Frequently Asked Questions About Uterine (Endometrial) Cancer

If you’ve been told you have uterine cancer (endometrial cancer), we realize you will have many questions about the disease, the treatment and the prognosis. At Henry Ford Cancer, we are here to support and guide you as you consider your options and make decisions about your treatment.

Below, we have provided answers to some of the most common questions we hear from patients like you about uterine cancer. If you have additional questions, our team is always ready to help. We’re available 24 hours a day, seven days a week to answer your questions. Call us at (888) 777-4167.

Basic information: uterine cancer

• What is uterine cancer?
• What are the risk factors for uterine cancer?
• Does a family history of uterine (endometrial) cancer increase the risk for the disease?
• What are the different types of uterine cancers?
• What are the different types of endometrial cancers?

Symptoms and diagnosis: uterine and endometrial cancer

• What type of screening is used for uterine cancer?
• What are the symptoms of uterine cancer?
• How is uterine cancer diagnosed?
• Is an endometrial tissue biopsy painful?
• How is the stage of uterine cancer determined?
• What are the main stages of uterine cancer?
• How can fertility be preserved in women with early stage endometrial cancer?
• Is it necessary to have protected sex during or after treatment of uterine cancer?
• Is uterine cancer contagious during sexual intercourse?

Treatment: uterine and endometrial cancer

• How is uterine cancer treated?
• What type of surgery may be done for uterine cancer?
• What type of radiation therapy is used for uterine cancer?
• How can radiation therapy for uterine cancer affect a woman’s sex life?
• Is chemotherapy required for uterine cancer?
• Are there ways to reduce the side effects of chemotherapy for uterine cancer?
• What are clinical trials for uterine cancer?

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What is uterine cancer?

Uterine cancer is the abnormal and uncontrolled growth of cells starting in the uterus. There are two main types of uterine cancer:

• Endometrial cancer (also called adenocarcinoma of the endometrium) is the most common uterine cancer. The disease develops in the lining of the uterus, and it is related to changes in hormone levels.
• Uterine sarcoma forms in the tissues or muscles of the uterus, and it is a rare type of cancer.

What are the risk factors for uterine cancer?

• Drugs that affect estrogen levels
• Obesity or high-fat diet, which increases estrogen levels
• Type 2 diabetes
• Age 55 or more
• Cancer of the breast or ovaries
• Endometrial hyperplasia (thickening)
• Radiation treatment for cancer
• Intrauterine device (IUD) containing hormones

Does a family history of uterine (endometrial) cancer increase the risk for the disease?

Sometimes a family history of endometrial cancer or colorectal cancer can increase your risk. Lynch syndrome is a heredity disorder that can affect all races, and it may be associated with endometrial cancer.

What are the different types of uterine cancers?

There are three different types of uterine cancers:

• Uterine leiomyosarcoma
• Endometrial stromal sarcoma
• Undifferentiated sarcoma

What are the different types of endometrial cancers?

There are several different types of endometrial cancer, often called endometrial carcinomas. Carcinoma refers to a type of cancer that starts in epithelial cells that are part of the lining the uterus, skin and most organs.

• Adenocarcinoma
• Squamous cell carcinoma
• Small cell carcinoma
• Transitional carcinoma
• Serous carcinoma
• Uterine carcinosarcoma

What type of screening is used for uterine cancer (endometrial) cancer?

There are no screening tests for uterine cancer. Although a Pap test checks for cervical cancer, the test may find abnormal cells from the uterus only if they have advanced and moved down to the cervix.

What are the symptoms of uterine cancer?

These are the symptoms for uterine sarcoma and endometrial cancer. If you have symptoms, contact your doctor.

• Bleeding between periods
• Bleeding after menopause
• Pain during sexual intercourse or when urinating
• Pain or pressure in the pelvic area
• Discharge that is watery, bloody or strong smelling
• Lump in the pelvic area

How is uterine cancer diagnosed?

