The uterus, also called the womb, is the small, pear-shaped organ that holds a baby during pregnancy. Endometrial cancer is the most common type of uterine cancer. It occurs in the organ's lining, the endometrium. Risk factors for uterine cancer include being obese, having high blood pressure, having too much of the hormone called estrogen and having problems ovulating.
During a pelvic exam the doctor will feel for lumps in the uterus, or anything that is not normal. Ultrasound examination can also help diagnose uterine cancer and rule out other conditions. The doctor can also take an endometrial biopsy, which is small sample of cells from the lining of the uterus. Endometrial cancer is classified by stage according to the development of the disease. Because surgery is the primary treatment in most cases, the staging is determined through exploratory surgery (laparotomy).
The stages of endometrial cancer include:
- Stage I— Cancer cells are confined to the uterus. The stage may be further classified as 1A, 1B, or 1C depending on how deeply the cancer has invaded the uterine (muscle) wall.
- Stage II — Cancer is found in the uterus and the cervix but has not spread outside the uterus. Stage II cancers may be further classified as stage IIA or IIB depending on whether the cancer has invaded the cervical stroma (supportive tissue).
- Stage III — The cancer has spread outside the uterus but not beyond the pelvis. In Stage IIIA, cancer has spread to the serosa (watery membrane) or the adnexa (appendages of the uterus such as the fallopian tubes) or pelvic peritoneal (lining of the pelvis). In stage IIIB, the cancer cells have spread to the vagina. In stage IIIC, cancer has spread to pelvic or paraaortic lymph nodes.
- Stage IV — The cancer has spread beyond the pelvis or has invaded tissue in the bladder or rectum. In stage IVA, the tumor has invaded the bladder or the mucous membrane of the bowel. In stage IVB, cancer has spread to distant sites, including intraabdominal or lymph nodes in the groin.
At the OHSU Knight Cancer Institute, we develop an individual treatment plan for each patient. For patients with uterine cancer, our multidisciplinary team will consider the disease and other factors, such as age, desire to have children and general health, to help choose the best treatment. Patients may also have the opportunity to participate in clinical trials that are studying new medications and other cancer treatments.