Uterine cancer

Overview

The uterus, also called the womb, is a hollow, pear-shaped organ located in a woman's lower abdomen (belly), between the bladder and the rectum. Cancers that occur in each part of the uterus have their own names, such as cervical cancer or endometrial cancer, but are sometimes broadly defined as uterine cancer because the structure is part of the uterus. Cancer of the uterus spreads through the bloodstream or lymphatic system.

Our approach

With one of the largest gynecologic oncology programs in the New York metropolitan region, Northwell Health takes a comprehensive approach to treating women with cancer of the reproductive organs, including uterine cancer. The specialists work together — and with the patient — to plan the most effective course of uterine cancer treatment using the latest, research-backed therapies available.

Highlights of the uterine cancer treatments and services include:

  • The latest technology to diagnose and treat both early-stage and recurrent uterine cancers
  • The latest surgical innovations — with an emphasis on minimally invasive and fertility-sparing techniques
  • Innovative uterine cancer treatments, including targeted therapies
  • Genetic testing for women at high risk of uterine cancer
  • An extensive clinical trials program

Multidisciplinary Uterine Cancer Treatment

Within the first several days of a visit, the team will conduct a complete array of tests and develop a personalized uterine cancer treatment program.

Each uterine cancer diagnosis is unique, so the team meets regularly to discuss the individual treatment approach for each specific situation during weekly teleconferences that allow the physicians to share ideas and best practices for delivering highly specific and fully explored collaborative patient care. Each phase of a patient’s treatment is reviewed, to ensure that treatment milestones are reached.

Risk factors

The following are risk factors for uterine cancer:

  • Age - The risk goes up as women get older.
  • History of endometrial hyperplasia
  • Estrogen therapy (ET)
  • Obesity is the leading risk factor for endometrial cancer
  • Diabetes
  • History of an inherited form of colon cancer (called hereditary nonpolyposis colon cancer or Lynch syndrome)  
  • History of breast or ovarian cancer
  • History of taking tamoxifen for breast cancer treatment or prevention
  • Race - African-American women are affected with uterine sarcoma at a rate twice that of white or Asian women.
  • History of radiation therapy to the pelvic area
  • High-fat diet
  • History of polycystic ovary syndrome (PCOS)
  • Reproductive and menstrual history. An increased risk is linked to never having children, having a first menstrual period before age 12, and/or going through menopause after age 55.

Symptoms

The following are the most common symptoms of uterine cancer. However, each individual may experience symptoms differently. Symptoms may include:

  • Unusual vaginal bleeding, spotting, or discharge
  • Vaginal bleeding after menopause
  • Frequent, difficult, or painful urination
  • Pain during sexual intercourse
  • Pain in the pelvic area

Cancer of the uterus usually does not occur before menopause. It usually occurs around the time menopause begins. The occasional reappearance of bleeding should not be considered simply part of menopause. It should always be checked by a doctor.

The symptoms of uterine cancer may look a lot like other conditions or medical problems. Consult a doctor for diagnosis.

Diagnosis

The first step in making a diagnosis of uterine cancer is usually a physical, during which a doctor will perform a pelvic exam and review personal and family medical history. If uterine cancer is suspected, the patient will be referred for further tests.  

When symptoms suggest uterine cancer, the following may be used to make a positive diagnosis:

  • Uterine biopsy - A uterine tissue sample is taken by inserting a small, flexible plastic tube into the uterus. A pathologist examines the tissue under a microscope to determine if cancer is present. 
  • Ultrasound - This imaging test uses sound waves to create images of internal organs and structures. 
  • Dilation and curettage (D&C) - During this minor surgical procedure, the cervix is expanded (dilated), and the cervical canal and uterine lining is scraped with a spoon-shaped instrument (curette). The sample is examined under a microscope by a pathologist to determine if cancer or other abnormal cells are present.
  • CT or CAT scan (computerized axial tomography) –This test uses a combination of X-rays and computer technology that produces detailed cross-sectional images of the structures inside of the abdomen and pelvis. 

Staging

Once a uterine cancer diagnosis has been confirmed, a doctor may conduct one or more of the diagnostic imaging tests listed above to determine the location of the cancer and how far it has spread.

This process is called staging. The stages of uterine cancer include:

  • Stage I - Cancer is found in the uterus only.
  • Stage II - Cancer has spread into connective tissue of the cervix, but has not spread outside the uterus.
  • Stage III - Cancer has spread beyond the uterus and cervix, but has not spread beyond the pelvis.
  • Stage IV - Cancer has spread beyond the pelvis, and likely to other organs. 

Staging is necessary in order to design the most effective treatment plan.

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