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Patient Carolina Smith is a 47-year-old woman who is post-menopausal. She came in last week with complaints of abnormal and painful vaginal bleeding, as well as lower abdominal pain. I initially ordered a transvaginal ultrasound, which was performed on the same day. The transvaginal ultrasound results showed an endometrial lining of thickness exceeding 4 mm. Additional testing needed to be done, so I ordered a biopsy and an MRI.

Today, the results came back from the pathologist and the radiologist. Based on the tissue samples, he has concluded that Ms. Smith has Type 1 Endometrial Adenocarcinoma. According to the radiologist, the tumor has invaded the myometrium and has extended into the cervical canal. This means the cancer is at stage II.

I will be calling in the patient to come in for an appointment, where I will explain to her the results. I will also explain the treatment options and what I suggest we do going forward.

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Stage I: in the uterus only

IA: endometrium only OR less than halfway through the myometrium

IB: has spread halfway or more through the myometrium

Stage II: has spread into the connective tissue of the cervix but has not spread outside the uterus

Stage III: has spread beyond the uterus and the cervix but has not spread beyond the pelvis

IIIA: has spread to the outer layer of the uterus and/or to the fallopian tubes, ovaries, and ligaments of the uterus

IIIB: has spread to the vagina and/or to the parametrium (connective tissue and fat around the uterus).

IIIC: has spread to lymph nodes in the pelvis and/or around the aorta

Stage IV: has spread beyond the pelvis

IVA: has spread to the bladder and/or bowel wall

IVB: has spread to the other parts of the body beyond the pelvis, including the abdomen and/or lymph nodes in the groin

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Surgery for Endometrial Cancer

Usually done for cancer that has not spread.

The most common treatment route.

Hysterectomy along with salpingo-oophorectomy (removal of uterus, fallopian tubes, and ovaries), and removal of lymph nodes. This surgery can be done either through the abdomen or the vagina. Laparoscopic surgery is another newer, more minimally-invasive option.

The hospital stay for an abdominal hysterectomy is usually 3 to 7 days. The average hospital stay after an abdominal radical hysterectomy is about 5 to 7 days. Complete recovery can take up to 4 to 6 weeks. A laparoscopic procedure and vaginal hysterectomy usually require a hospital stay of 1 or 2 days and 2 to 3 weeks for recovery. Complications of these surgeries are not common and depend on the surgical approach. They include nerve or vessel damage, excessive bleeding, wound infection, blood clots, and damage to nearby tissues (the urinary and intestinal systems).

All surgery will cause infertility. For premenopausal women, they will experience menopause right away.

Lymphedema can result from the removal of lymph nodes.

Sex life can be affected. Hysterectomy will shorten the vagina and may cause numbness.

For a woman who still wants to get pregnant, surgery may be able to be put off and other treatments tried first.

Radiation Therapy for Endometrial Cancer

Done if cancer has spread beyond the deep uterine muscle layer. It is often used after surgery.

Two types: Brachytherapy and external beam radiation therapy

Common side effects of radiation therapy include tiredness, upset stomach, or loose stools. Severe fatigue, which may not start until about 2 weeks after treatment begins, is also common. Diarrhea is common, but usually can be controlled with over-the-counter medicines. Nausea and vomiting may occur, but can be treated with medicine. These side effects are more common with external beam radiation than with brachytherapy.

Side effects tend to be worse when chemotherapy is given with radiation.

Sex life can be affected. During treatment, tissues can get irritated and vagina might feel tender. Because radiation can damage the lining of the vagina, light bleeding might occur during and after sex. Rarely, ulcers might develop. When treatment ends, there might be scarring, which can make the vagina feel leathery and tough. Vagina might narrow or shorten.

Chemotherapy for Endometrial Cancer

Done if cancer has spread beyond the deep uterine muscle layer. Not used for stage I or stage II cancers. Used for high grade cancers that spread quickly and cancer that comes back after treatment.

Chemotherapy is the use of drugs that kill cancer cells. Combination of drugs is often used. Chemo is given in cycles. Drugs include Carboplatin, Paclitaxel, and Cisplatin.

