An Overview of Uterine Cancer

Fran Drescher in Capitol Hill
Uterine cancer survivor Fran Drescher. Stefan Zaklin/Getty Images Entertainment

Uterine cancer is a type of cancer that affects the uterus, an integral part of the female reproductive system. This cancer most commonly develops in the endometrium of the uterus, resulting in endometrial cancer, the most prevalent type of uterine cancer. Much less commonly, cancer develops in the muscles and other tissues that support the uterus.

When this occurs, it is called a uterine sarcoma. Less than 5 percent of uterine cancers are sarcomas.

Causes and Risk Factors

Unfortunately, we cannot pinpoint what causes uterine cancer, but we are aware of risk factors that may increase the likelihood of it developing. Uterine cancer most often occurs in women who are post-menopausal. Younger women can also develop the disease, but this happens much less often.

In cases of uterine sarcomas, we know that prior pelvic radiation therapy treatment may increase the risk in some women. It is also evident that uterine sarcomas occur more frequently in African-American women than in Caucasians, though the reason is unclear.

Fortunately, we know more about endometrial cancer than we do about uterine sarcomas. Researchers have identified several known risk factors, including:

  • never being pregnant
  • beginning menstruation before age 12, and continuing through age 50 or more

One thing to keep in mind with uterine cancer risk factors is that some women who are at increased risk will never have uterine cancer while some women who do not present any risks do develop uterine cancer.


The most common symptom of uterine cancer is vaginal bleeding that occurs after menopause. Before then, vaginal bleeding is considered abnormal when:

Another symptom is a watery, vaginal discharge that is tinged with blood. In the early stages of uterine sarcoma, there may not be any noticeable symptoms.

With endometrial cancer, the most common and first experienced symptom is abnormal vaginal bleeding. Other symptoms include a watery vaginal discharge, pain during sexual intercourse, and pelvic pain.


If uterine cancer is suspected, a thorough pelvic exam will first be done by a gynecologist. This is an excellent time to discuss personal and family medical history, symptoms, and to ask questions. If you haven't had a recent Pap smear and are due for one, the gynecologist may do along with the pelvic exam. Pap smears very rarely ever detect uterine cancer, but one may be done to rule out other cervical conditions.

To confirm the presence or absence of cancer, an endometrial biopsy will be necessary. This can be done in the gynecologist's office and takes only a few moments to complete.

Most women report feeling moderate pain and cramping that lasts only through the biopsy, and some mild cramping afterward.

Another method of obtaining endometrial tissue samples is through a dilation and curettage (D&C). During a D&C, the uterus is scraped with an instrument called a curette. You are given an anesthetic so you will not feel anything during the procedure, but you can expect mild cramping afterward.

If biopsy samples reveal uterine sarcoma or endometrial cancer, then the cancer is staged. Staging refers to how far the cancer has spread to nearby tissue or organs.


Treatment options depend heavily on the type and stage of uterine cancer, but surgery is the most common form of treatment for all types.

Surgeries include:

  • hysterectomy, a surgical removal of the uterus
  • hysterectomy with bilateral salpingo-oophorectomy, a surgical removal of the uterus, fallopian tubes, and ovaries
  • lymph node dissection, the removal of pelvic lymph nodes during hysterectomy that are later screened for cancer

Radiation therapy is also an option for treating uterine cancer. This type of treatment uses high-energy beams of radiation to shrink tumors or eliminate cancer cells. Radiation therapy works by damaging a cancer cell's DNA, making it unable to multiply. Although radiation therapy can damage nearby healthy cells, cancer cells are highly sensitive to radiation and typically die when treated. Healthy cells that are damaged during radiation are resilient and are often able to fully recover.

Chemotherapy may also be prescribed to treat uterine cancer in some women. Chemotherapy drugs work by eliminating rapidly multiplying cancer cells. However, there are other healthy cells in the body that multiply just as quickly, such as hair follicle cells. Unfortunately, many chemotherapy drugs may not be able to discern the two, attacking healthy cells and causing side effects, such as hair loss.


Because we don't know exactly what causes uterine cancer, prevention can be difficult.

We do know that prior radiation therapy may increase the risk of uterine sarcoma, but it should not be avoided for the sake of uterine cancer prevention.

Since we know more about what increases the risk of endometrial cancer, risk reduction methods are more plentiful. Long-term use of oral contraceptives and maintaining a healthy weight are both methods of reducing your risk of developing endometrial cancer. Because endometrial cancer is fueled by estrogen, using a hormone replacement therapy during menopause that contains progestin along with estrogen may decrease a woman's risk. This type of hormone therapy does have side effects, however, and is not for everyone.

Even with endometrial cancer, you cannot avoid risk factors like previous tamoxifen use to treat breast cancer. A physician or patient would never reject the use of tamoxifen based on the slight risk of developing endometrial cancer in the future. The risk simply does not outweigh the benefits.


American Cancer Society. What is Uterine Sarcoma? A Detailed Guide June 2006. 

National Cancer Institute. Uterine Sarcoma. 26 June 2008.