Guest Author - Rhonda Cravey

Uterine Cancer Signs and Symptoms

Endometrial cancer is the most common type of uterine cancer. Most cases of endometrial cancer occur in women who have gone through menopause. Therefore, postmenopausal women should be especially alerted to the following signs and symptoms of endometrial cancer:

• Abnormal vaginal bleeding or spotting
  
• Vaginal discharge – watery pink or white
  
• Pelvic pain or pressure
  
• Pain during sexual intercourse
  
• Enlarged uterus

Many of these signs and symptoms can be attributed to non-cancerous conditions such as a vaginal infection, uterine fibroid or uterine polyp. It is important for you to fully explain your symptoms to your doctor so that she can make an accurate diagnosis.

Uterine Cancer Screening and Diagnosis

Unlike many other types of cancer, there is no screening test that will detect endometrial cancer. When you go to the doctor she will obtain a medical history from you which will include an overview of your current symptoms. The doctor will use this information to determine what type of testing should be done next.

Some possible tests include:

• Endometrial biopsy – Involves taking a small sample of tissue from the uterine lining (endometrium). The sample is examined under a microscope for abnormal cells. An endometrial biopsy is performed in the physicians office and usually doesn’t require anesthesia.
  
• Pap test – Involves removal of a sample of cells from the cervix, the lower, narrow end of the uterus that opens into the vagina. A pap test (also called a pap smear) is used to detect cancer or abnormal cells that may lead to cancer. It is also used to find non-cancerous conditions. Since endometrial cancer begins inside the uterus, it is rarely detectable by a Pap test.
  
• Pelvic exam – During a pelvic exam, the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum are felt to find any abnormalities in their size or shape. A tool called a speculum is used to hold the vagina open so the upper portion of the vagina and cervix can be seen.
  
• Abdominal exam and exam of lymph nodes
  
• Transvaginal ultrasound – This is a type of pelvic ultrasound which looks at the uterus, ovaries, cervix and vagina. It is called transvaginal because access is through the vagina. A wand-like device (transducer) is inserted into the vagina. The transducer uses high-frequency sound waves to create a video image.
  
• Dilation and curettage (D&C) – If enough tissue cannot be obtained during a biopsy, or if the biopsy suggests cancer, then a D&C is usually performed. The D&C will take place in an OR under general anesthesia. It involves the removal of tissue from the uterine lining. This tissue is then examined under a microscope for abnormal cells that could be cancerous.

Uterine Cancer Treatment

The most common treatment option for endometrial cancer is a hysterectomy. There are several different kinds of hysterectomies but the one most commonly performed for endometrial cancer is a total abdominal hysterectomy with bilateral salpingo-oophorectomy. A total abdominal hysterectomy with bilateral salpingo-oophorectomy is the removal of the uterus, cervix, fallopian tubes, and ovaries.

Depending in the stage of the disease, radiation and chemotherapy may also be used to treat endometrial cancer.

Staging

Stage 1 – Cancer is only in the uterus.
Stage 2 – Cancer is in the uterus and the cervix.
Stage 3 – Cancer has also spread to the lymph nodes.
Stage 4 – Cancer has spread past the pelvic region and can affect the bladder, rectum, and other parts of the body.