Side effects: nausea and vomiting, loss of appetite, mouth sores, vaginal sores, and hair loss. Also low white blood cell count, low platelet count, and low red blood cell count. Most side effects go away when treatment ends.

Different drugs can cause different side effects.

Sandwich therapy is when chemo is given for a few cycles, followed by radiation therapy.

Chemoradiation is when chemotherapy is given at the same time as radiation therapy.

Hormone Therapy for Endometrial Cancer

Uses hormones or hormone-blocking drugs to treat cancer.

Most often used to treat endometrial cancer that's advanced (stage III or IV) or has come back after treatment. Often used along with chemotherapy.

Hormones include Progestins, Tamoxifen, Luteinizing hormone-releasing hormone agonists, and Aromatase inhibitors

Progestins are most common and they slow the growth of endometrial cancer cells. Useful for women who might want to get pregnant in the future.

Side effects include hot flashes, night sweats, weight gain, worsening of depression, increased blood sugar levels, and (rarely) serious blood clots.

Targeted Therapy for Endometrial Cancer

Uses drugs to identify and attack certain types of cancer cells.

Still fairly new and still being studied.

These drugs are mostly used to treat high-risk endometrial cancers and those that have spread (metastasized) or come back (recurred) after treatment.

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Vaginal brachytherapy → radioactive material put into a cylinder called an applicator is then inserted into the vagina sort of resembles a tampon (size and amount dependent on pt stage/grade)

Helps reduce irradiation to the bladder and rectum

The upper part of the vagina is always treated (near the uterus)

For stages 1 + 2, grade 2

LDR Brachytherapy (not commonly used in the US)

The applicator is left inside for about 1-4 days typically a hospital stay with pateint staying immobile carries risk of blood clots in the legs

Called deep venous thrombosis

Low-dose rate brachytherapy doses + 60-70 cGy surface dose in 2 fx sessions

HDR Brachytherapy

Radiation is only inside the patient for about 10-20 minutes each treatment with the patient able to go home after one tx is done

May be given weekly or daily for 3 doses

High-dose-rate brachytherapy of 7 Gy to 0.5 cm depth 3 fx

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Carolina Smith

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I had Stage 2 endometrial cancer, which means it had spread all the way to the uterus and cervix. Seeing my bereaved face my doctor consoled me and gave me different treatment options and then I agreed to go for surgery on my uterus which is called a hysterectomy with bilateral salpingo-oophorectomy.

I have been visiting my doctor regularly for follow-ups every 6 months and blood tests, CT scans are done as needed. I have undergone 25 radiation therapy sessions to lower the risk of recurrence.  Luckily my diagnosis was made earlier stage and the carcinoma had not spread to another part of the body. However, after surgery, the most common short-term side effects I encountered were abdominal pain and tiredness. My ovaries were removed as a part of treatment which ends the body's production of estrogen, resulting in early menopausal symptoms like hot flashes, night sweating, vaginal dryness. I heard that natural menopause doesn’t suffer in that level. I am having pelvic floor disorder problems like UTI and constipation.
I had side effects from radiation therapy also that includes mostly fatigue, nausea, diarrhea also need to empty bladder and bowel more frequently as well as discomfort with urination. Most of them gone after few weeks of treatment. I was fine for couple of months. But I had more chronic problems after few months of treatment; increased frequency of urination, irregular bowel movement, narrowing, scarring and dryness of vagina.

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Where in the body is endometrial cancer?

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Where in the body is endometrial cancer?

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Endometrial cancer begins in the lining (endometrium) of the uterus. Endometrial cancer is a type of cancer that begins in the uterus.

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Endometrial carcinoma usually appears as a thickening of the endometrium though may appear as a polypoid mass. A transvaginal ultrasound would be the first imaging procedure performed on a patient with endometrioid adenocarcinoma. This procedure examines the vagina, uterus, fallopian tubes, and bladder. An ultrasound transducer (probe) is inserted into the vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumors by looking at the sonogram.

