Endometrial cancer grows in the lining of your uterus. It is one of the most common gynecologic cancers. It can also spread to other parts of your body.
Doctors don’t know what causes this cancer. But they do know that some women are more likely to get it. These include women who have had more menstrual cycles and those who have gone through menopause.
A risk factor is anything that raises a person’s chance of getting a disease like cancer. Different types of cancer have different risk factors. Some, like smoking and inheriting certain genes, can be avoided. Others, like age and family history, cannot. There are also ways to lower a person’s risk by eating healthy and exercising regularly. However, no one knows for sure whether these things will prevent a person from getting any type of cancer.
There are several known risk factors for endometrial cancer. People who have a family history of the disease are at higher risk. In addition, there is evidence that a number of dietary and hormone factors increase the risk. One such factor is polycystic ovarian syndrome (PCOS). This condition causes the body to produce too much androgen and estrogen and not enough progesterone. This can stimulate the tissue in the uterus to grow. Women who have this condition are at increased risk of atypical endometrial hyperplasia, which isn’t cancer but can sometimes develop into uterine cancer if it isn’t treated. Another risk factor is having a tumor called granulosa cell tumor in the ovaries. This tumor can make too much estrogen and cause the lining of the uterus to grow out of control.
People who have a family history of other types of cancer may be at an increased risk for endometrial cancer as well. This includes relatives who have had breast or ovarian cancer. In addition, there is evidence that if you have the genetic mutations for Lynch syndrome or hereditary non-polyposis colorectal cancer (HNPCC), you’re at an increased risk of endometrial cancer as well. Finally, there is some evidence that if you’ve had radiation treatments for other types of cancer, you’re at an increased risk of endometrial tumors.
A person’s age and whether she has been through menopause are both important risk factors for endometrial cancer. Postmenopausal women are more likely to have the disease than premenopausal women. Researchers are investigating why this is. Pregnancy seems to decrease a woman’s risk for endometrial cancer because it shifts the balance of estrogen and progesterone in her body.
Cancer starts when cells in the body start to grow out of control. Most of the time, this growth isn’t a problem, but sometimes it is. In the uterus, the hollow pear-shaped organ where a baby grows, cancer can start in the inner lining called the endometrium. If left untreated, it can spread to the ovaries, fallopian tubes, bladder and other organs in the pelvic area. When it spreads to the muscle of the uterus, it’s called sarcoma of the uterus and is treated in a different way (see PDQ summary on Uterine Sarcoma Treatment).
The type and stage of the cancer determines your outlook (prognosis). The most common type of endometrial cancer is called type 1 and is the least likely to spread outside the uterus. This type of cancer tends to be cured with surgery alone. Another type of endometrial cancer, called type 2, is more likely to spread and has a poorer prognosis than type 1. This type is more likely to cause blood in the vagina, and it often starts in the ovary or fallopian tube. This type of cancer may be caused by too much estrogen, or it can also be the result of a rare ovarian tumor that secretes estrogen.
A small number of people develop a type of endometrial cancer that doesn’t appear to be related to estrogen or progesterone. This type is less common and usually has a worse prognosis than types 1 or 2. This type is called grade 3 endometrioid carcinoma or poorly differentiated endometrial carcinoma. It’s sometimes found in patients with a family history of Lynch syndrome, or in those who have undergone high-dose radiation therapy to treat other kinds of cancer.
A woman’s risk of getting endometrial cancer increases with age. Most cases of endometrial cancer are diagnosed in women between 45 and 74 years old. Other risks include abnormal ovulation patterns, which can happen in women with polycystic ovary syndrome; taking hormones after menopause that contain only estrogen (ERT); and a high-fat diet. If you’ve had a type of ovarian cancer called granulosa cell tumor or any type of sarcoma, you have an increased risk for endometrial cancer.
Getting regular checkups, and discussing any health changes you notice with your doctor, are important ways to protect yourself from many types of cancer, including endometrial cancer. Seeing your gynecologist right away when you have abnormal vaginal bleeding, especially if it’s blood-tinged, is one of the best ways to catch this type of cancer.
