Uterine Cancer

Most cancers of the uterus begin in the lining of the uterus and are therefore called endometrial cancers.  This is the most common gynecologic cancer, affecting an estimate 40,000 American women in 2003 and claiming the lives of 6,800.  Endometrial cancers usually develop after menopause, especially if a woman is taking unopposed estrogen (estrogen therapy without progesterone) or if she has other risk factors such as obesity, high blood pressure, diabetes, tamoxifen use, family history, or a late menopause.  Warning symptoms include any bleeding after menopause or irregular, unpredictable bleeding before menopause. 

There is a more rare form of uterine cancer called uterine sarcoma in which the cancer cells develop in the muscle of the uterus rather than the lining.  These account for less than 5% of all uterine cancers, but are much more aggressive than endometrial cancers.   Uterine sarcomas are much more likely to develop in African American women or those who have a history of previous pelvic radiation therapy. 

Currently, there are no screening tests for endometrial cancer, other than yearly pelvic exams.  While Pap smears are great to detect cervical cancer, they are not helpful to diagnose endometrial cancer.  The good news is that women may lower their risk for endometrial cancer by maintaining a healthy weight and exercising.  Women with unexpected post-menopausal bleeding should contact their physicians and be fully evaluated. 

New horizons in research have focused on ways to identify the particularly aggressive endometrial cancer by evaluating the genetic make-up of the tumors.  Identifying these genes may also help in the developing specific drugs to combat these cancer strains.  Familial endometrial cancers are also being explored:  families have been identified who have a damaged gene called HNPCC, which causes an increased risk for uterine as well as colon cancers. 

Created: 11/10/2003  -  Donnica Moore, M.D.