Uterine cancer is the most common cancer of the female reproductive system, with more than 49,500 Americans diagnosed with the disease each year. It tends to develop after menopause, when a woman is between the ages of 50 and 60.
Experts from Memorial Sloan Kettering discuss the latest approaches to early detection, screening, and treatment for women with endometrial cancer.
The uterus is a hollow, pear-shaped organ in a woman’s pelvis in which a fetus grows after conception. Most cancers begin in the lining of the uterus, which is called the endometrium. Rarer forms develop within the actual muscle of the uterine wall; this is called uterine sarcoma and is managed differently.
Types of Uterine (Endometrial) Cancer
There are many different types of uterine cancer. Each type varies in the way it behaves and how it should be managed. For this reason, specialized pathology review is often recommended.
- Endometrioid adenocarcinoma: This type of uterine cancer forms in the glandular cells of the uterine lining. It accounts for as much as 75 percent of all uterine cancers. Endometrioid adenocarcinoma is commonly detected early and has a high cure rate.
- Clear cell adenocarcinoma: About 5 percent of uterine cancers are of this type, which is primarily diagnosed in women who were exposed in utero to an estrogen drug known as diethylstilbestrol (DES). From 1938 to 1971, DES was prescribed to some pregnant women to prevent miscarriage. The female children of women exposed to DES have an increased risk of rare types of uterine, cervical, and vaginal cancers. This form of adenocarcinoma tends to recur (come back after treatment) or metastasize (spread) to other areas of the body.
- Serous adenocarcinoma: These tumors are more likely to spread to lymph nodes and other parts of the body. About 10 percent of uterine cancers diagnosed are of this type.
- Adenosquamous carcinoma: This rare form of uterine cancer has elements of both adenocarcinoma and carcinoma of the squamous cells that line the outer surface of the uterus.
- Carcinomasarcoma: This rare form of uterine cancer was previously thought to be a type of uterine sarcoma. However, it is now felt to be an endometrial cancer. It has elements of both adenocarcinoma and sarcoma. These tumors have a high risk of spread to lymph nodes and other parts of the body.
More than 90 percent of women with endometrial cancer experience abnormal vaginal bleeding. In some cases the bleeding may appear as vaginal discharge that is watery, or pink or white instead of red. Women in their late 30s and early 40s may also experience heavy bleeding between periods. For women who have gone through menopause, any vaginal bleeding should be discussed with their doctors; one in ten postmenopausal women with vaginal bleeding are found to have uterine cancer.
Other symptoms of uterine cancer may include:
- Difficulty urinating
- Pain when urinating
- Pain during sexual intercourse
- Pelvic pain (usually a symptom of later stages of disease)
- Unexplained weight loss (usually a symptom of later stages of disease)
While these and other symptoms do not necessarily indicate cancer, you should consult your doctor for examination, since early detection of many types of uterine cancer greatly increases the chance of a cure.