During a pelvic exam, your healthcare provider will feel around your uterus and other reproductive organs to see if there are any lumps or abnormalities. They may also order an imaging test to help them see the tissue inside your uterus and the surrounding area better.
A transvaginal ultrasound (TVUS) is a painless procedure that uses sound waves to create images of your uterus. This helps doctors see any cysts, polyps, or any other growths in your uterus. It can also show how thick the lining of your uterus is. This information helps doctors decide if you need a biopsy of the area.
If a biopsy is needed, your healthcare provider will use a hysteroscopy to remove a sample of the lining of your uterus. This is done by inserting a thin tube with a camera through your cervix into the uterus. Then, they’ll use a special tool to scrape off the cells for testing. They send the cells to a specialized healthcare provider called a pathologist, who looks at them under a microscope to see if they’re cancerous.
Sometimes, the hysteroscopy isn’t able to remove enough tissue for a biopsy. Or, the specialized healthcare provider can’t tell whether the cells are cancerous. In that case, your healthcare provider might need to do a D&C. During this procedure, your cervix is dilated and then a tool called a curette is used to scrape away tissue from the lining of your uterus.
Your healthcare provider might need to use a CT scan to find out how far the endometrial cancer has spread. A CT scan is an x-ray of your whole body, but it takes more detailed pictures than a traditional x-ray. A computer then combines the pictures to make a 3D image of the area being studied. This will show your healthcare provider how far the cancer has spread, and if it has reached other parts of your pelvic area, such as your bladder or rectum.
Women with endometrial cancer often have a good outlook if they are diagnosed and treated early. About 95% of women with stage 1 endometrial cancer are alive 5 years after their diagnosis. But that number is lower for people with more advanced cancer, which has spread beyond the uterus.
The most common treatment is surgery to remove the uterus (hysterectomy or salpingo-oophorectomy). Sometimes doctors use other treatments, including hormone therapy or radiation to help prevent the cancer from coming back. You will need regular follow-up tests after your treatment is over. These tests can show if the cancer is still present or has recurred.
Your doctor will look at your results from the biopsy, the Pap test, and other health information to decide what type of treatment you need. He or she will also talk to you about your personal and family situation. This can help determine how severe your cancer is and whether you should be treated now or if it will get worse later on.
Doctors don’t know what causes endometrial cancer, but having many menstrual periods raises your risk. And if you had a hysterectomy when you were young, it can increase your chance of getting the disease later. The more granulosa cell tumors in your ovary, the higher your chances of having endometrial cancer. Having polycystic ovarian syndrome (PCOS) and taking estrogen-only hormone replacement therapy increases your risk, too.
Another factor is your age. The older you are when you have a diagnosis, the more likely you are to die from it.
You can help yourself by learning as much as you can about your condition and what to expect from treatment. Your doctor can tell you about local and national resources that can help. You can also find a support group in your area. Joining a support group can help you feel less alone as you cope with this illness. You can find out about support groups by asking your doctor or visiting the website of the American Cancer Society. You should also try to stay mentally healthy. This can help you deal with stress and other problems that may come up during treatment.
The 5-year survival rate for endometrial cancer is 95% if diagnosed in its earliest stage. Your doctor might recommend using birth control pills or an IUD to reduce your risk.
Your doctor will ask questions about your symptoms and health history. They will do a pelvic exam to look at your uterus and cervix.
The most common symptom of endometrial cancer is abnormal vaginal bleeding. This can include bleeding between periods, pain during sex, and changes in the amount of blood you have with each period. It’s important to report these symptoms to your doctor. It’s also important to know that abnormal vaginal bleeding isn’t always caused by cancer. It could also be a sign of other health conditions, like fibroids or polyps.
Uterine cancer includes two types: endometrial cancer and uterine sarcoma. Both forms develop in the lining of your uterus. Endometrial cancer is the most common gynecologic cancer, and it’s also one of the most treatable.
If you have early stage uterine cancer, surgery can usually cure it. Your doctor may use a procedure called dilation and curettage, or D&C, to remove tissue from the uterus and send it for testing. They may also perform a biopsy to check for a tumor. A Pap test can’t screen for or diagnose uterine cancer.
