The uterus consists of 2 main layers: the endometrium (inner layer) and the myometrium (outer layer).
Most cancers of the uterus are from cells that form glands in the endometrium layer and are called endometrial carcinomas. The focus of this document is on the most common type of endometrial carcinoma, known as endometrioid adenocarcinoma. More aggressive forms include clear-cell, serous and poorly differentiated carcinoma.
Endometrial cancer is often mistaken for but is not the same as cervical cancer, which starts in the cervix and may spread to the body of the uterus
Unusual vaginal bleeding, spotting and/or abnormal discharge; difficulty or pain when urinating; pain during sexual intercourse; abdominal fullness/pressure; pelvic pain; pelvic mass; weight loss.
There are no regular screening test recommendations for endometrial cancer at this time. In most cases, endometrial cancers are found by noticing related signs and symptoms, which is followed up by examination. For those at elevated or high risk, screening may include endometrial biopsies and/or transvaginal ultrasounds at regular intervals.
The primary treatment for early stage endometrial cancer is surgery which may entail removal of the uterus (hysterectomy) or removal of the uterus along with the fallopian tubes and ovaries (total abdominal hysterectomy with bilateral salpingo-oophorectomy). Lymph nodes from the pelvis and along the aorta may also be removed and analyzed. Other therapies, including vaginal brachytherapy (VB), pelvic radiation, or both may be recommended either before or after surgery.
If the endometrial cancer is aggressive and/or of high grade, the surgery may be more extensive including removal of the omentum. Chemotherapy is often given along with radiation therapy.
Surgery may be appropriate to alleviate symptoms. Disseminated metastatic endometrial is typically treated with chemotherapy and radiation therapy and/or hormonal therapy.
Demographics: Older age; female gender
Lifestyle: High fat diet; obesity
Medical History: Estrogen-only hormone replacement therapy; Tamoxifen use; other causes of excess exposure to estrogen unopposed by progesterone; polycystic ovarian syndrome (PCOS); diabetes; endometrial hyperplasia; prior radiation exposure; nulliparity; early menarche and late menopause; infertility; prior pelvic radiation therapy
Risk reduction options: Birth control pills; hysterectomy and bilateral salpingo-oophorectomy; pregnancy; physical activity
Inherited: Family history of disease; inherited genetic syndromes
Associated Myriad MyRisk™ Genes: MLH1, MSH2, MSH6, PMS2, EPCAM, TP53, PTEN, STK11