Endometrial or uterine cancer can start in different parts of the uterus. Most uterine cancers start in the endometrium (the inner lining of the uterus). This is called endometrial cancer. Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make mucus and other fluids). Uterine sarcoma is an uncommon form of uterine cancer that forms in the muscle and tissue that support the uterus.

Several factors are associated with an increased risk of endometrial cancer, including obesity, exposure to endogenous or exogenous estrogens, tamoxifen use and certain inherited conditions. You can reduce your risks with physical activity, taking combination oral contraceptives, and having a history of pregnancy and/or breast feeding.

Surgical removal of the uterus or hormone therapy is used to prevent endometrial cancer in women with abnormal overgrowth of the endometrium. There is no standard or routine screening test for endometrial cancer.

Signs & Symptoms

These and other signs and symptoms may be caused by endometrial cancer or by other conditions. Check with your doctor if you have any of the following:

  • Vaginal bleeding or discharge not related to menstruation (periods)
  • Vaginal bleeding after menopause
  • Difficult or painful urination
  • Pain during sexual intercourse
  • Pain in the pelvic area

Treatment

Standard treatments for endometrial cancer include surgery, radiation therapy and hormone therapy. Endometrial cancer can usually be cured. Uterine sarcoma is harder to cure. One of our gynecologic cancer specialists, Marcia C. Bowling, MD, Ajit Gubbi, DO or Dené C. Wrenn, MD, MS, can help you determine the best care plan for you.

Surgery is the most common treatment for endometrial cancer, and in many cases, it can be performed using robotic technology. Robot-assisted surgery is a system that allows your OHC surgeon to make precise, delicate incisions and motions. The robot is never in control and is never making decisions.

The following surgical procedures may be used:

  • Total hysterectomy: Surgery to remove the uterus, including the cervix. If the uterus and cervix are taken out through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are taken out through a large incision in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are taken out through a small incision in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
  • Bilateral salpingo-oophorectomy: Surgery to remove both ovaries and both fallopian tubes.
  • Radical hysterectomy: Surgery to remove the uterus, cervix, and part of the vagina. The ovaries, fallopian tubes, or nearby lymph nodes may also be removed.
  • Lymph node dissection: A surgical procedure in which the lymph nodes are removed from the pelvic area and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy.

Sometimes additional therapy such as radiation therapy or hormonal therapy may be needed after surgery.

Sentinel lymph node mapping may be used to detect whether cells have escaped a tumor and spread to the sentinel nodes. The sentinel nodes are the first lymph nodes into which the cancer is likely to have spread. Sentinel lymph node mapping and biopsy is performed as part of the surgery to remove the tumor. First, a dye is injected into the uterus. The first lymph nodes that absorb the solution are identified as sentinel lymph nodes, because they are the first lymph nodes most likely to contain cancer cells if any spreading has occurred. The surgeon removes the sentinel nodes and sends them to a lab where a pathologist will look for cancer cells. If no cancerous cells are found, it’s a good sign that the cancer hasn’t spread outside of the uterus. If cancer cells are found, it will change the stage and treatment.