If you have later stage uterine cancer, it’s more difficult to treat. But treatment can improve your quality of life by relieving your symptoms. Your doctor will give you chemotherapy drugs that kill cancer cells and help your body fight the disease. They may also recommend an operation to remove your uterus, cervix, fallopian tubes, and sometimes the ovaries (a total hysterectomy or oophorectomy).
Abdominal swelling can be a sign of many conditions, including Endometrial Cancer. It may be caused by a buildup of fluid, or it can happen when you eat too much food and the contents of your stomach can’t digest properly. Abdominal swelling can also be a result of a hernia. This is where a weakness in your abdominal wall muscles allows the contents of your stomach to push through into your small intestine.
It’s important to make an appointment with your doctor if you experience any of these symptoms. Early diagnosis and treatment can improve your outlook.
The exact cause of Endometrial Cancer isn’t known, but it can be linked to changes in the levels of estrogen and progesterone in the body. When these hormones change, the cells in the lining of the uterus can become abnormal and grow out of control. These cells can then spread to other areas of the body, causing cysts and causing the pain and bloating that are often seen as symptoms of Endometrial Cancer.
Women who have a swollen abdomen should see their GP for an examination. The doctor will ask about your symptoms and medical history, and then do a pelvic exam to look at your uterus and other reproductive organs. They may order an ultrasound scan to help them find the cause of the pain and bloating. They might also recommend a procedure called a dilatation and curettage (D&C) to remove a sample of the lining of your uterus for testing in a laboratory. This is done in a clinic under anaesthetic, so you won’t feel the procedure. If the cancer is found, treatments such as radiation and chemotherapy might be needed to reduce the size of any tumours and slow down any growth.
If you have bloating or a feeling that your abdomen is larger than usual, even when you’re not eating more than normal, talk to your doctor. This symptom can be a sign of many different medical problems, including a urinary tract infection (UTI), a hernia, or even a tumor in the abdominal or pelvic area.
Your doctor may order a pelvic exam to check for any abnormalities in the area, such as a tumor. A blood test or an X-ray might also be ordered. If a biopsy is needed, your doctor will dilate your cervix and use a tool to remove a sample of the endometrium. This procedure is called dilation and curettage (D&C).
Most cases of Endometrial Cancer are adenocarcinomas, which grow from glandular cells. Type 2 endometrial cancers (such as papillary serous carcinoma, clear-cell carcinoma, mucinous adenocarcinoma, and undifferentiated carcinoma) grow faster than type 1 and tend to spread outside the uterus more quickly. This is why doctors consider these types of endometrial cancer to have a poorer outlook (prognosis).
Women with rare ovarian tumors that make estrogen and those with a genetic syndrome called Lynch syndrome (also known as hereditary nonpolyposis colorectal cancer) are at a higher risk for this type of cancer. Other risk factors include age, obesity, and a high-fat diet.
If you have a low-grade cancer, your doctor might prescribe medications that can prevent the cancer from spreading to other parts of the body, such as chemotherapy with drugs that kill cancer cells or hormone therapy with pills or injections. A new treatment for endometrial cancer that has spread to other areas of the body, or has come back after previous treatment, is targeted therapy, which uses medicines designed to target specific changes in cancer cells.
There are many things that could cause abnormal vaginal bleeding, including non-cancerous conditions. But it is important to see your doctor if you have any concerns. If you have a gynecological problem, such as endometrial hyperplasia, it can become cancerous if left untreated. The symptoms include heavy or irregular menstrual periods and a thickening of the uterine lining.
Women who have had Endometrial Cancer may also experience a variety of other symptoms. Some of these are more common in later stages of the disease and can include pain in the pelvis or a feeling that there is a lump (tumor) in the abdomen. The symptoms also can be a sign that the cancer has spread to other parts of the body.
The most common symptom of uterine cancer is abnormal vaginal bleeding, especially if it happens after menopause or at any age. Often this is blood that can’t be seen. It may be blood between periods or even after sexual intercourse or urination. It can also be spotting or an unusual discharge that has a foul, unexpected odor.
