The uterus is a female reproductive organ, within which the fetus develops during pregnancy. The uterus is located in the pelvis, and is contiguous with the cervix. The uterus is typically 3-4 inches long, although a number of conditions, both benign and cancerous, may cause this organ to grow in size.
Cancers of the uterus most commonly arise from the endometrial lining, a layer of glandular cells that grown and shed with each menstrual cycle. Endometrial cancers typically develop in women in their 50s and early 60s, although aggressive variants of this disease tend to arise in women in the late 60s to 70s. In addition, cancers may arise from the muscle and/or connective tissue surrounding the endometrial layer, and are known as sarcomas.
The most common symptom of endometrial or uterine cancer is abnormal bleeding after menopause. Other symptoms that occur less commonly include:
- Abnormal vaginal discharge
- Irregular bleeding around the menopause transition
- Pelvic pain
- Urinary symptoms, such as urgency or frequency
Several risk factors are known to increase the likelihood for endometrial cancer development. These include:
- Obesity, often with associated hypertension and diabetes
- Elevated estrogen levels, potentially due to hormone supplements
- Genetic predisposition through deleterious mutations in the Hereditary Non-Polyposis Colon Cancer (HNPCC) genes
Women who have never had a pregnancy, or have had a long history of irregular menstrual cycles, may also be at increased risk for endometrial cancer. For uterine sarcomas, there are no clear risk factors.
Genetic predisposition through deleterious mutations in the Hereditary Non-Polyposis Colon Cancer (HNPCC) genes
The typical treatment for endometrial and uterine cancer includes hysterectomy, with removal of the ovaries and fallopian tubes. In some circumstances, additional biopsies of the regional lymph nodes are indicated to determine potential spread of cancer. Many obstetrician-gynecologists work together with gynecologic oncologists to optimize the surgical management of women with these diseases.