Uterine cancer (cancer of the endometrium) is the most common gynecologic cancer. It typically afflicts postmenopausal women between ages 50 and 60. It's uncommon between ages 30 and 40 and rare before age 30. Most premenopausal women who develop uterine cancer have a history of anovulatory menstrual cycles or other hormonal imbalance. About 33,000 new cases of uterine cancer are reported annually; of these, roughly 5,500 are fatal.

Causes of Uterine Cancer

Uterine cancer appears linked to several predisposing factors:

low fertility index and anovulation
history of infertility or failure of ovulation
abnormal uterine bleeding
obesity, hypertension, diabetes, or nulliparity
familial tendency
history of uterine polyps or endometrial hyperplasia
prolonged estrogen therapy with exposure unopposed by progesterone.

In most patients, uterine cancer is an adenocarcinoma that metastasizes late, usually from the endometrium to the cervix, ovaries, fallopian tubes, and other peritoneal structures. It may spread to distant organs, such as the lungs and the brain, by way of the blood or the lymphatic system. Lymph node involvement can also occur. Less common uterine tumors include adenoacanthoma, endometrial stromal sarcoma, lymphosarcoma, mixed mesodermal tumors (including carcinosarcoma), and leiomyosarcoma.

Signs & Symptoms of Uterine Cancer

According to the National Cancer Institute, abnormal bleeding after menopause is the most common symptom of cancer of the uterus. Other symptoms, according to the National Cancer Institute, may include:

unusual vaginal bleeding or discharge
difficult or painful urination
pain during sexual intercourse
pain in the pelvic area

Cancer of the uterus often 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 physician.

Diagnostic Tests

The tests used to diagnose cancer of the uterus include:

Physical examination - to check the abdomen for swelling
Tranvaginal ultrasound - allows the doctor to look at the size of the ovaries, uterus and thickness of the endometrium
Dilatation and curettage procedure (D&C) - tissue samples of the uterus lining are taken for analysis.
X-rays.
Blood tests - to check your general health and help make decisions about your treatment.

Treatment

Specific treatment for uterine cancer will be determined by your physician based on:

your overall health and medical history
extent of the disease
your tolerance for specific medications, procedures, or therapies
expectations for the course of the disease
your opinion or preference

Methods of treatment may include:

hysterectomy - surgery to remove the uterus
salpingo-oophorectomy - surgery to remove the fallopian tubes and ovaries
radiation therapy
hormone therapy
chemotherapy

Prevention Tips

All women should have regular pelvic exams and Pap smears beginning at the onset of sexual activity (or at the age of 20 if not sexually active) to help detect signs of any abnormal development.

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