Uterine cancer refers to any type of cancer that is in your uterus. Most uterine cancers start in the layer of cells that make up the lining of your womb, called the endometrium. But some uterine cancers, called uterine sarcomas, begin in the muscles and tissues of your uterus.
There is no simple way to screen for uterine cancer. A Pap test (Pap smear) doesn’t check for it and it is not treated with the same way as cervical cancer. However, if you have certain gynecologic conditions, like polycystic ovarian syndrome or granulosa cell tumors, you may be at higher risk for endometrial cancer.
A type of cancer called endometriosis can cause abnormal vaginal bleeding. It may be heavier than your normal period or you might have periods that don’t stop. If you have any changes in your vaginal bleeding, talk to your doctor straight away. If the symptoms get worse, you could be more at risk of developing endometrial cancer.
Vaginal bleeding is a common symptom of endometrial cancer, especially after menopause. If you have a history of other gynecological conditions, such as uterine fibroids or polyps, or if you have a family history of ovarian cancer, it is more important to tell your doctor right away about any changes in vaginal bleeding.
During the diagnosis process, your doctor will ask questions about your health and symptoms and examine you. This might include a pelvic exam where the doctor feels your uterus, bladder and ovaries for any lumps or swelling. They will also do a pap test (or smear), which is a way of checking the cells on your cervix for signs of noncancerous conditions, such as infection or inflammation.
To check whether your blood is coming from the lining of your uterus, your doctor might also do an ultrasound scan or a biopsy. They might take a sample of the lining of your uterus and send it to a laboratory to be examined under a microscope to see whether it has any cancerous cells. They might also look at the cancer cells to find out their “grade” – this is a number that shows how abnormal they appear under the microscope. A higher grade usually means the cancer is more likely to spread. The type of treatment you receive depends on the grade of your cancer.
Surgery is the main treatment for most women with endometrial cancer. It involves removing the uterus, fallopian tubes and ovaries (total hysterectomy with bilateral salpingo-oophorectomy). Lymph nodes in the pelvis and abdomen may be removed and tested for cancer cells.
Chemotherapy is often part of the treatment for stage III and IV endometrial cancer. It usually includes paclitaxel and carboplatin or ifosfamide. Immunotherapy drugs, like pembrolizumab or lenvatinib, may also be added to chemo in some patients.
Surgery is the main treatment for most people with endometrial cancer that has not spread. This usually involves removing the uterus, fallopian tubes and both ovaries. If the cancer is stage I or II, it may also include removing the cervix and pelvic lymph nodes. The doctor will do this procedure to check for cancer in the omentum (the layer of fat that wraps around the abdomen). Pelvic washings may also be done. This will help the surgeon know how far the cancer has spread.
If the cancer has spread to the omentum and bladder (stage III), the surgeon might try to remove as much of it as possible (called tumor debulking). The surgeon will also do pelvic washings and a pelvic and para-aortic lymph node dissection to find out how far the cancer has spread.
After surgery, the doctor will give chemotherapy (often called chemo) to wipe out any remaining cancer cells. The type of chemotherapy depends on the type of cancer: For early stage serous adenocarcinoma or clear cell adenocarcinoma, doctors usually use paclitaxel (Ifex) in combination with cisplatin or carboplatin. For a uterine carcinosarcoma, the doctors might use ifosfamide in combination with doxorubicin or paclitaxel.
If your cancer has spread to other parts of the body, your doctor will treat it with other types of drugs. These are given to control the growth of the cancer and relieve pain or other symptoms. Some of these are given by mouth and others are given into the bloodstream through a vein.
Other types of treatment are used to treat the symptoms or prevent the cancer from spreading, especially hormone therapy and radiation. Some women who have a recurrence of the cancer can benefit from using progesterone, which can stop the cancer from growing. Others might need estrogen replacement therapy or tamoxifen to maintain their hormone levels and reduce the risk of the cancer returning. Other treatments that might be used for advanced endometrial cancer are targeted therapy and immunotherapy. Both of these work to block certain weaknesses that cancer cells have, so the cancer cells die.
