Gynecologic Cancer Care
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The uterus is lined with a special tissue called the endometrium. When cancer grows in this lining, it is called endometrial cancer. Most cancers of the uterus are endometrial cancer. Approximately three in 100 women will be diagnosed with uterine cancer at some point in their lives. More than 80 percent of people with uterine cancer survive for five years or longer after receiving the diagnosis.

Risk

Endometrial cancer usually happens in women past menopause. More than 95 percent of endometrial cancer happens in women over 40. Postmenopausal women have a high risk for endometrial cancer with the following:

  • Are obese
  • Have amenorrhea (absence of menstruation) or oligomenorrhea (infrequent menstruation)
  • Have a history of polycystic ovary syndrome
  • Have a family history of endometrial, ovarian or colon cancer

Symptoms

The most common symptom of endometrial cancer is abnormal vaginal bleeding. This can include:

  • Changes in the length or heaviness of menstrual periods
  • Vaginal bleeding or spotting between menstrual periods
  • Vaginal bleeding after menopause

Other potential symptoms of endometrial cancer include:

  • Watery or blood-tinged vaginal discharge
  • Pain in the lower abdomen or pelvis
  • Painful intercourse

Diagnosis

A pelvic exam can find abnormalities in your uterus and other reproductive organs. A transvaginal ultrasound (TVUS) exam may be ordered to check for tumors or other abnormalities.

If your doctor detects abnormalities during the ultrasound exam, they may order one or more of the following tests to collect a sample of tissue for testing:

  • Endometrial biopsy — In this test, your doctor inserts a thin flexible tube through your cervix into your uterus. They apply suction to remove a small piece of tissue from your endometrium through the tube.
  • Hysteroscopy — In this procedure, your doctor inserts a thin flexible tube with a fiber-optic camera through your cervix into your uterus. They use this endoscope to visually examine your endometrium and biopsy samples of abnormalities.
  • Dilation & Curettage (D&C) — If the results of a biopsy are unclear, your doctor might collect another sample of endometrial tissue using D&C. To do so, they dilate your cervix and use a special tool to scrape tissue from your endometrium.

Staging

The cancer is classified into four stages based on how much it has grown or spread:

  • Stage 1 — The cancer is only present in the uterus.
  • Stage 2 — The cancer is present in the uterus and cervix.
  • Stage 3 — The cancer has spread outside the uterus, but not as far as the rectum or bladder. It might be present in the fallopian tubes, ovaries, vagina, and/or nearby lymph nodes.
  • Stage 4 — The cancer has spread beyond the pelvic area. It might be present in the bladder, rectum, and/or distant tissues and organs.

Treatment

Endometrial cancer is often treated with a type of surgery called hysterectomy where surgeons remove the uterus and possibly the ovaries and fallopian tubes.

Depending on the stage of the cancer, your doctor may also recommend chemotherapy and/or radiation treatment and hormone therapy.