph nodes in the pelvis and lower abdomen
Sometimes a radical hysterectomy is done. This means removal of the:
- Uterus
- Cervix and surrounding tissue
- Upper vagina
Depending on your health and how far uterine cancer has spread, surgery may be:
Minimally invasive:After making several small incisions (cuts) in the abdomen, the doctor uses a laparoscope or robotic surgery to remove the organs. The uterus often is removed through the vagina.
Open: A large incision is made in the abdomen
Surgery for uterine cancer may include:
Pelvic washings:The surgeon puts saline (salt water) into the pelvic area after the uterus has been removed. The saline is then examined under a microscope.
Tumor debulking: If the cancer has spread into the abdomen, it may be debulked. This means the surgeon removes as much of the cancer as possible before other types of treatment.
Radiation Therapy
** Radiation therapy may be used to treat uterine cancer after a hysterectomy or as the main treatment when surgery is not possible. Depending on the stage and grade of the cancer, radiation therapy also may be used at other points of treatment.
** New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target uterine cancer tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
MD Anderson provides the most advanced radiation treatments for uterine cancer, including:
Brachytherapy: Tiny radioactive seeds are placed in the body close to the tumor
3D-conformal radiation therapy:everal radiation beams are given in the exact shape of the tumor
Intensity-modulated radiotherapy (IMRT): Treatment is tailored to the specific shape of the tumor
** Talk to your doctor about possible side effects of radiation treatment for uterine cancer. Some women get lymphedema in their legs. This is caused by blockage of the lymph fluid. Lymphedema may not start until months after treatment, but it usually does not go away. However, there are treatments to help.
Chemotherapy
MD Anderson offers the most up-to-date and advanced chemotherapy options for uterine cancer.
Hormone Therapy
Some hormones can cause certain uterine cancers to grow. If tests show the cancer cells have receptors where hormones can attach, drugs can be used to reduce hormones or block them from working.
Hormones that may be used to treat uterine cancer include:
- Progestins
- Tamoxifen
- Aromatase inhibitors
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