A doctor can use chemotherapy to treat advanced endometrial cancer. This can be done after surgery or before surgery to shrink the tumor and decrease the risk that it will come back (recur). Chemotherapy may also be used with radiation therapy to decrease the risk of the cancer spreading to other parts of the body, such as the lungs. This is called systemic therapy.
If you have stage III or IV endometrial cancer, your doctor may suggest hormone therapy to lower your estrogen and progesterone levels. This can help the cancer cells die. The most common hormone therapy drug for endometrial cancer is metformin. You might take this drug alone or with other medicines that suppress the immune system, such as mTOR inhibitors everolimus or ridaforolimus and signal transduction inhibitors temsirolimus or lenvatinib. You might also want to ask your doctor about clinical trials that are testing new treatments for advanced endometrial cancer.
For some women, the cancer will spread to lymph nodes in the pelvis and para-aortic area before it can be removed with surgery. These cancers are often treated with a combination of surgery, radiation therapy and drugs that block the growth of new blood vessels. The chemotherapy drugs might be fluorouracil or capecitabine (Furoxaban). Your doctor will also remove the ovaries, fallopian tubes and pelvic lymph nodes in this stage of disease.
Your doctor might recommend hormone therapy to slow the growth of recurrent or metastatic endometrial cancer that has spread beyond the uterus. You might be given synthetic progestin to lower your estrogen levels and make cancer cells less likely to grow. You might also be given radiation therapy to the pelvis to reduce the risk of local recurrence or to relieve pain and symptoms from distant metastases.
Many people who have endometrial cancer are able to have children after treatment. Your doctor will talk to you about your family planning goals before starting any therapy. You might consider having a genetic test to find out whether you might pass on certain mutations to your children. These genes are known as inherited cancer syndromes.
For women who aren’t healthy enough for surgery or whose cancer is in stages I and II (where it has not spread to the lymph nodes), radiation may be used as their main treatment. The radiation can help kill any cancer cells that are still there and decrease the chance of the cancer coming back in the pelvis (called locoregional recurrence). Radiation can be given in a pill or delivered through vaginal brachytherapy or external radiation.
Radiation works by exposing cancer cells to high-energy x-rays over several days. The x-rays knock electrons off the cells and they can’t repair this damage. This stops the cells from growing and destroys them. Radiation can also be used before surgery to shrink a tumor and make it easier to remove.
In a randomized clinical trial, women who had stage III or IV endometrial cancer who received adjuvant chemotherapy plus radiation (chemoradiation) had a lower risk of the cancer returning in the pelvis within five years than those who had surgery alone. However, many women don’t qualify for this more intensive treatment. The type and stage of your cancer, age and overall health, and whether you want to have children all affect your treatment plan.
Chemotherapy can kill cancer cells and prevent them from growing. It’s usually given with other treatments, like radiation or hormone therapy. It’s important to talk to your doctor about the types and amounts of drugs you’ll receive, what their side effects are, and how often you will receive them.
When you’re treated for endometrial cancer, doctors also look at what types of hormones are in your body to see if the cancer is fueled by them. If it is, drugs can be given to reduce or block these hormones.
Some women are diagnosed with endometrial cancer at a time when they are considering or planning to have children. For young premenopausal women who have low-risk disease and don’t have a history of serous or clear cell carcinoma, preserving fertility with progestins is an option. For women who have intermediate or high-risk disease, surgery (hysterectomy) can’t be delayed and must be done to ensure that the cancer is not recurrent.
In targeted therapy, doctors use drugs to target and destroy cancer cells without harming normal cells. They do this by blocking the cancer cells’ ability to grow and spread. They also can interfere with the molecules that cancer cells need to grow and survive. Targeted therapy can be given as a pill or an infusion and may be used alone or with other therapies like chemotherapy and radiation.
Generally, women with endometrial cancer are treated by surgically removing the uterus (hysterectomy) and possibly the cervix (bilateral salpingo-oophorectomy). The type of surgery depends on the stage of the disease. Women with early-stage endometrial cancer have a very good prognosis (95% survival for five years or more). For women with more advanced endometrial cancer, the outlook is less favorable (less than 20% survival for five years or more), especially when it has spread beyond the uterus (metastasized).