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In a normal transvaginal ultrasound, the endometrial lining appears as a thin transverse white color line. In an ultrasound with a patient that has endometrial carcinoma the patient's endometrial lining appears thicker.

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Uterus Ultrasound Normal Vs Abnormal Image Appearances Comparison | Uterine Pathologies USG

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MRI is best suited to detect and evaluate endometrial cancer within the endometrial cavity; tumor infiltration into the myometrium, endocervix, and gross extension into the parametria; and other pelvic tumor deposits. On T2-weighted images, endometrial cancer usually appears of intermediate signal intensity.

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Dr Jay Mehta’s Fertility & Endometriosis Clinic

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Endometrial Cancer Staging- Part 1 (Radical Hysterectomy)

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Abdominal Hysterectomy: Everything You Need to Know

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Radiologist report for Carolina Smith age 47

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https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq
https://youtu.be/JdtnR04mSZU
https://radiopaedia.org/cases/deep-pelvic-endometriosis-mri-1?lang=us
https://bodymri.stanford.edu/clinical-services/endometrial-carcinoma
https://www.sciencedirect.com/science/article/pii/S0378603X13000259

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On This Page

Key Points

Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.

Obesity and having metabolic syndrome may increase the risk of endometrial cancer.

Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can increase the risk of endometrial cancer.

Signs and symptoms of endometrial cancer include unusual vaginal bleeding or pain in the pelvis.

Tests that examine the endometrium are used to diagnose endometrial cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium.

The endometrium is the lining of the uterus, a hollow, muscular organ in a woman's pelvis. The uterus is where a fetus grows. In most nonpregnant women, the uterus is about 3 inches long. The lower, narrow end of the uterus is the cervix, which leads to the vagina.

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Cancer of the endometrium is different from cancer of the muscle of the uterus, which is called sarcoma of the uterus. See the PDQ summary on Uterine Sarcoma Treatment for more information about uterine sarcoma.

Obesity and having metabolic syndrome may increase the risk of endometrial cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for endometrial cancer.

Risk factors for endometrial cancer include the following:

Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can increase the risk of endometrial cancer.

Endometrial cancer may develop in breast cancer patients who have been treated with tamoxifen. A patient who takes this drug and has abnormal vaginal bleeding should have a follow-up exam and a biopsy of the endometrial lining if needed. Women taking estrogen (a hormone that can affect the growth of some cancers) alone also have an increased risk of endometrial cancer. Taking estrogen combined with progesterone (another hormone) does not increase a woman's risk of endometrial cancer.

Signs and symptoms of endometrial cancer include unusual vaginal bleeding or pain in the pelvis.

These and other signs and symptoms may be caused by endometrial cancer or by other conditions. Check with your doctor if you have any of the following:

Vaginal bleeding or discharge not related to menstruation (periods).

Vaginal bleeding after menopause.

Difficult or painful urination.

Pain during sexual intercourse.

Pain in the pelvic area.

Tests that examine the endometrium are used to diagnose endometrial cancer.

Because endometrial cancer begins inside the uterus, it does not usually show up in the results of a Pap test. For this reason, a sample of endometrial tissue must be removed and checked under a microscope to look for cancer cells. One of the following procedures may be used:

Endometrial biopsy: The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells.

Dilatation and curettage: A procedure to remove samples of tissue from the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. The tissue samples are checked under a microscope for signs of disease. This procedure is also called a D&C.
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Hysteroscopy: A procedure to look inside the uterus for abnormal areas. A hysteroscope is inserted through the vagina and cervix into the uterus. A hysteroscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Other tests and procedures used to diagnose endometrial cancer include the following:

Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.

Transvaginal ultrasound exam: A procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An ultrasound transducer (probe) is inserted into the vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumors by looking at the sonogram.
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Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis and treatment options depend on the following:

The stage of the cancer (whether it is in the endometrium only, involves the uterus wall, or has spread to other places in the body).

How the cancer cells look under a microscope.

Whether the cancer cells are affected by progesterone.

Endometrial cancer can usually be cured because it is usually diagnosed early.

