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Alternative Names Return to topEndometrial/uterine adenocarcinoma; Uterine cancer; Adenocarcinoma of the endometrium/uterus; Cancer - uterine; Cancer - endometrial; Uterine corpus cancer
Definition Return to top
Endometrial cancer is cancer that starts in the endometrium, the lining of the uterus (womb).
Causes Return to top
Endometrial cancer is the most common type of uterine cancer. Although the exact cause of endometrial cancer is unknown, increased levels of estrogen appear to play a role. Estrogen helps stimulate the buildup of the lining of the uterus. Studies have shown that high levels of estrogen in animals result in excessive endometrial growth and cancer.
Most cases of endometrial cancer occur between the ages of 60 and 70 years, but a few cases may occur before age 40.
The following increase your risk of endometrial cancer:
Associated conditions include the following:
Symptoms Return to top
Exams and Tests Return to top
A pelvic examination is frequently normal, especially in the early stages of disease. Changes in the size, shape, or feel of the uterus or surrounding structures may be seen when the disease is more advanced.
Tests that may be done include:
If cancer is found, other tests may be done to determine how widespread the cancer is and whether it has spread to other parts of the body. This is called staging.
Stages of endometrial cancer:
Cancer is also described as Grade 1, 2, or 3. Grade 1 is the least aggressive, and grade 3 is the most aggressive.
Treatment Return to top
Treatment options involve surgery, radiation therapy, and chemotherapy.
A hysterectomy may be performed in women with the early stage 1 disease. Removal of the tubes and ovaries (bilateral salpingo-oophorectomy) is also usually recommended.
Abdominal hysterectomy is recommended over vaginal hysterectomy. This type of hysterectomy allows the surgeon to look inside the abdominal area and remove tissue for a biopsy.
Surgery combined with radiation therapy is often used to treat women with stage 1 disease that has a high chance of returning, has spread to the lymph nodes, or is a grade 2 or 3. It is also used to treat women with stage 2 disease.
Chemotherapy may be considered in some cases, especially for those with stage 3 and 4 disease.
Support Groups Return to top
The stress of illness may be eased by joining a support group whose members share common experiences and problems. See cancer - support group.
Outlook (Prognosis) Return to top
Endometrial cancer is usually diagnosed at an early stage. The 1-year survival rate is about 92%.
The 5-year survival rate for endometrial cancer that has not spread is 95%. If the cancer has spread to distant organs, the 5-year survival rate drops to 23%.
Possible Complications Return to top
Complications may include anemia due to blood loss. A perforation (hole) of the uterus may occur during a D and C or endometrial biopsy.
There can also be complications from hysterectomy, radiation, and chemotherapy.
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if you have abnormal vaginal bleeding or any other symptoms of endometrial cancer. This is particularly important if you have any associated risk factors or if you have not had routine pelvic exams.
Any of the following symptoms should be reported immediately to the doctor:
Prevention Return to top
All women should have regular pelvic exams beginning at the onset of sexual activity (or at the age of 21 if not sexually active) to help detect signs of infection of abnormal development. Women should have Pap smears beginning 3 years after becoming sexually active.
Women with any risk factors for endometrial cancer should be followed more closely by their doctors. Frequent pelvic examinations and screening tests such as a Pap smear and endometrial biopsy should be considered.
Women who are taking estrogen replacement therapy should have regular pelvic examinations and Pap smears.
References Return to top
American Cancer Society. Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society; 2008.
Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 3rd ed. Orlando, Fl: Churchill Livingstone; 2004:2273-2304.
Katz VL, Lentz GM, Lobo RA, Gershenson DM. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007.
Hernandez E, American College of Obstericians and Gynecologists. ACOG practice bulletin number 65: management of endometrial cancer. Obstet Gynecol. 2006;107(4):952.Update Date: 5/2/2008 Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine; Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.