Most cancers of the uterus begin in the lining of the uterus and are therefore
called endometrial cancers. This is the most common gynecologic cancer, affecting
an estimate 40,000 American women in 2003 and claiming the lives of 6,800.
Endometrial cancers usually develop after menopause, especially if a woman is
taking unopposed estrogen (estrogen therapy without progesterone) or if she
has other risk factors such as obesity, high blood pressure, diabetes, tamoxifen
use, family history, or a late menopause. Warning symptoms include any bleeding
after menopause or irregular, unpredictable bleeding before menopause.
There is a more rare form of uterine cancer called uterine sarcoma in which
the cancer cells develop in the muscle of the uterus rather than the lining.
These account for less than 5% of all uterine cancers, but are much more aggressive
than endometrial cancers. Uterine sarcomas are much more likely to develop
in African American women or those who have a history of previous pelvic radiation
Currently, there are no screening tests for endometrial cancer, other than
yearly pelvic exams. While Pap smears are great to detect cervical cancer,
they are not helpful to diagnose endometrial cancer. The good news is that
women may lower their risk for endometrial cancer by maintaining a healthy weight
and exercising. Women with unexpected post-menopausal bleeding should contact
their physicians and be fully evaluated.
New horizons in research have focused on ways to identify the particularly
aggressive endometrial cancer by evaluating the genetic make-up of the tumors.
Identifying these genes may also help in the developing specific drugs to combat
these cancer strains. Familial endometrial cancers are also being explored:
families have been identified who have a damaged gene called HNPCC, which causes
an increased risk for uterine as well as colon cancers.
Created: 11/10/2003  - Donnica Moore, M.D.