Key Points

After endometrial cancer has been diagnosed, tests are done to find out if cancer cells have spread within the uterus or to other parts of the body.

There are three ways that cancer spreads in the body.

Cancer may spread from where it began to other parts of the body.

The following stages are used for endometrial cancer:

Stage I

Stage II

Stage III

Stage IV

Endometrial cancer may be grouped for treatment as follows:

Low-risk endometrial cancer

High-risk endometrial cancer

Endometrial cancer can recur (come back) after it has been treated.

After endometrial cancer has been diagnosed, tests are done to find out if cancer cells have spread within the uterus or to other parts of the body.

The process used to find out whether the cancer has spread within the uterus or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Certain tests and procedures are used in the staging process. A hysterectomy (an operation in which the uterus is removed) will usually be done to treat endometrial cancer. Tissue samples are taken from the area around the uterus and checked under a microscope for signs of cancer to help find out whether the cancer has spread.

The following procedures may be used in the staging process:

Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test of the cervix is usually done. The doctor or nurse also inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.
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Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).

PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

Lymph node dissection: A surgical procedure in which the lymph nodes are removed from the pelvic area and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy.

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

Tissue. The cancer spreads from where it began by growing into nearby areas.

Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.

Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Cancer may spread from where it began to other parts of the body.

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.

Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if endometrial cancer spreads to the lung, the cancer cells in the lung are actually endometrial cancer cells. The disease is metastatic endometrial cancer, not lung cancer.

The following stages are used for endometrial cancer:

Stage I

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In stage I, cancer is found in the uterus only. Stage I is divided into stages IA and IB, based on how far the cancer has spread.

Stage II

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In stage II, cancer has spread into connective tissue of the cervix, but has not spread outside the uterus.

Stage III

In stage III, cancer has spread beyond the uterus and cervix, but has not spread beyond the pelvis. Stage III is divided into stages IIIA, IIIB, and IIIC, based on how far the cancer has spread within the pelvis.

Stage IV

In stage IV, cancer has spread beyond the pelvis. Stage IV is divided into stages IVA and IVB, based on how far the cancer has spread.

Endometrial cancer may be grouped for treatment as follows:

Low-risk endometrial cancer

Grades 1 and 2 tumors are usually considered low-risk. They usually do not spread to other parts of the body.

High-risk endometrial cancer

Grade 3 tumors are considered high-risk. They often spread to other parts of the body. Uterine papillary serous, clear cell, and carcinosarcoma are three subtypes of endometrial cancer that are considered grade 3.

Endometrial cancer can recur (come back) after it has been treated.

The cancer may come back in the uterus, the pelvis, in lymph nodes in the abdomen, or in other parts of the body.

Key Points

There are different types of treatment for patients with endometrial cancer.

Five types of standard treatment are used:

Surgery

Radiation therapy

Chemotherapy

Hormone therapy

Targeted therapy

New types of treatment are being tested in clinical trials.

Treatment for endometrial cancer may cause side effects.

Patients may want to think about taking part in a clinical trial.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Follow-up tests may be needed.

There are different types of treatment for patients with endometrial cancer.

Different types of treatment are available for patients with endometrial cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Five types of standard treatment are used:

Surgery

Surgery (removing the cancer in an operation) is the most common treatment for endometrial cancer. The following surgical procedures may be used:

After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given radiation therapy or hormone treatment after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:

The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat endometrial cancer, and may also be used as palliative therapy to relieve symptoms and improve quality of life.

Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body ( systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas ( regional chemotherapy).

The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Hormone therapy

Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances made by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach ( receptors), drugs, surgery, or radiation therapy is used to reduce the production of hormones or block them from working.

Targeted therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. Monoclonal antibodies, mTOR inhibitors, and signal transduction inhibitors are three types of targeted therapy used to treat endometrial cancer.

Monoclonal antibody therapy: Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells. Bevacizumab is used to treat stage III, stage IV, and recurrent endometrial cancer.

mTOR inhibitor therapy: mTOR inhibitors block a protein called mTOR, which helps control cell division. mTOR inhibitors may keep cancer cells from growing and prevent the growth of new blood vessels that tumors need to grow. Everolimus and ridaforolimus are used to treat stage III, stage IV, and recurrent endometrial cancer.