• Pelvic ultrasound: An ultrasound transducer moves over the belly, creating images.
• Transvaginal ultrasound: An ultrasound transducer is inserted into the vagina, creating images.
• Endometrial biopsy: Tissue is removed from the uterine lining.
• Hysteroscopy: A tiny telescope is inserted into the uterus.
• Dilation and curettage: Endometrial tissue is scraped from the uterus.

Is an endometrial tissue biopsy painful?

An endometrial biopsy may cause cramping, and a nonsteroidal anti-inflammatory drug may be suggested. The cervix is numbed before a thin, flexible tool is inserted through the cervix and into the uterus to gently remove endometrial tissue.

How is the stage of uterine cancer determined?

To determine the stage of uterine cancer and treatment for it, doctors consider three main factors:

• Tumor size
• Lymph node involvement
• Metastasis (cancer spread) to distant organs or parts of the body

What are the main stages of uterine cancer?

• Stage 1: Cancer is only in the uterus.
• Stage 2: Cancer has spread outside the uterus.
• Stage 3: Cancer has spread to abdominal tissues and lymph nodes.
• Stage 4: Cancer has spread to the bladder, rectum, lungs or other organs.

How can fertility be preserved in women with early stage endometrial cancer?

Fertility preservation options for women with early stage endometrial cancer:

• Freeze unfertilized eggs.
• Fertilize eggs and freeze embryos for later implantation.
• Freeze one ovary and ovarian tissue to help preserve eggs.
• Shield the reproductive organs to reduce radiation exposure.
• Transposition the ovaries to protect them from radiation.

Is it necessary to have protected sex during or after uterine cancer treatment?

For three days after intravenous or oral chemotherapy treatment, the chemotherapy drugs may be excreted in the salvia and vaginal fluids. If trying to conceive a baby, it may be necessary to have protected sexual intercourse for six months to two years following uterine cancer or endometrial cancer treatment.

Is uterine cancer contagious during sexual intercourse?

Uterine cancer is not contagious during sexual intercourse.

How is uterine cancer treated?

The treatment options for uterine cancer include surgery, radiation therapy and chemotherapy. In some cases, patients may be eligible to participate in certain clinical trials that involve new types of treatments.

What type of surgery may be done for uterine cancer?

A hysterectomy is usually performed for uterine cancer. Whenever possible, a minimally invasive hysterectomy is performed:

• Laparoscopic-assisted vaginal hysterectomy
• Laparoscopic hysterectomy
• Robotic hysterectomy
• Vaginal hysterectomy

Other surgeries may be performed:

• Abdominal hysterectomy
• Modified radical hysterectomy
• Radical hysterectomy
• Bilateral salpingo-oophorectomy
• Pelvic and para-aortic lymph node dissection

What type of radiation therapy is used for uterine cancer?

• External beam radiation focuses on the tumor and shrinks it. Special MRI-guided radiation therapy involves MRI imaging performed simultaneously as radiation is delivered to precisely targeted cancer cells.
• Internal radiation (intracavity brachytherapy) involves radioactive seeds enclosed in a device and temporarily positioned in the uterus.

How can radiation therapy for uterine cancer affect a woman’s sex life?

Radiation therapy can cause narrowing or shortening of the vagina (vaginal stenosis), making intercourse uncomfortable. Vaginal dilators may prevent and treat vaginal stenosis, and topical benzylamine may relieve symptoms.

Is chemotherapy required for uterine cancer?

Chemotherapy is often required for fast-growing uterine cancer that has spread to parts of the body where surgery is not recommended. Combination chemotherapy is most effective and involves two or more drugs, given in cycles.

Are there ways to reduce the side effects of chemotherapy for uterine cancer?

Several prescription medications are available to reduce the side effects of nausea and vomiting from chemotherapy. In addition:

• Drink extra fluids.
• Eat a light meal before a treatment.
• Eat small amounts through the day.
• Avoid high-fat foods.
• Chew ginger.
• Try acupuncture.

What are clinical trials for uterine cancer?

Clinical trials for uterine cancer involve medical research to evaluate a new treatment, such as a new drug or approach to radiation therapy and surgery. Patients volunteer for the studies and may receive a new treatment before it is available to the public. Risks include possible side effects and ineffective treatment, which your care team will review with you prior to enrollment.