Uterine cancer

Friday 30 September, 2011

Reviewed: Assoc. Professor David Allen, Surgical Oncologist, Peter MacCallum and Mercy Hospital for Women; Dr Pearly Khaw, Gynae-Radiation Oncologist, Peter MacCallum; Dr Sam Leung, Radiation Oncologist, Radiation Oncology Victoria

On this page: The uterus | Cancer of the uterus | Adenocarcinoma of the endometrium | Other types of uterine cancer | Unusual bleeding | Causes of uterine cancer | How common is cancer of the uterus?

Cancer of the uterus is also called cancer of the womb, uterine cancer, endometrial cancer or cancer of the lining of the womb. The lining of the uterus is called the endometrium. Because cancer of the uterus usually starts in this lining, the cancer is sometimes called ‘endometrial cancer'. We will talk about ‘cancer of the uterus' or ‘uterine cancer'.

If you have uterine sarcoma or cervical cancer, call the Cancer Council Helpline on 13 11 20 for more information.

Many women feel understandably shocked and upset when they are told that they have or may have cancer of the uterus. This information aims to help you to understand what cancer of the uterus is and how it is diagnosed and treated. We also include information about support services you may like to use.

We can't tell you which is the best treatment for you. You need to discuss this with your doctors. However, we hope this information will answer some of your questions and help you think about the questions you want to ask your doctors.

If you find this page helpful, you may like to pass it on to your family and friends, who may also find it useful.

The uterus

The uterus is part of the female reproductive system. It is also called the womb.

The uterus is about the size and shape of an upside-down pear. The uterus sits quite low in the abdomen and is held there lightly by muscle. The uterus is joined to the vagina by the cervix, or neck of the uterus.

Each month, in women who are able to have children, hormones are released in the body that cause ovulation and periods (menstruation).

In ovulation, an egg travels from one of the ovaries down the Fallopian tube. If the egg is fertilised, it implants in the lining of the uterus, where it grows into a baby.

The lining of the uterus is called the endometrium. The endometrium is made up of several layers that include skin-like cells (surface epithelium), blood vessels, tissue spaces and glands. Each month the endometrium grows thicker to prepare for pregnancy. If a woman does not become pregnant, the top layers of the endometrium are shed and flow out through the vagina in the monthly period.

Menopause is when a woman's periods stop and she is no longer able to have a baby. Her body stops releasing the hormones that cause ovulation and periods.

The female reproductive system

Diagram of the female reproductive system including uterus (womb)

 The uterus

A diagram of the uterus

Cancer of the uterus

Cancer of the uterus is the most common gynaecological cancer affecting women in Australia. Most cancers of the uterus are cancers of the lining of the uterus (the endometrium). Cancers can also develop in the muscle layers of the uterus. Knowing which type of cancer you have is important because it affects the decisions you and your doctor will make about treatment.

Adenocarcinoma of the endometrium

An adenocarcinoma is a cancer that starts in glandular tissue. Most women (about 87%) who are diagnosed with cancer of the uterus have this type of cancer.

Other types of cancer of the uterus

The less common types of cancer of the uterus are adenosquamous carcinoma, papillary serous carcinoma and, rarely, clear cell carcinoma or uterine sarcoma.  If you have uterine sarcoma your treatment options will be different than for other types of cancer of the uterus. Call the Cancer Council Helpline (13 11 20) for more information.

Unusual bleeding

Sometimes women develop a very thick lining of the uterus (endometrial hyperplasia). This can mean that they have very heavy periods or bleeding at irregular times or have a watery, bloody discharge, even if they have gone through menopause.

Some types of endometrial hyperplasia may later become cancerous. If you have finished having children, your doctor may advise you to have a hysterectomy.

Unusual bleeding (such as frequent spotting) before and after menopause must be investigated. Usually an ultrasound test and/or a biopsy is done to assess the thickness of the endometrium. In a biopsy, a sample of the endometrium is taken to be looked at under a microscope. This is usually done by dilatation and curettage (D&C) under anaesthetic or using a small sampling device in the doctor's rooms.

Causes of cancer of the uterus

The exact cause of cancer of the uterus is not known. Some things seem to put women at more risk:

  • age: it is more common in women aged over 50 years
  • endometrial hyperplasia
  • menopause, never having children or being infertile
  • being overweight
  • high blood pressure and diabetes
  • a family history of uterus, breast cancer or bowel cancer: if you think you are at risk you should discuss this with your doctor
  • being on oestrogen hormone replacement without progesterone
  • being on tamoxifen or anastrozole for treatment of breast cancer. If you are taking tamoxifen or anastrozole, you should discuss this risk with your doctor.

Uterine cancer is not caused by sexual activity and cannot be passed on this way.

Remember, most women who have known risk factors do not get cancer of the uterus. Many women who do get cancer of the uterus have none of these risk factors. 

How common is cancer of the uterus?

In Victoria each year, over 560 women are diagnosed with cancer of the uterus. It is more common in women over the age of 50 than younger women.

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