Uterine Cancer Support Group

Endometrial cancer involves cancerous growth of the endometrium (lining of the uterus). It mainly occurs after menopause, and presents with vaginal bleeding. A hysterectomy (surgical removal of the uterus) is generally performed.

It is the most common gynecologic cancer in the United States, with over 35,000 women being diagnosed each year in the U.S. Because of effective screening, it is only the third most common cause of gynecologic cancer deaths (behind ovarian and cervical cancer).

The same risk factors for endometrial cancer predisposes women to endometrial hyperplasia, which is a precursor lesion for endometrial cancer. An atypical complex hyperplasia carries a 30% risk of developing endometrial cancer while a typical simple hyperplasia only carries a 2-3% risk.

The primary treatment is surgical. Surgical treatment should consist of, at least, cytologic sampling of the peritoneal fluid, abdominal exploration, palpation and biopsy of suspicious lymph nodes, abdominal hysterectomy, and removal of both ovaries (bilateral salpingo-oophorectomy). Lymphadenectomy, or removal of pelvic and para-aortic lymph nodes, is sometimes performed for tumors that have high risk features, such as pathologic grade 3 serous or clear-cell tumors, invasion of more than 1/2 the myometrium, or extension to the cervix or adnexa. Sometimes, removal of the omentum is also performed.

Abdominal hysterectomy is recommended over vaginal hysterectomy because it affords the opportunity to examine and obtain washings of the abdominal cavity to detect any further evidence of cancer.

Women with stage 1 disease who are at increased risk for recurrence and those with stage 2 disease are often offered surgery in combination with radiation therapy. Chemotherapy may be considered in some cases, especially for those with stage 3 and 4 disease.