Endometrial Cancer Overview

Endometrial (uterine) cancer occurs when abnormal, cancerous cells form in the uterus.

The uterus, also called the womb, is a hollow, pear-shaped organ located in a woman’s lower abdomen, between the bladder and the rectum.

The uterus has four parts:

• Cervix: The narrow, lower portion of the uterus

• Corpus: The broader, upper part of the uterus

• Myometrium: The outer layer of the corpus; the muscle that expands during pregnancy to hold the growing fetus

• Endometrium: The inner lining of the uterus

Some conditions in the uterus, caused by abnormal, rapid, and uncontrolled division of cells, are not cancer. Three of these benign conditions include:

• Fibroid tumors: Common, benign tumors of the uterine muscle that do not develop into cancer. Fibroid tumors of the uterus are often found in women in their forties. Symptoms of fibroid tumors, which depend on size and location, include irregular bleeding, vaginal discharge, and frequent urination. Many times, however, fibroids do not cause symptoms and do not need to be treated. After menstrual periods cease, fibroid tumors may become smaller and disappear.

• Endometriosis: A benign condition of the uterus that’s common among women in their thirties and forties, especially women who have never been pregnant. Tissue that looks and acts like endometrial tissue begins to grow in unusual places, such as on the surface of the ovaries, on the outside of the uterus, and in other tissues in the abdomen.

• Hyperplasia: An increase in the number of normal cells lining the uterus. Although it’s not cancer, it may develop into cancer in some women. The most common symptoms are heavy menstrual periods, bleeding between periods, and bleeding after menopause.

Risk Factors

Known risk factors for uterine cancer include being African-American, having taken tamoxifen for breast cancer treatment or prevention, and having had radiation therapy to the pelvic area. The following have been suggested as risk factors:

• Age 50 or older

• History of endometrial hyperplasia

• Estrogen replacement therapy

• Obesity

• Diabetes

• Hypertension (high blood pressure)

• History of an inherited form of colon cancer

Diagnostic Tests and Procedures

• A detailed medical history, both family and personal

• A thorough physical exam

• Pelvic examination of the uterus, vagina, ovaries, bladder, and rectum (may include a Pap test)

• Biopsy, or the removal of a sample of tissue via a hollow needle or scalpel

• Dilation and curettage (D & C), a minor operation in which the cervix is dilated (expanded) so that the cervical canal and uterine lining can be scraped with a spoon-shaped instrument called a curette

When cancer cells are found, other tests are used to determine if the disease has spread from the uterus to other parts of the body. These procedures may include blood tests, chest X-rays, computed tomography (CT or CAT) scans of the abdomen, an ultrasound, and special exams of the bladder, colon, and rectum.

Treatment

Treatment for uterine cancer may include hysterectomy, or surgery to remove the uterus; salpingo-oophorectomy, or surgery to remove the fallopian tubes and ovaries; radiation therapy; hormone therapy; and chemotherapy.