Uterine cancer can encompass both uterine sarcomas, which are rare, and endometrial cancers. The endometrium is the lining of the uterus, and endometrial cancer is commonly used synonymously with uterine cancer because almost all uterine cancers start in the endometrium. The National Cancer Institute estimates that in 2009, there will be 42,160 new cases of endometrial cancer, and 7,780 deaths from the disease.
Uterine Sarcomas
Uterine sarcomas are rare, making up 1 percent of all gynecologic cancers and less than 5 percent of uterine cancers. This type of cancer is aggressive and women with uterine sarcomas have a survival rate lower than 50 percent, even when the cancer is caught early.
Endometrial Cancer
Endometrial cancer is the most common gynecologic cancer in the United States. Because of symptoms such as abnormal or post-menopausal bleeding, it is often caught early. Women taking tamoxifen or estrogen without progesterone are at higher risk for endometrial cancer. Although endometrial cancer has a high survival rate, the actual prognosis depends on the stage of the cancer and the cell characteristics.
Diagnosis
Endometrial cancer is diagnosed by endometrial biopsy, an in-office procedure in which a small piece of endometrium is removed, or by dilatation and curettage, which is minor surgery that removes some of the endometrium after the cervix has been dilated.
Uterine sarcomas can be found by pelvic exam, dilatation and curettage, or endometrial biopsy. Sometimes a Pap smear might show uterine cells, but because the cancer begins in the uterus and not the cervix, it might not be found in a Pap test. These uterine cancers are often found by accident during an unrelated hysterectomy. Once it has been diagnosed, a transvaginal ultrasound can be done to check whether the cancer has spread anywhere else in the uterus. Other tests, such as CT scans, chest X-rays and blood tests, might also be cone.
Treatment
For uterine sarcomas, surgical treatment includes removal of the uterus and ovaries, lymph node dissection and any tumor reduction. Because of the rarity of the disease, there is a lack of widespread randomized trials for treatment, and so radiation therapy has not been proven to definitively improve survival, and chemotherapy has only shown minimal benefit.
Surgery is the most common treatment for endometrial cancer and can include a hysterectomy (either total or radical), and removal of the ovaries. Further treatment can include hormone therapy and radiation therapy, and for advanced uterine cancer, chemotherapy.
Future Directions
For uterine sarcomas, chemotherapy drugs are being evaluated to see whether they affect survival rates. Clinical trials are being done, and your doctor can give you more information on which ones are available to you. Ways of preventing and screening for endometrial cancer are being explored, and clinical trials are being done to find more effective treatments for metastatic and recurrent endometrial cancers.
Tags: endometrial cancer, uterine cancers, uterine sarcomas, being done, caught early
