Uterine cancer most often starts growing in the endometrium – the lining of the uterus. Endometrial cancer is the most common type of cancer of the uterus. While it can occur at earlier ages, endometrial cancer is most common among women in their 60s and 70s. Among factors that increase risk for endometrial cancer are diabetes, estrogen replacement therapy without the use of progesterone, history of endometrial polyps and obesity.
- Abnormal vaginal bleeding, including spotting between periods and bleeding after menopause
- Extremely long, heavy or frequent vaginal bleeding after age 40
- Lower abdominal pain or cramping
- Thin, white or clear vaginal discharge after menopause
Abnormal pap smears may raise suspicion for endometrial cancer, but are not designed to detect uterine cancer. Tests to diagnose uterine or endometrial cancer include endometrial aspiration or biopsy and dilation and curettage (D and C).
Treatment options involve surgery, radiation therapy, and chemotherapy.
- Surgical removal of the uterus (hysterectomy), which may also include removal of the tubes and ovaries (bilateral salpingo-oophorectomy), and the pelvic and para-aortic lymph nodes is the most common way to treat uterine cancer. At Avera McKennan, 64 percent of hysterectomies to treat endometrial cancer are done robotically. The remaining 36 percent are done through an open procedure. Both of these procedures allow the surgeon to look inside the abdominal area and/or remove tissue for a biopsy.
- Surgery combined with radiation therapy is often used to treat women with disease that has a high chance of returning, has spread to the lymph nodes, or is a grade 2 or 3.
- Chemotherapy or hormonal therapy may be considered in some cases, especially for those with advanced stage disease.