Uterine Cancers

Uterine cancer is considered the fourth most common cancer in women in the United States. It is estimated that as many as 7,400 women will die from this type of cancer in 2007. Uterine malignancies most commonly affect women after the reproductive years, between the ages 50–70. Obese women are at higher risk for developing uterine cancer.

The uterus is a hollow reproductive organ that houses the fetus and supports the development of the baby during pregnancy. The uterus can be viewed as a pear divided into two parts, or two ends. The lower end extends into the vagina (the female genital canal) and is referred to as the cervix. The higher, wider part is called the body (or corpus, meaning body in Latin). The uterine body is lined by two layers of different cells. The inner lining is called the [Page 766]endometrium. The outer lining is called the myometrium. These two layers of the uterus can give rise to different types of cancer.

Endometrial cancer arising from the inner endometrial lining of the uterus is most often (95 percent) adenocarcinoma. The endometrial lining of the uterine corpus contains tiny cells that resemble glands. The cancer of these cells is called adenocarcinoma. Another type of cancer that can occur in the endometrial lining is called adenosquamous carcinoma. This malignant tumor arises from another type of cell in the endometrial layer—the squamous cell. This type of cell is found on various surfaces of the body, such as skin.

Uterine cancers that may arise in myometrium are called sarcomas (5 percent incidence rate). The myometrium has a similar composition to muscle. These types of cancer tend to be more aggressive, more invasive, and more resistant to treatment.

Another type of uterine cancer that may occur includes features of cancers arising from the endometrial as well as myometrial lining. This type of cancer is called uterine carcinosarcoma.

There are numerous risk factors for developing uterine cancer. One of the major risks is prolonged exposure to estrogen (hormone produced by reproductive organs that stimulates sexual maturation and growth and regulates menstrual cycle). This exposure may be due to certain diseases, tumors, or medicines. Another important risk factor is obesity. It has been found that an individual 20–50 pounds overweight has tripled her risk for developing uterine cancer. Moreover, if an individual is more than 50 pounds overweight, the risk goes up to 10 times. It has been observed that fat cells in the human body produce estrogen, a hormone linked to increased incidence of uterine cancer. Some other risks include nulliparity (not having given birth to children), diabetes, hypertension, gallbladder disease, and late onset of menopause.

Any unusual discharge, bleeding, or spotting from the vagina, especially in women after menopause, may be a presenting symptom of uterine cancer. Additional symptoms may include abdominal pain, mass, and weight loss.

The diagnosis of uterine malignancy is accomplished through several steps. First, a gynecologist (a doctor specializing in treating the female reproductive system) must examine any woman suspected of having uterine cancer. The doctor may take an endometrial biopsy (a sample of the endometrium for close examination under the microscope) and perform an ultrasound. There are some other procedures that may be suitable, depending on the patient. Hysteroscopy is a method that allows the doctor to look closely inside the uterus and inspect it with a small telescope. If there is any evidence of malignant area, a biopsy can be taken. Dilation and curettage (D&C) procedure provides more information if biopsy results are inconclusive. During this procedure, the cervix (lower part of the uterus) is dilated (enlarged) and a special instrument is inserted into the uterus to scrape off a sample of the tissue inside.

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