Uterine or endometrial cancer primarily affects women age 55 or older, according to the American Cancer Society, which reports that approximately 88 percent of women diagnosed with stage IA uterine cancer survive 5 years or longer.
Uterine cancer is the most common of type of gynecologic cancer.
Scripps surgeons, medical oncologists, gynecologic oncologists, radiation oncologists, pathologists, nurses and clinicians are focused on defeating uterine cancer, using leading-edge treatments and therapies.
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There is no annual screening test for uterine cancer. But women at risk of developing the disease should talk with their doctor about developing a screening and awareness regimen, starting with yearly pelvic exams and possibly other procedures — such as an endometrial biopsy — to help identify and attack the disease at its earliest stages.
Risk factors for uterine cancer include:
- Late menopause
- Never giving birth
- High blood pressure
- Estrogen treatment
- Hereditary nonpolyposis colon cancer (HNPCC)
Signs and symptoms of uterine cancer include:
- Unexplained vaginal bleeding or non-blood discharge
- Pelvic pain
- The sensation of a mass in the pelvic area
- Weight loss
Tests to detect and diagnose endometrial cancer may include:
- Transvaginal ultrasound is where a probe is inserted into the vagina to bounce sound waves off the wall of the uterus and make images for physicians to review for any uterine abnormalities in wall thickness and shape. The test can also help doctors see if nearby organs show abnormalities in appearance.
- Uterine (endometrial) biopsies involve removing and examining a tissue sample and can be performed through standard procedures or through outpatient dilation and curettage (D&C).
- Hysteroscopy is the insertion of a small telescope (diameter of one-sixth of an inch) into the cervix for a physician to view the uterus.
- Cystoscopy or proctoscopy under anesthesia is the insertion of slender tubes with lights and/or lenses that allow doctors to see urinary organs and the rectum for possible spread of cancer that involves large uterine malignant tumors.
- Pelvic exam may include a physical check of the vulva, uterus, cervix, fallopian tubes, ovaries, bladder and rectum.
- Imaging tests can include computed tomography (CT) and magnetic resonance imaging (MRI), chest X-ray or positron emission tomography (PET/CT).
- A blood test known as a complete blood count (CBC) may be performed or one that checks for high levels of CA-125 commonly associated with the spread of a uterine cancer.
Treatment of uterine cancer may include one or more of the following: surgery, chemotherapy or radiation therapy.
- Hysterectomy involves the removal of the uterus (and possibly the cervix). It can be performed through an abdominal incision, through the vagina or through minimally-invasive procedures such as laparoscopic surgery or robotic-assisted surgery, which is aimed to reduce scarring and improve recovery times.
- Bilateral salpingo-oophorectomy is the surgical removal of the fallopian tubes and both ovaries.
- Lymph node dissection is the removal of lymph nodes from the pelvic region — and the area adjacent to the heart’s aorta — to determine if the uterine cancer has spread. The surgery can be performed through a minimally-invasive laparoscopic surgery.
Chemotherapy can be part of a treatment plan to attack cancer that has spread from the uterus. A combination of chemotherapy drugs may be part of treatment for uterine cancer.
External beam radiation therapy may be provided in combination with chemotherapy. A form of radiation therapy called brachytherapy, in which radioactive sources are placed directly into the body through catheters or small plastic tubes may be used.
High-dose rate brachytherapy may be given alone or in conjunction with a shortened course of external beam radiation therapy. Scripps has the most comprehensive and advanced radiation therapy choices in San Diego.
Hormone therapy drugs that slow the growth of uterine cancer or reduce the production of estrogen are treatment and post-treatment options. These drugs include progestin, tamoxifen and gonadotropin-releasing hormone agonists.
Complementary therapies, including therapeutic nutrition and supplementation, acupuncture, yoga and massage therapy, can help manage cancer symptoms.