Cancer of the uterus

Reviewed by Dr Philip Owen, consultant obstetrician and gynaecologist

What is cancer of the uterus?

The uterus (womb) is a muscular organ within the pelvis. It has a cavity in the middle which is lined with tissue called the endometrium. Until the menopause, the endometrium builds up every month and is passed during a woman's period.

Cancer of the uterus may develop if there are changes in the cells of endometrium during the last few years before the menopause or in the years just after. Cancer of the uterus should not be confused with cervical cancer, which is an entirely different condition.

What causes cancer of the uterus?

It is still uncertain what makes the mucous membrane grow and become malignant (cancerous). Some risk factors for the development of this cancer exist including being overweight.

Having children tends to reduce a woman's risk of this disease. Correctly prescribed hormone replacement therapy (HRT) does not cause cancer of the uterus.

Cancer of the uterus is rarely seen in women under 40 and is far more common in women over 60.

What are the symptoms of cancer of the uterus?

This will vary according to whether or not the woman is still having periods. If she is still having periods then the cancer may make her periods more irregular or heavier. If her periods have stopped, then any bleeding from the vagina is abnormal and cancer of the womb needs to be considered as a possibility.

Any woman past the menopause should consult her doctor immediately if she has sudden and unexpected vaginal bleeding. The fact that cancer of the uterus often develops very slowly should not lead any woman to take any unexpected bleeding lightly.

How is cancer of the uterus diagnosed?

In order to diagnose cancer of the uterus, a gynaecologist may wish to perform one of a number of investigations. These include taking a biopsy from the lining of the womb, passing a tiny telescope through the neck of the womb (hysteroscopy) or an ultrasound scan of the pelvis (transvaginal ultrasound).

How is cancer of the uterus treated?

Approximately 90 per cent of women with cancer of the uterus are treated with hysterectomy - surgical removal of the womb and ovaries. The five-year survival rates following surgery are over 70 per cent.

Sometimes surgical treatment is supplemented with radiotherapy. Radiotherapy alone may be used in advanced cases, or cases of recurrent disease, or where surgery is not appropriate.

There is no reliable evidence that chemotherapy or hormone treatment is effective for cancer of the uterus, however, more research is being carried out in this area.

Prognosis

Because cancer of the womb grows slowly and women are alerted to a problem by abnormal bleeding from the vagina, most cancers are detected and treated at an early stage.

Cure rates following surgery are very high.

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