Cancer is the out of control growth of cells. Uterine cancer is the growth of cancer cells in the uterus. The walls of the uterus are is made of an inner and outer lining. The endometrium is the inner lining. The myometrium is the muscular, outer lining. The most common type of uterine cancer (adenocarcinoma) begins in the endometrium. Less common cancers called sarcomas, begin in the myometrium.
This fact sheet will focus on endometrial cancer.
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Cancer occurs when cells in the body divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a clump of tissue forms, called a growth or tumor. These types of growth, called malignancy, can invade nearby tissues. Cancer that has invaded nearby tissues can then spread to other parts of the body.
Exposure to estrogen seems to have a strong link to uterine cancer. It is not clear exactly what causes cancer cells to develop. It is probably a combination of genetics and environment.
Uterine cancer is more common in women aged 50-60 years old. Other factors that may increase your chances of uterine cancer:
- Obesity —especially in women experiencing menopause before age 45
- High blood pressure
- Polycystic ovary syndrome
- History of abnormal or precancerous cells in the uterus
- Endometrial polyps
- No history of pregnancy
- Early start of menstrual periods
- Late menopause , which lengthens exposure to estrogen
Uterine cancer may cause:
- Abnormal bleeding between menstrual periods
- Vaginal bleeding or spotting in postmenopausal women
- Pain in the pelvic area
- Pain during urination
- Pain during intercourse
The doctor will ask about your symptoms and medical history. A pelvic exam of the vagina, uterus, ovaries, bladder, and rectum will be done.
Your bodily fluids and tissues may be tested. This can be done with:
- Blood tests
- Biopsy —tissue samples are examined under a microscope to look for the presence of cancer
- Dilation and curettage (D&C)—procedure to remove a sample of uterine tissue
- Hysteroscopy —a lighted scope with a camera is used to examine the uterus
- Pap test —presence of cancer may indicate it has spread beyond the uterus
The physical exam combined with all of your test results, will help to determine the stage of cancer you have. Staging is used to guide your treatment plan. Like other cancers, uterine cancer is staged from I-IV (1-4). Stage I is a cancer that has stayed in one area, while stage IV cancer is one that has spread to other parts of the body.
Treatments for uterine cancer depend on the stage of the cancer. Options may include:
A hysterectomy may be done to remove the uterus. Other nearby structures, such as the fallopian tubes, ovaries, and lymph nodes may also need to be removed.
This is the use of radiation to kill cancer cells and shrink tumors. It is often used with surgery or for women who cannot tolerate surgery. Radiation therapy may be:
- External—radiation directed at the tumor from a source outside the body
- Internal (brachytherapy)—radioactive materials are placed into the body near the cancer cells
Hormones can affect how cancer cells work. Some types of uterine cancer may be managed with hormone medications. This option is usually reserved for advanced or recurrent cancer.
This is the use of drugs to kill cancer cells. Chemotherapy may be given as an injection, through a catheter, or by mouth. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy may have limited benefit for treating uterine cancer.
Steps that may help to reduce your chances of uterine cancer include:
- Report any menstrual changes or abnormal bleeding to your doctor.
- Lose excess weight and maintain a healthy weight.
- Exercise regularly.
- If you have diabetes, follow your treatment plan.
- Talk to your doctor about the risks and benefits of hormone-based birth control.
- Breastfeed your baby.
American Cancer Society https://www.cancer.org
National Cancer Institute https://www.cancer.gov
Canadian Cancer Society https://www.cancer.ca
Women's Health Matters—Women's College Hospital http://www.womenshealthmatters.ca
Endometrial cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/endometrial-cancer.html. Accessed January 8, 2018.
Endometrial cancer. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T113952/Endometrial-cancer . Updated May 24, 2017. Accessed January 8, 2018.
Endometrial cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/endometrial-cancer. Updated March 2017. Accessed January 8, 2018.
General information about endometrial cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq. Updated October 13, 2017. Accessed January 8, 2018.
8/31/2009 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T113952/Endometrial-cancer : Thomas CC, Wingo PA, Dolan MS, Lee NC, Richardson LC. Endometrial cancer risk among younger, overweight women. Obstet Gynecol. 2009;114(1):22-27.
1/29/2010 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T113952/Endometrial-cancer : Dey S, Hablas A, Seifeldin IA, et al. Urban-rural differences of gynaecological malignancies in Egypt (1999-2002). BJOG. 2010;117(3):348-355.
1/11/2018 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T115517/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.
- Reviewer: EBSCO Medical Review Board Mohei Abouzied, MD, FACP
- Review Date: 11/2018
- Update Date: 01/11/2018