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Learn About Endometrial/Uterine Cancer
Written by NCI/PDQ®

Source: Cancer Resource Room

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What is Endometrial Cancer?
Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.

The endometrium is the lining of the uterus. The uterus is a hollow, muscular organ in a woman’s pelvis. View - Female Pelvis - Front The uterus is where a fetus grows. In most nonpregnant women, the uterus is about 3 inches long.

Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called sarcoma of the uterus. Refer to the PDQ summary on Uterine Sarcoma Treatment for more information.

Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can affect the risk of developing endometrial cancer.
Endometrial cancer may develop in breast cancer patients who have been treated with tamoxifen. A patient taking this drug should have a pelvic examination every year and report any vaginal bleeding (other than menstrual bleeding) as soon as possible. Women taking estrogen (a hormone that can affect the growth of some cancers) alone have an increased risk of developing endometrial cancer. Taking estrogen in combination with progesterone (another hormone) does not increase a woman’s risk of this cancer.

What are the symptoms of endometrial cancer?
Possible signs of endometrial cancer include unusual vaginal discharge or pain in the pelvis. A woman should see her doctor if any of the following problems occur:

  • Bleeding or discharge not related to menstruation (periods).
  • Difficult or painful urination.
  • Pain during sexual intercourse.
  • Pain in the pelvic area.

How is endometrial cancer diagnosed? Tests that examine the endometrium are used to detect (find) and diagnose endometrial cancer.
Because endometrial cancer begins inside the uterus, it does not usually show up in the results of a Pap test. For this reason, a sample of endometrial tissue must be removed and examined under a microscope to look for cancer cells. One of the following procedures may be used:

  • Endometrial biopsy: The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells.
  • Dilatation and curettage (D&C): A surgical procedure to remove samples of tissue or the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. Tissue samples may be taken for biopsy. This procedure is also called a D&C.

Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (whether it is in the endometrium only, involves the whole uterus, or has spread to other places in the body).
  • How the cancer cells look under a microscope.
  • Whether the cancer cells are affected by progesterone.

Endometrial cancer is highly curable.

After endometrial cancer has been diagnosed, tests are done to find out if cancer cells have spread within the uterus or to other parts of the body.
The process used to find out whether the cancer has spread within the uterus or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Certain tests and procedures are used in the staging process. A hysterectomy (an operation in which the uterus is removed) will usually be done to help find out how far the cancer has spread.

The following stages are used for endometrial cancer:

  • Stage I
    In stage I, cancer is found in the uterus only. Stage I is divided into stages IA, IB, and IC, based on how far the cancer has spread.
    • Stage IA: Cancer is in the endometrium only.
    • Stage IB: Cancer has spread into the inner half of the myometrium (muscle layer of the uterus).
    • Stage IC: Cancer has spread into the outer half of the myometrium.
  • Stage II
    In stage II, cancer has spread from the uterus to the cervix, but not beyond the cervix. Stage II is divided into stages IIA and IIB, based on how far the cancer has spread into the cervix.
    • Stage IIA: Cancer has spread to the glands where the cervix and uterus meet.
    • Stage IIB: Cancer has spread into the connective tissue of the cervix.
  • Stage III
    In stage III, cancer has spread beyond the uterus and cervix, but has not spread beyond the pelvis. Stage III is divided into stages IIIA, IIIB, and IIIC, based on how far the cancer has spread within the pelvis.
    • Stage IIIA: Cancer has spread to:
      the outermost layer of the uterus; or
      tissue just beyond the uterus; or
      cells in the peritoneum.
    • Stage IIIB: Cancer has spread beyond the uterus and cervix, into the vagina.
    • Stage IIIC: Cancer has spread to lymph nodes near the uterus.
  • Stage IV
    In stage IV, cancer has spread beyond the pelvis. Stage IV is divided into stages IVA and IVB, based on how far the cancer has spread.
    • Stage IVA: Cancer has spread to the bladder or rectum.
    • Stage IVB: Cancer has spread to other parts of the body beyond the pelvis, including lymph nodes in the abdomen and/or groin.

Recurrent Endometrial Cancer
Recurrent endometrial cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the pelvis, in lymph nodes in the abdomen, or in other parts of the body.

To read more about Endometrial Cancer >>>

Support & Education Programs

We know that being diagnosed with cancer can be stressful for you and your family. We offer a variety of cancer support services to help patients and families gain the support and information they will need to meet the challenges ahead.

To find information on the Gynecological Support Group, education and support workshops plus wellness services, please view the HOPES calendar.

Read the most recent SUPPORT publication, a resource written by patients and families for patients and families >>>

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