Uterine Cancer 101: Types, Stages & Treatments

Uterine cancer is a female reproductive cancer that affects the uterus. According to data revealed by the American Cancer Society, approximately 66,200 people in the United States will be diagnosed with uterine cancer in 2023.  

This cancer can have a profound impact on a woman's life, her physical well-being, and her overall quality of life. In this blog post, we will share a detailed understanding of uterine cancer, including its types, symptoms, stages, and treatment options. Read on to learn more.      

Types of Uterine Cancer

1. Endometrial cancer

This is the most common type of uterine cancer that develops in the endometrium, a tissue that lines the uterus and undergoes changes throughout a woman's menstrual cycle. When abnormal cell growth occurs within the endometrium, it leads to the development of endometrial cancer.    

Causes and risk factors   

Although the exact cause of endometrial cancer is still unknown, certain factors, primarily hormonal imbalances, can put individuals at greater risk. In most cases, it happens in women with an increased estrogen level. Other risk factors include: 

• Obesity 

• Older age (typically after menopause) 

• History of polycystic ovary syndrome (PCOS) 

• Personal or family history of colorectal or ovarian cancer   

Symptoms   

• Abnormal vaginal bleeding, such as bleeding between periods, after menopause, or excessively heavy or prolonged menstrual bleeding   

• Pelvic pain   

• Difficulty urinating   

• Pain during intercourse   

Individuals experiencing any of these endometrial cancer symptoms should consult a healthcare professional for a thorough evaluation.   

2. Uterine sarcoma   

It is a comparatively less common but more aggressive type of uterine cancer that develops in the muscle and other supporting tissues of the uterus. Uterine sarcoma refers to a group of cancers that typically arise from the mesenchymal cells of the uterus.     

Causes and risk factors   

Although researchers are still trying to find out the exact causes of uterine sarcoma, certain risk factors may increase the likelihood of developing this disease. These factors include:  

• History of undergoing cancer treatment, particularly radiation therapy in the pelvic region 

• Certain genetic conditions, such as Li-Fraumeni syndrome or hereditary retinoblastoma, etc. 

• Exposure to tamoxifen, a medication used in breast cancer treatment 

Symptoms    

Uterine sarcoma may present with similar symptoms to endometrial cancer, such as abnormal vaginal bleeding or pelvic pain. However, the symptoms may be more severe and progress rapidly for sarcoma.    

Stages of Uterine Cancer

Oncologists use the staging system developed by the International Federation of Obstetrics and Gynecology (FIGO) for uterine cancer to detect the spread and extent of cancer.   

Stage I

At this stage, cancer is confined to the uterus and has not yet spread to other body parts. Stage I can be divided into two sub-stages:   

• Stage IA: Cancer is limited to the endometrium (lining of the uterus) or involves less than half of the myometrium (muscle layer of the uterus).   

• Stage IB: The tumor has spread to half or more of the myometrium.   

Stage II 

The tumor has extended from the uterus to the cervical stroma (tissue supporting the cervix) at this stage, but it has not yet spread elsewhere.  

Read more: All You Need to Know About Cervical Cancer 

Stage III

At stage III, cancer has spread beyond the uterus but is still confined to the pelvic area. The four sub-stages of stage III uterine cancer are:    

• Stage IIIA: Cancer has started affecting the serosa (outermost layer) of the uterus as well as the tissues of the fallopian tubes and ovaries, but it has not reached other body parts.   

• Stage IIIB: The tumor has spread to the vagina, or the adjacent tissue known as the parametrium.   

• Stage IIIC1: Cancer has reached the regional pelvic lymph nodes - small organs that help fight infection.   

• Stage IIIC2: Cancer has spread to the para-aortic lymph nodes, located near the spine, with or without the involvement of the regional pelvic lymph nodes.   

Stage IV

At this advanced stage, cancer has spread extensively and metastasized to distant organs or structures. The following are the two sub-stages of stage IV uterine cancer:   

• Stage IVA: Cancer has metastasized and spread to the mucosa or inner lining of the rectum or bladder.   

• Stage IVB: Cancer has spread to the lymph nodes in the groin area and/or distant organs such as the bones or lungs.   

Understanding the FIGO staging system allows healthcare professionals to assess the extent of cancer and determine appropriate treatment strategies tailored to each patient's situation. Consult a healthcare provider to discuss individual cases and receive personalized guidance regarding uterine adenocarcinoma treatment.   

Treatment Options for Uterine Cancer

1. Surgery  

It is a common treatment for uterine cancer that involves the removal of the tumor and surrounding tissues. The following are some surgical options that healthcare providers consider for uterine cancer:   

a. Hysterectomy

This surgical procedure involves the removal of the uterus and cervix, and the extent of the surgery depends on the stage and spread of the cancer.  

Surgeons may perform a simple hysterectomy when the cancer is confined to the uterus and cervix. However, in more advanced cases, they may have to opt for a radical hysterectomy, which involves the removal of the upper part of the vagina and nearby tissues as well.    

b. Oophorectomy

In cases involving postmenopausal women, healthcare providers typically recommend bilateral salpingo-oophorectomy - a procedure they perform to remove both fallopian tubes and ovaries.   

c. Lymph node removal

While performing a hysterectomy, surgeons may consider removing nearby lymph nodes if the cancer has spread beyond the uterus. It can be done through a sentinel lymph node biopsy, where a dye is injected into the uterus to identify and remove the few lymph nodes where the dye collects. Alternatively, surgeons may also perform a lymphadenectomy, which involves removing a group of lymph nodes.    

There can be a few common short-term side effects after surgery, including pain, tiredness, nausea, and difficulty with bladder and bowel movements. Removal of the ovaries can result in early menopause, leading to symptoms like hot flashes and vaginal dryness. Swelling in the legs, known as lymphedema, can occur after a lymphadenectomy. Discuss these concerns with a healthcare professional to get medication and dietary recommendations.    

2. Radiation therapy

For uterine cancer, oncologists may recommend radiation therapy after surgery to eliminate any remaining cancer cells. They may also recommend it before surgery or as an alternative primary treatment option depending on individual cases. Radiation therapy options may include treatment of the whole pelvis or targeted radiation to the vaginal cavity (vaginal brachytherapy).    

3. Chemotherapy

For endometrial cancer, chemotherapy is typically administered after surgery. It is also a common treatment option for recurrent endometrial cancer. The treatment consists of a specific number of cycles given over a set period, often using a combination of drugs.   

4. Hormone therapy

Oncologists recommend hormone therapy to slow down the growth of certain types of uterine cancer cells with hormone receptors. For uterine cancer, hormone therapy usually involves the use of high-dose progesterone pills. It can be used alone or in combination with other treatments and may be considered for cases where surgery or radiation therapy may not be possible.   

5. Targeted therapy

It is a personalized treatment approach focused on specific genes, proteins, or the tumor environment contributing to cancer growth. It aims to block the growth and spread of cancer cells while minimizing harm to healthy cells.   

Targeted therapy for uterine cancer is available through clinical trials, and in some cases, it may be incorporated into standard treatment protocols.    

The Bottom Line

The prognosis for uterine cancer is favorable for localized cancers confined to the uterus, with high survival rates. However, advanced stages of uterine cancer that have spread to distant organs may have a poorer prognosis. It is crucial to work closely with the healthcare team to determine the most appropriate treatment plan and to receive regular follow-up care. For any queries or concerns about uterine cancer, contact ACTC, one of the best cancer treatment centers in Florida.