Last Modified : 2006-06-19
The endometrium is the lining of the uterus, a hollow, muscular organ in a woman’s pelvis. The uterus is where a fetus grows. In most nonpregnant women, the uterus is about 3 inches long. The lower, narrow end of the uterus is the cervix, which leads to the vagina.
Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called sarcoma of the uterus. Refer to the PDQ summary on Uterine Sarcoma Treatment for more information.
Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can affect the risk of developing endometrial cancer.Endometrial cancer may develop in breast cancer patients who have been treated with tamoxifen. A patient taking this drug should have a pelvic exam every year and report any vaginal bleeding (other than menstrual bleeding) as soon as possible. Women taking estrogen (a hormone that can affect the growth of some cancers) alone have an increased risk of developing endometrial cancer. Taking estrogen in combination with progesterone (another hormone) does not increase a woman’s risk of this cancer.
Possible signs of endometrial cancer include unusual vaginal discharge or pain in the pelvis.These and other symptoms may be caused by endometrial cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:
Because endometrial cancer begins inside the uterus, it does not usually show up in the results of a Pap test. For this reason, a sample of endometrial tissue must be removed and examined under a microscope to look for cancer cells. One of the following procedures may be used:
The prognosis (chance of recovery) and treatment options depend on the following:
Endometrial cancer is highly curable.
The process used to find out whether the cancer has spread within the uterus or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Certain tests and procedures are used in the staging process. A hysterectomy (an operation in which the uterus is removed) will usually be done to help find out how far the cancer has spread.
The following stages are used for endometrial cancer:In stage I, cancer is found in the uterus only. Stage I is divided into stages IA, IB, and IC, based on how far the cancer has spread.
In stage II, cancer has spread from the uterus to the cervix, but has not spread outside the uterus. Stage II is divided into stages IIA and IIB, based on how far the cancer has spread into the cervix.
In stage III, cancer has spread beyond the uterus and cervix, but has not spread beyond the pelvis. Stage III is divided into stages IIIA, IIIB, and IIIC, based on how far the cancer has spread within the pelvis.
In stage IV, cancer has spread beyond the pelvis. Stage IV is divided into stages IVA and IVB, based on how far the cancer has spread.
Recurrent endometrial cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the pelvis, in lymph nodes in the abdomen, or in other parts of the body.
Different types of treatment are available for patients with endometrial cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Four types of standard treatment are used:Surgery (removing the cancer in an operation) is the most common treatment for endometrial cancer. The following surgical procedures may be used:
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy or hormone treatment after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.
ChemotherapyChemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Hormone therapyHormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.
New types of treatment are being tested in clinical trials.Information about ongoing clinical trials is available from the NCI Web site.
Treatment of stage I endometrial cancer may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of stage IIA endometrial cancer is usually a combination of therapies, including internal and external radiation therapy and surgery.
Treatment of stage IIA endometrial cancer may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of stage IIB endometrial cancer may include the following:
Treatment of stage III endometrial cancer may include the following:
Information about ongoing clinical trials is available from the NCI Web site.
Treatment of stage IV endometrial cancer may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of recurrent endometrial cancer may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.