Youth Cancer

Cancer of the Uterus

Cancer of the uterus (uterine cancer) only affects women. The uterus, is the place in a woman's body where a baby grows before being born.

  • The lining of the uterus is called the endometrium and is shed each month, as a period.
  • Cancer that starts in the uterus lining is called endometrial or uterus cancer.
  • Cancer that starts in the muscle layers of the uterus is called uterine sarcoma.

 

What causes uterine cancer?

Like other cancers, cuterine cancer is not infectious. The exact cause of womb cancer is not yet known. It most commonly occurs in women between the ages of 50 and 64 and after menopause.

There are factors that increase the risk of getting uterine cancer:

  • Being overweight: four out of ten cancers of the womb are said to be caused by being overweight.
  • Inherited faulty gene: while rare there may be gene fault HPNCC (hereditary non-polyposis colorectal cancer) that can be present that raises the risk of uterine cancer.
  • Post Menopause HRT (Hormone replacement therapy): Women who have had their menopause and who take oestrogen-only HRT, for a long time may have a slightly increased risk of developing the disease.

 

Some other possible risk factors for women:

  • Taking tamoxifen (a hormonal therapy sometimes taken to treat breast cancer) over a long period of time.
  • Not having children or been pregnant.
  • Having had Cowden syndrome or polycystic ovary syndrome (PCOS).

 

What are the symptoms?

The most usual early symptom of uterinecancer is abnormal vaginal bleeding. That is bleeding between periods, heavier periods than normal and abnormal vaginal discharge. Other symptoms of uterine cancer might be:

  • Pain in the lower abdomen (tummy), back or legs.
  • Discomfort or pain during sexual intercourse.

Sometimes a cervical screening or smear test is not enough to identify uterine cancer, as the sample is taken from the cervix, situated in the lower part of the womb.

TIP:
If you have any of these above symptoms you should have them checked by your doctor - but remember, they are common to many illnesses of the uterus and may not be attributable to cancer.

 

How is it diagnosed?

After visiting a GP a referral will probably be made to a hospital for some tests. These may include:

  • Vaginal ultrasound: A small device is gently put into the vagina. Sound waves are used to make up a picture of the inside of the womb. This may be uncomfortable but not painful.
  • Hysteroscopy: A thin, flexible tube with a light at the end, is passed through the vagina into the uterus. Doctors look inside the uterus and take tissue samples (biopsy). Usually done as an outpatient under a local anaesthetic (the patient is awake). Afterward there may be some bleeding and period-type pains for a day or so.
  • Dilatation and curettage (D&C): Carried out under a general anaesthetic. The cervix is stretched so that the gynaecologist (a specialist in reproductive organs) can insert an instrument to remove samples of tissue from the lining of the uterus, for examination. After D&C, most women have period-type pains for a day or so.

If the results of the test show uterine cancer, another referral will be made to a doctor who specialises in the treatment of the uterus (called a gynaecologist ).

Some of the tests will be done by a specialist.

 

Staging


The stage of a cancer is a term used to describe its size and whether it has spread beyond the original area where it started.

Uterine cancer is divided into four stages:

  • Stage 1 uterine cancer: contained within the uterine only.
  • Stage 2 uterine cancer: has spread to the cervix.
  • Stage 3 uterine cancer: more advanced, but is contained within the pelvis.
  • Stage 4 means the cancer has spread beyond the uterine into surrounding organs.


If the cancer has spread to other parts of the body this is secondary (or metastatic) uterine cancer.

Recurrent endometrial cancer is when the cancer comes back some time after initial treatment.

Grading

Grading refers to the appearance of the cancer cells under the microscope. There are three grades:

  • Grade 1: cells look very like the normal cells, usually grow slowly and less likely to spread.
  • Grade 2: cells look more abnormal than low-grade cells.
  • Grade 3: cells look very abnormal. Likely to grow more quickly and more likely to spread.

 

How is it treated?

A team of doctors and other staff at the hospital will plan treatment. It will depend on the size of the tumour and where it is.

Treatment may be coordinated by an oncologist (a doctor who specialises in treating cancer with chemotherapy) a gynaecologist (a doctor who specialises in reproductive organs) and a radiologist (a doctor who specialises in treating cancer with radiation).

Treatment may involve:

  • Hormonal therapy
  • Chemotherapy
  • Radiotherapy
  • Surgery

Most people have chemotherapy to shrink to size of the tumour and to get rid of any cancer cells around the body. This is usually followed with surgery to remove the tumour.

 

Hormonal therapy for uterine cancer 

Advanced uterine cancer maybe treated with hormonal treatment (progesterone). Progesterone is a hormone that occurs naturally in women. This may shrink the cancer and control symptoms.


Chemotherapy for uterine cancer

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It may be used if the cancer comes back, or has spread to other parts of the body or does not respond to hormonal treatment.

In some people, chemotherapy may help to shrink the cancer and relieve symptoms.


Surgery for uterine cancer

The surgical treatment for uterine cancer is the removal of the uterus (hysterectomy) and is carried out by a gynaecological surgeon. 

Usually, the fallopian tubes and both ovaries will also be removed (total hysterectomy with bilateral salpingo-oophorectomy.)

Sometimes the lymph nodes close to the womb will also be removed, the reason being to remove as much of the cancer as possible and to enable the pathologist(person in the laboratory) to see if there are any cancer cells in the lymph glands.

Often no further treatment is necessary.

For more information have a look at our surgery fact sheet.

Radiotherapy for uterine cancer

Radiotherapy (the use of powerful x-rays) is given to people with cancer of the uterus before and/or after surgery. This is to shrink and destroy the tumour.