Signal transduction inhibitor therapy: Signal transduction inhibitors block signals that are passed from one molecule to another inside a cell. Blocking these signals may kill cancer cells. Metformin is being studied to treat stage III, stage IV, and recurrent endometrial cancer.

New types of treatment are being tested in clinical trials.

Information about clinical trials is available from the NCI website.

Treatment for endometrial cancer may cause side effects.

For information about side effects caused by treatment for cancer, see our Side Effects page.

Patients may want to think about taking part in a clinical trial.

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Patients can enter clinical trials before, during, or after starting their cancer treatment.

Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI's clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Follow-up tests may be needed.

Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

For more information from the National Cancer Institute about endometrial cancer, see the following:

For general cancer information and other resources from the National Cancer Institute, see the following:

About PDQ

Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government's center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

Purpose of This Summary

This PDQ cancer information summary has current information about the treatment of endometrial cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Reviewers and Updates

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

Clinical Trial Information

A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

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The best way to cite this PDQ summary is:

PDQ® Adult Treatment Editorial Board. PDQ Endometrial Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq. Accessed <MM/DD/YYYY>. [PMID: 26389334]

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On This Page Endometrial cancer is a disease in which malignant (cancer) cells form in the tissues of the endometrium. Obesity and having metabolic syndrome may increase the risk of endometrial cancer. Taking tamoxifen for breast cancer or taking estrogen alone (without progesterone) can increase the risk of endometrial cancer.

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What to Expect- First Radiation Treatment 

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What to Expect- First Radiation Treatment 

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Radiation Treatment: How is Radiation Treatment Given?

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What to Expect from Brachytherapy if it is an option: 

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What to Expect from Brachytherapy if it is an option: 

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What to Expect from Brachytherapy Treatment

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External beam radiation therapy (beams radiation to the primary tumor)  and brachytherapy (insertion of radioactive material inside the body)

Both can be used in some cases depending on the severity (stage) with external beam therapy administered first followed by brachytherapy

Radiation is given after surgery killing any remaining cancer cells in the area. Usually, the patient is given 4-6 weeks to heal after surgery before starting radiation therapy

It can also be given before surgery to help reduce the size of the tumor

Dependent on health status as well

External Beam Therapy

Given 5 days a week from 4-6 weeks

Special immobilization devices like customized vacklock is made to ensure the patient is in the same position every day to avoid unnecessary radiation other than the primary tumor target

Treatment take about 15-20 min daily

At time chemo can be given in combination of radiation therapy

Stage IB or higher/ Grade 3 disease

Theres an increased risk of pelvic noval involvement + of pelvic rad therapy

40-50 Gy recommended w boosting up to 65 Gy for group involvement

The endometrial cavity can be take up to 75-90 Gy w/EBT & LDR brachytherapy (tx fields →

Bladder & rectum must be kept at 65-70 Gy or less

Small bowel kept at 45-40 Gy or less

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→Superior: L5-S1 interspace, to include the common iliac nodes →Inferior: bottom of the obturator foramen/include at least one-half of the vagina (radiopaque 

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→ Anterior: encompassing the pubic symphysis                 → Posterior: split the sacrum (block may be added to reduce the rectal dose & dose to small  bowel)

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Acute Side Effects of Radiation Therapy 

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Acute Side Effects of Radiation Therapy 

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down below are some acute side effect that are caused by radiation therapy that usually occur within 1-2 weeks after treatment has begun ↓

Skin changes: from mild redness → peeling & blistering

Skin can release fluid leading to infection

Proper care and cleaning to help protect the exposed area and as it heals skin gets darker and harder

Acute cystitis (30 Gy → whole bladder) (75-80 Gy to part of bladder)

irritation of the bladder causing problems with urinating resulting in discomfort, blood in urine, & urge to urinate often

