Uterine Cancer

Uterine Cancer :

Uterine cancer is the most common cancer of the female reproductive system. Most cases begin in the lining of the uterus (endometrium) and are therefore also called endometrial cancer.

The uterus is a hollow, pear-shaped organ where a baby grows during pregnancy. It consists of:

  • Cervix: Lower part connecting the uterus to the vagina

  • Body (Corpus): Upper part containing the muscle wall and inner lining (endometrium)

During the menstrual cycle, the endometrium thickens and sheds if pregnancy does not occur. Abnormal changes in this lining can lead to uterine cancer, especially after menopause.

Uterine Cancer Risk Factors

Risk factors that increase the likelihood of uterine cancer include:

  • Obesity and high-fat diet

  • Age (more than 95% occur after age 40)

  • Estrogen therapy without progesterone

  • Use of tamoxifen

  • Diabetes

  • Polycystic ovary syndrome (PCOS)

  • Never having been pregnant

  • Early menstruation or late menopause

  • Personal or family history of uterine, ovarian, breast, or colon cancer (Lynch syndrome)

  • Pelvic radiation therapy

Having risk factors does not mean cancer will develop, but awareness and regular medical follow-up are important.

Symptoms of Uterine Cancer

Common symptoms include:

  • Vaginal bleeding or spotting after menopause

  • Heavy or irregular menstrual bleeding

  • Abnormal vaginal discharge

  • Pelvic pain or pressure

  • Unexplained weight loss

Any abnormal bleeding should be evaluated promptly by a gynecologic oncologist.

Diagnosis of Uterine Cancer

Early diagnosis improves treatment outcomes. Evaluation may include:

  • Detailed medical history and pelvic examination

  • Endometrial biopsy (primary diagnostic test)

  • Dilation and Curettage (D&C) if biopsy is inconclusive

  • Hysteroscopy for direct visualization and tissue sampling

Additional Tests

  • Imaging: Ultrasound, CT scan, MRI, PET scan, Chest X-ray

  • Blood tests: CBC, CA-125 (in selected cases)

Genetic Testing

Genetic counseling and testing may be recommended if:

  • Cancer is diagnosed before age 50

  • There is a history of colon, rectal, or endometrial cancer

  • A family member has Lynch syndrome gene mutations (MLH1, MSH2, MSH6, PMS2)

Uterine Cancer Treatment

Treatment is personalized by a multidisciplinary gynecologic oncology team based on cancer type, stage, and overall health. Surgery is often the main treatment.

Surgical Treatment

Common procedures include:

  • Total hysterectomy (removal of uterus)

  • Bilateral salpingo-oophorectomy (removal of ovaries and fallopian tubes)

  • Lymph node removal

  • Omental biopsy

Advanced or selected cases may require radical hysterectomy or tumor debulking.

Surgery may be:

  • Minimally invasive (laparoscopic or robotic)

  • Open surgery, depending on disease spread

Additional Treatments

  • Radiation Therapy:
    Includes brachytherapy, 3D-CRT, and IMRT for precise targeting

  • Chemotherapy:
    Used in advanced or high-risk disease

  • Hormone Therapy:
    For hormone-sensitive cancers (progestins, tamoxifen, aromatase inhibitors