What causes it and other answers to questions about uterine cancer.
Uterine cancer is the most common cancer of the female reproductive organs. The American Cancer Society predicts that about 69,120 women will be newly diagnosed with cancers of the uterus in 2025, which includes both endometrial cancers and uterine sarcomas. It’s important to note, however, that there are more than 900,000 survivors of endometrial cancer in the U.S. today.
“Most cancers of the uterus are diagnosed early — and therefore treatable and curable with surgery alone,” said Dr. Marta Crispens, a gynecologic oncologist with Vanderbilt-Ingram Cancer Center. “Some women, however, have aggressive forms that are more difficult to treat.”
What causes uterine cancer?
“The most common type of uterine cancer is caused by an imbalance in the hormones estrogen and progesterone,” Crispens said. Estrogen is produced during the first part of the menstrual cycle and causes the endometrium to grow; progesterone is produced during the second half of the menstrual cycle, causing the endometrial lining to mature. If a woman does not get pregnant in a particular cycle, then both hormones briefly disappear and the endometrial lining is shed, resulting in a menstrual period. “When a woman’s body does not produce enough progesterone, it can overproduce estrogen, creating an imbalance,” Crispens said. “If there is constant stimulation by estrogen without progesterone to balance it out, then pre-cancers or cancers of the uterine lining may occur.”
The risk of uterine cancer increases with age, peaking in the early 70s. However, even young women may develop uterine cancer. Women with polycystic ovarian syndrome have an increased risk of developing cancer of the uterus due to the hormonal imbalance that occurs with this syndrome. “The usual treatment for uterine cancer is hysterectomy,” Crispens said. “However, there may be fertility-sparing options available for some young women.” This usually involves treatment with progesterone to try to reverse the effects of high levels of estrogen.
Genetic risk factors
Uterine cancer can be hereditary. The most common genetic syndrome causing an increased risk of this cancer is Lynch syndrome, which is also associated with an increased risk of colon cancer. “A woman with a family history of endometrial and colon cancer may want to consider testing to determine if she carries a gene that might predispose her to developing one of these cancers,” Crispens said. “If she does, then she may want to pursue more frequent colonoscopies for early detection or hysterectomy to reduce cancer risk.”
Women with a family history of uterine and colon cancer should consider being evaluated by an expert in cancer genetics. The diagnosis can be made by a simple blood test.
What are the symptoms of uterine cancer?
The most common symptom is abnormal bleeding, either heavy or irregular menstrual bleeding, bleeding between periods or bleeding after menopause. “Such bleeding is never normal and should prompt a visit to the gynecologist,” Crispens said. “Evaluation may include pelvic ultrasound, endometrial biopsy in the office or dilation and curettage.”
If a woman is diagnosed with endometrial cancer, she should be seen by a gynecologic oncologist to be sure that she is getting the most appropriate treatment for her case. “Most patients can be treated with surgery, which can usually be performed laparoscopically, or with a small incision,” Crispens said. Biopsy of lymph nodes may be necessary to determine if the cancer has spread. Some patients will require radiation and/or chemotherapy.
Can uterine cancer be prevented?
Obesity is an important risk factor for the development of uterine cancer. As with many cancers, maintaining a normal weight, eating a healthy diet and getting regular exercise may decrease a woman’s risk of developing this disease.
Birth control pills decrease the risk of uterine cancer by 50 percent after five years of continuous use. Women who have irregular menstrual periods should talk to their gynecologists about medication to regulate their periods and prevent prolonged periods of the hormonal imbalance that can cause endometrial cancers.
Other resources
For more information about uterine and other women’s cancers, check out the Foundation for Women’s Cancer website at foundationforwomenscancer.org, the American Cancer Society website at cancer.org or the National Cancer Institute website at cancer.gov.
Vanderbilt Gynecologic Oncology provides expert care for women with cancers affecting the female reproductive system. These experts offer sophisticated, compassionate care with the latest treatments, for even the most complicated diagnoses. Call our team at 615-936-8422.