Bleeding & urgency begin at 30-40 Gy

Radiation proctitis: irritation in the intestine causing rectal irritation/bleeding can be treated with enemas contains a steroid (hydrocortisone) that have anti-inflammatories

Radiation vaginitis: irritation of the vagina → discomfort & discharge

Dr can recommend douching the area w/dilute solution of hydrogen peroxide

Severe irritation leads to open sore in the vagina → estrogen cream

Low blood counts: causing anemia and leukopenia & return back to normal once radiation is complete after a couple of a weeks

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Chronic Side Effects of Radiation Therapy 

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Chronic Side Effects of Radiation Therapy 

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down below are some chronic side effects that are caused by radiation therapy that usually begin within 2 weeks after treatment has begun and can be long-term ↓

Vaginal stenosis:

More common in vaginal brachytherapy with scar tissue forming in the vagina causing it to become shorter/more narrow → vaginal stenosis

Makes sex painful

Prevent by stretching walls of vagina with sex 3-4 times a week or a vaginal dilator

Vaginal dryness & pain w/sex can be long-term (physical therapists who specializes in pelvic floor therapy help treat these symptoms & improve sexual function)

Premature menopause (4-5 Gy)

Radiation causes damage to ovaries most of time not issue with women who are being treated for endometrial cancer since they have already gone through it naturally or as a result of surgery (hysterectomy)

Can also talk about fertility preservation if one has not hit menopause yet

Lymphedema:

Blockages keeping fluid from draining out of the leg → severe swelling

This doesn’t go away after radiation is done typically star after several months or years after treatment is completed

Common if pelvic lymph nodes were removed during surgery

Weakening of the bones:

Radiation to pelvis → fractures of hips/pelvic bones

Important to contact dr if feeling pain

Blockage:

An obstruction for an abnormal connection to form between the bowel and vagina → fistula can be treated with surgery

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Recommendation for patients undergoing treatment & ways to avoid them if possible

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Recommendation for patients undergoing treatment & ways to avoid them if possible

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Be sure to talk to the doctor about what it is your going through as far as side effects including us & the nurses

Get proper rest/sleep

Adequate nutrition

Make sure to take any prescribed medication to help combat some pain or side effects that can help with treatment tolerability for patient

Maintain a low-residue diet to help with the increased bowl movements due to radiation

Communicate with us therapists with any concerns

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Type 1, Grade 2 endometrioid adenocarcinoma

Typically estrogen responsive

Diagnosed in obese women at younger ages

Perimenopause or early in menopause

Preceded by endometrial hyperplasia

Low grade and good prognosis

atypical endometrial hyperplasia/ endometrioid intraepithelial neoplasia is a precursor lesion

Gene alterations are common: PTEN, ARID1A, PIK3CA, KRAS, CTNNB1

account for 75 to 80% of endometrial cancers

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https://www.cancer.org/cancer/endometrial-cancer/treating/surgery.html

https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq

https://www.cancer.org/cancer/endometrial-cancer/treating/by-stage.html

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The stage (extent) of endometrial cancer is the most important factor in choosing treatment. But other factors can also affect your treatment options, including the type of cancer, your age and overall health, and whether you want to be able to have children. Tests done on the cancer cells are also used to find out if certain treatments, like hormone and targeted therapy, might work.

is the first treatment for almost all women with endometrial cancer. The operation includes removing the uterus, fallopian tubes, and ovaries. (This is called a total hysterectomy bilateral salpingo-oophorectomy or TH/BSO). Lymph nodes from the pelvis and around the aorta may also be removed (a pelvic and para-aortic lymph node dissection [LND] or sampling) and tested for cancer spread. Pelvic washings may be done, too. The tissues removed at surgery are tested to see how far the cancer has spread (the stage). Depending on the stage of the cancer, other treatments, such as radiation and/or chemotherapy may be recommended.

For some women who still want to be able to get pregnant, surgery may be put off for a time and other treatments tried instead.

If a woman isn't well enough to have surgery, other treatments, like radiation, will be used.

Stage I cancers

Stage I is only in the uterus. It has not spread to lymph nodes or distant sites.