Chemotherapy is usually recommended as an adjuvant therapy after surgery to kill any remaining cancer cells and increase the chance of cure. A combination of agents is typically used, including the chemotherapy drugs cisplatin and paclitaxel. In some cases, a woman with stage III endometrial cancer might benefit from other chemotherapy agents such as vinblastine or leucovorin.
For patients with stage IV endometrial cancer, a drug called neomycin is sometimes used to prevent metastasis to the lungs and other organs. Another option for people with stage IV endometrial cancer is to take a drug called everolimus, which stops tumors from growing by blocking the cell’s ability to make new blood vessels. Another option for some people with stage IV endometrial cancer involves a drug called ridaforolimus, which targets a molecule found in many types of cancers and has been shown to help treat some cancers that have not responded to other drugs.
Several research trials of immunotherapy, or cancer-immunity therapy, have been reported recently. In general, these trials have shown that drugs that prompt the body’s own immune system to attack the cancer might improve outcomes for some people with endometrial cancer. However, more research is needed.
When cancer grows in your uterus, it’s called endometrial cancer. This is the most common type of gynecologic cancer.
The type of endometrial cancer you have determines your prognosis. Localized endometrioid carcinoma (type 1 and grade 1) is associated with excellent outcomes, while invasive endometrioid, serous, and clear cell carcinoma has worse prognosis.
If you have endometrial cancer, doctors work to find out whether it has spread inside the uterus or to other parts of your body. They use a number of tests and procedures to do this. The process is called staging. The stage of the cancer tells how serious it is and how much treatment you need. The stages are indicated by Roman numerals from I to IV, with the lowest stage indicating that the cancer hasn’t grown beyond the uterus.
Most endometrial cancers are adenocarcinomas, which start in gland cells that line the uterus. They can grow and spread quickly or slow down, depending on how abnormal the cancer cells look under a microscope. These cancers are divided into several types, including clear-cell carcinoma, mucinous adenocarcinoma, undifferentiated carcinoma and dedifferentiated carcinoma. A higher number means the cancer cells look more abnormal, and a lower number means the cancer is less likely to grow and spread.
In most cases, doctors treat stage 1 endometrial cancer by removing the uterus (a hysterectomy) and sometimes also the fallopian tubes and the upper portion of the vagina. Doctors might also give you hormone therapy after surgery to prevent the cancer from coming back. You might need other treatment, such as radiation therapy or vaginal brachytherapy, to help prevent your cancer from spreading. If you want to have children in the future, your doctor might suggest fertility-sparing treatments like progestin therapy, which uses hormones to cause your cancer cells to shrink or disappear for a short time.
The chances of getting endometrial cancer increase as you get older. It’s important to talk to your doctor about your family history, personal health and habits, and any symptoms you have. These can all affect your chance of getting cancer, even if you don’t have any of the following risk factors:
A small percentage of endometrial cancers are type 2. These tend to grow and spread outside the uterus faster than the other types. They also have a poorer outlook (than the other types). We don’t know what causes these. They don’t seem to be caused by too much estrogen. Type 2 endometrial cancers include papillary serous carcinoma, clear cell carcinoma, and undifferentiated carcinoma.
Some women get cancer of the uterine lining only after menopause, when hormones no longer control the growth of cells. This is called postmenopausal endometrial cancer. Others get it earlier, before menopause, because they have a condition that makes them produce a lot of extra estrogen. These conditions are known as risk factors for this type of cancer. They are obesity, having a condition called polycystic ovarian syndrome, or taking estrogen-only hormone replacement therapy. Women with these risks are twice as likely to get this type of cancer.
Most endometrial cancers start in gland cells that look like those of the uterus lining (endometrium). The way that the gland cells are organized is used to classify the cancer as either adenocarcinoma or squamous cell carcinoma. Adenocarcinoma is the most common form of endometrial cancer. Most adenocarcinomas are endometrioid adenocarcinoma, which is less aggressive and usually doesn’t spread very fast. Other types of adenocarcinoma include mucinous adenocarcinoma and serous adenocarcinoma.
