Uterine cancers

Uterine cancer is cancer that develops in the uterus (womb), the organ in which a baby grows during pregnancy. There are two main types of uterine cancer: endometrial cancer and uterine sarcoma. They start in different parts of the womb, behave differently and are treated in slightly different ways. In this post I explain the difference, the risk factors and symptoms of each, and how uterine cancer is diagnosed and treated.

Endometrial cancer: the most common uterine cancer

Endometrial cancer starts in the endometrium, the inner lining of the womb, and accounts for over 90% of uterine cancer cases. It usually affects women after the menopause, and it often causes abnormal vaginal bleeding early on. That early warning sign is one reason why endometrial cancer is so often found at a stage when it can be cured.

Risk factors for endometrial cancer include:

• excess weight
• hormone replacement therapy that contains oestrogen without progesterone
• starting periods early or having a late menopause
• polycystic ovary syndrome (PCOS)
• a family history of Lynch syndrome, an inherited condition that raises the risk of womb and bowel cancer

Uterine sarcoma: a rarer uterine cancer

Uterine sarcoma is much rarer, accounting for less than 5% of uterine cancers. It develops in the muscle or connective tissue of the womb, called the myometrium, rather than the lining. Uterine sarcomas tend to be more aggressive than endometrial cancers. They may cause pelvic pain, a noticeable lump in the pelvis or unusual bleeding.

Risk factors for uterine sarcoma include previous radiotherapy to the pelvis and certain medicines, such as tamoxifen, a drug used to treat breast cancer. If you take tamoxifen, report any unusual bleeding to your doctor.

Symptoms of uterine cancer

The most common symptom of uterine cancer is abnormal vaginal bleeding, especially bleeding after the menopause. Other symptoms include bleeding between periods, unusual discharge, pelvic pain, a lump in the tummy and pain during sex. These symptoms usually have a less serious cause, but they always deserve a proper assessment.

How is uterine cancer diagnosed?

Diagnosis usually involves a pelvic examination and imaging, such as an ultrasound or MRI scan (see gynaecological ultrasounds). A biopsy of the womb lining, sometimes taken during a hysteroscopy, confirms the diagnosis. If uterine cancer is found, further scans show how far it has spread. This is called staging, and it guides the choice of treatment.

How is uterine cancer treated?

Treatment for uterine cancer usually involves surgery, most often a hysterectomy to remove the womb, sometimes together with the ovaries and fallopian tubes. Wherever it is safe, Mr Abu performs this by keyhole surgery, as described on our total laparoscopic hysterectomy page. Depending on the stage, radiotherapy, chemotherapy or hormone therapy may also be recommended. Finding and treating uterine cancer early usually leads to better outcomes, especially for endometrial cancer.

What to do if you are worried

If you have any concerns, it is best to see a gynaecologist promptly. Keep a note of your symptoms, have the tests that are recommended, and follow up on your results. Ask about your treatment options, and do not hesitate to ask for a second opinion if you need one.

Cancer Research UK explains the types of womb cancer and the symptoms of womb cancer. To book a consultation or second opinion with Mr Jafaru Abu, please get in touch.