Cancer Types
Uterine Cancer
Information about uterine cancer.
What is uterine cancer?
Uterine cancer develops when abnormal cells in the uterus (womb) grow in an uncontrolled way. There are two main types of uterine cancer: endometrial cancer (which grows in the lining of the uterus) and uterine sarcomas (which grow in the muscle or other tissues of the uterus).
Endometrial cancer is the most common form, accounting for around 95% of all uterine cancers.
Who can be affected by uterine cancer?
Uterine cancer is most often found in people who are 50 years and older, but can also be found in younger people, particularly if they have other risk factors.
Uterine cancer affects people with a uterus: women, trans-men, non-binary people assigned female at birth and some intersex people. Uterine cancer is more common in Māori and Pacific peoples. Around 400-500 people are diagnosed with uterine cancer each year in New Zealand.
Risk factors
Anything that can increase your risk is called a risk factor. Having one or more of these risk factors does not mean that you will develop uterine cancer.
The risk factors for uterine cancer are:
- Being over 50 years old
- Being postmenopausal
- Never been pregnant
- Starting periods early (before 12 years old)
- Reaching menopause late (after 55 years old)
- Polycystic ovary syndrome
- Obesity
- Diabetes
- Taking oestrogen-only hormone replacement therapy (HRT) or taking Tamoxifen
- Personal or family history of endometrial, ovarian, breast of bowel cancer
- Having a known inherited cancer syndrome, such as Lynch syndrome
Signs and symptoms
There may be no warning signs that you have uterine cancer. The most common symptom for uterine cancer is:
- Abnormal or irregular vaginal bleeding, particularly after menopause. If you experience irregular bleeding PLEASE see your doctor for further investigation.
Other signs and symptoms of uterine cancer may include:
- Watery or smelly discharge from the vagina
- Pain or discomfort in the lower abdomen
Although these symptoms are usually caused by conditions other than cancer, it's important to get them checked by your doctor as soon as possible.
Diagnosis
To check for uterine cancer the doctor may examine your abdomen. This may include putting two fingers inside your vagina while pressing on your abdomen to feel your uterus. If your doctor suspects uterine cancer they will refer you for further tests.
The main initial test is a transvaginal ultrasound. To get the best assessment of the uterus the person who does the scan (an ultra-sonographer) will insert the ultrasound probe into the vagina. While the examination may be uncomfortable it should not be painful.
If the ultrasound is abnormal the doctor will need to take a sample from the lining of the uterus to look at more closely under the microscope. There are two ways this can be done, you may need one or both procedures:
The doctor may insert a very thin plastic tube into the uterus, called a pipelle, to take a sample of tissue. The doctor may do a hysteroscopy. A hysteroscopy is when a narrow telescope device called a hysteroscope is put through your cervix into your uterus. Other tests that may also be used to diagnose and determine the extent of uterine cancer include radiological imaging tests (such as a CT scan, MRI scan or x-ray) and blood tests.
Treatment
If you are found to have uterine cancer, you will be referred to a specialist. A team of health professionals with expertise and experience in treating uterine cancer will look after your care.
The treatment for uterine cancer depends on the type and stage (how far it has spread), the severity of your symptoms and your preferences.
If the cancer is found early, then surgery may be the only treatment that is required. Surgery usually involves removal of the uterus and the cervix and may also involve removal of the ovaries and fallopian tubes. The surgeon may also remove some lymph nodes in the pelvis to check if the cancer has spread.
Other treatment may include radiotherapy (radiation to destroy cancer cells), chemotherapy (medicines to destroy cancer cells) or hormone therapy (medicine for people who have a tumour that expresses a hormone receptor).
For most people the outcome following treatment is good and the disease is cured. Early investigation of abnormal bleeding is important to ensure that uterine cancer is diagnosed and treated at an early stage.