UTERINE CANCER

General Information

DEFINITION--Cancer of the endometrium lining of the uterus.

BODY PARTS INVOLVED--Uterus.

SEX OR AGE MOST AFFECTED-- Postpuberty females; more frequent in postmenopausal women, usually between ages 50 and 60; .

SIGNS & SYMPTOMS

Early stages:

• Bleeding or spotting, especially after sexual intercourse. This often occurs after menstrual activity has ceased for 12 months or more. A watery or blood-streaked vaginal discharge may precede bleeding or spotting.
• Enlarged uterus. It is sometimes a large enough mass to be felt externally.

Later stages:

• Spread to other organs, causing abdominal pain, chest pain and weight loss.

CAUSES--Unknown. Appears to be linked to several predisposing factors listed in Risks.

RISK INCREASES WITH

• Diabetes mellitus.
• Obesity.
• High blood pressure.
• Use of estrogen without also using progesterone.
• Family history of breast or ovarian cancer.
• History of uterine polyps, menstrual cycles without ovulation, or other signs of hormone imbalance.
• Delayed menopause.
• Chronic anovulation (absence of ovulation).
• Studies show that use of the drug tamoxifen for breast cancer may increase risk.

HOW TO PREVENT

• See your doctor for pelvic examinations every 6 to 12 months.
• Obtain medical care for any uterine bleeding or spotting after menopause.
• Proper dosages of any female hormones (birth-control or estrogen replacement following menopause). Ask your doctor.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms, especially abnormal bleeding.
• Medical history and physical exam by a doctor.
• Diagnostic tests may be numerous, first to diagnose the cancer, and then to determine any spread to other body organs (staging). May include laboratory blood tests, Pap smear (See Glossary), liver function tests, chest x-ray, CT scan, mammogram, barium enema, MRI, vaginal ultrasound, endometrial biopsy, dilatation and curettage (D & C) (See Glossary for all).

APPROPRIATE HEALTH CARE

Doctor's treatment. > Treatment will depend on the extent of the disease and may involve one or a combination of the following: surgery, radiation, hormonal therapy and anticancer drugs (chemotherapy).

• Surgery treatment may involve removing the uterus, and usually, the ovaries and fallopian tubes.
• Psychotherapy or counseling for depression may be recommended.

POSSIBLE COMPLICATIONS--Fatal spread of cancer to the bladder, rectum and distant organs.

PROBABLE OUTCOME--With early diagnosis and treatment, 90% of patients survive at least 5 years.

How To Treat

GENERAL MEASURES--

• The more you can learn and understand about this disorder, the more you will be able to make informed decisions about where to go for your care, the treatments available, the risks involved, side effects of therapy and expected outcome.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Anticancer drugs, including cortisone drugs.
• Hormone therapy.

ACTIVITY--Resume your normal activities as soon as symptoms improve after treatment. Discuss concerns regarding sexual activity with your partner and doctor. In most cases, full sexual activity after therapy should be resumed as soon as possible.

DIET--No special diet, but eat a well-balanced diet even if you lose your appetite from radiation or drug therapy. Vitamin and mineral supplements are helpful.

Call Your Doctor If

• You have symptoms of uterine cancer.
• The following occurs after surgery: Excessive bleeding (soaking a pad or tampon at least once an hour). Signs of infection, such as fever, muscle aches and headache.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.