Doctors use tests and procedures to find out whether cancer has spread within the uterus or to other parts of the body. One of the most important tests is a hysterectomy, an operation in which the uterus is removed. During the hysterectomy, doctors remove tissue from the area around the uterus and check it under a microscope to see if there are any cancer cells. This process is called staging.
Women who have had a hysterectomy are at lower risk for endometrial cancer than those who don’t. But other types of cancer can still happen to these women. The earliest stages of endometrial cancer are hard to detect. That’s why doctors recommend regular pelvic exams, Pap smears, and vaginal ultrasounds.
Uterine sarcomas are cancerous tumors that begin in the muscle wall of the uterus. The three types of uterine sarcomas are: leiomyosarcoma, endometrial stromal sarcoma (ESS), and undifferentiated uterine sarcoma.
They can cause pain in the pelvis and abdomen and a feeling of fullness. They are usually diagnosed in premenopausal or postmenopausal women.
Diagnosing uterine sarcoma usually begins with a physical exam and a complete health history. Your doctor will ask you about your past illnesses and whether you have any family members with uterine sarcoma or other types of cancer.
A sample of tissue from the uterus is usually needed to diagnose a uterine sarcoma. A biopsy is usually done by inserting a needle into the uterus and taking a small piece of tissue to be examined under a microscope. In some cases, other tests may be needed to help make the diagnosis.
If a uterine sarcoma is diagnosed, treatment will depend on the type of sarcoma and how much it has spread. Some sarcomas can be treated with surgery alone. Others need chemotherapy, radiation therapy, or both. Hormone therapy may be used to control the growth of some sarcomas. It works by removing hormones that can cause the uterus to grow or by blocking the action of hormones that can encourage cancer cells to grow. New types of hormone therapy are being tested in clinical trials.
The prognosis for uterine sarcomas is generally poorer than for endometrial cancer. This is because most sarcomas tend to spread quickly and are harder to treat than most endometrial cancers.
Leiomyosarcomas have a better prognosis than the other two types of uterine sarcomas. But they can recur.
If a sarcoma recurs in the uterus or pelvis, your doctor may suggest a combination of surgeries and other treatments. These may include total abdominal hysterectomy (TAH) with removal of the fallopian tubes (bilateral salpingo-oophorectomy). Some patients with recurrent sarcoma in the uterus or pelvis who did not have previous RT may be candidates for EBRT with or without brachytherapy and systemic therapy. If the recurrence is in a different part of the pelvis, your doctor may also suggest a combination of surgery and chemotherapy.
When uterine carcinosarcoma develops, the cancer cells look like a mix of endometrial adenocarcinoma and sarcoma. It is a very rare type of cancer that affects women of postmenopausal age. It often affects the lining of the uterus, but it may also spread to the muscular outer layer (myometrium) of the uterus or to nearby tissues in the pelvic area.
Doctors diagnose uterine carcinosarcoma by taking a sample of tissue from the uterus to examine under a microscope. They may also perform a pelvic exam or an ultrasound to see the uterus and surrounding structures. They will ask about your symptoms and health history and your family’s medical history. For example, they will ask if you have had other health problems or illnesses, such as abnormal vaginal bleeding or pain in your pelvis or belly. They will also want to know if you have had any previous cancer or treatment.
Your healthcare provider will order blood tests and X-rays to check for signs of cancer in your body. They will also use a procedure called a biopsy to take out a small piece of the uterus lining and examine it under a microscope.
This is the only way to confirm if you have uterine cancer. The biopsy also helps determine the stage of your uterine cancer. The staging explains how far the cancer has spread. Your healthcare provider will use the results of the biopsy and other information to decide what treatment is best for you.
Your healthcare team will give you advice about how to avoid getting uterine cancer in the future. They will recommend lifestyle changes and other treatments, such as hormone therapy or surgery. They may also suggest medicines, such as tamoxifen and cyclophosphamide.
Uterine carcinosarcoma is a rare aggressive biphasic neoplasm. It has a poor prognosis and few predictive factors. In this study we assessed the effect of clinical and histopathologic features on recurrence and survival in 196 patients with uterine carcinosarcoma. The recurrence rate was significantly lower in patients with tumors confined to the uterine wall and absence of myometrial invasion.