Stage I endometrioid cancers

Standard treatment includes surgery to remove and stage the cancer (see above). Sometimes this is the only treatment needed. The patient is then closely watched for signs that the cancer has come back (recurred).

For women with higher grade tumors, radiation will likely be recommended after surgery. Vaginal brachytherapy (VB), pelvic radiation, or both can be used.

Some younger women with early endometrial cancer may have their uterus removed without removing the ovaries. This prevents menopause and the issues that can come with it. This also increases the chance that the cancer will come back, but it doesn't make it more likely that you will die from the cancer. This may be something that you want to discuss with your doctor.

Women who cannot have surgery because of other medical problems or who are frail due to age are often treated with just radiation (external radiation and/or vaginal brachytherapy).

Fertility-sparing treatment for stage IA grade 1 endometrioid cancers: For young women who still want to have children, surgery may be postponed while progestin therapy is used to treat the cancer. Progestin treatment can cause the cancer to shrink or even go away for some time, giving the woman a chance to get pregnant. Still, this is experimental and can be risky if the patient isn't watched closely. An endometrial biopsy or a D&C should be done every 3 to 6 months. If there's still no cancer after 6 months, the woman can try to become pregnant. She will continue to be checked for cancer every 6 months. Because the cancer often comes back again, doctors recommend TH/BSO after childbearing is complete.

Many times, progestin treatment doesn't work and the cancer doesn't get better or keeps growing. Putting off surgery can give the cancer time to spread outside the uterus. If it doesn't go away in 6 to 12 months , surgery to remove and stage the cancer is recommended (hysterectomy and removal of both fallopian tubes and ovaries).

A second opinion from a gynecologic oncologist and pathologist (to confirm the grade of the cancer) before starting progestin therapy is important. Seeing a fertility expert is also a good idea. It's important to understand that this isn't a standard treatment and may increase risk of cancer growth and spread.

Other types of stage I endometrial cancers

Cancers such as papillary serous carcinoma, clear cell carcinoma, or carcinosarcoma are more likely to have already spread outside the uterus when diagnosed. Women with these types of tumors don't do as well as those with lower grade tumors. If the biopsy done before surgery shows a high-grade cancer, the surgery may be more extensive. Along with the total hysterectomy and removal of both fallopian tubes and ovaries, the pelvic and para-aortic lymph node will be removed, and the omentum is often removed, too.

After surgery, chemotherapy (chemo) with or without radiation therapy are given to help keep the cancer from coming back. The chemo usually includes the drugs carboplatin and paclitaxel, but other drugs can also be used.

If the cancer can't be removed with surgery, both chemotherapy (chemo) with or without and radiation are used. Sometimes, the tumor then shrinks so that surgery can then be done to remove it.

Stage II cancers

When an endometrial cancer is stage II, it has spread to the connective tissue of the cervix. But it still hasn't grown outside the uterus.

One treatment option is to have surgery first, followed by radiation therapy. The surgery includes a radical hysterectomy (the entire uterus, the tissues next to the uterus, and the upper part of the vagina are removed), removal of both fallopian tubes and ovaries (BSO), and pelvic and para-aortic lymph node dissection (LND) or sampling. Radiation therapy, often both vaginal brachytherapy and external pelvic radiation, may be given after the patient has recovered from surgery. Another option is to give the radiation therapy first, and then do a simple hysterectomy, BSO, and possible LND or lymph node sampling.

The lymph nodes that have been removed are checked for cancer cells. If there's cancer in them, the cancer isn't really a stage II - it's a stage IIIC.

In some cases, a woman with early stage endometrial cancer might be too frail or ill from other diseases to safely have surgery. These women are treated with external radiation and brachytherapy.

For women with high-grade cancers, like papillary serous carcinoma or clear cell carcinoma, the surgery may include omentectomy and peritoneal biopsies along with the total hysterectomy, removal of both fallopian tubes and ovaries, pelvic and para-aortic lymph node dissections, and pelvic washings. After surgery, radiation therapy, chemo, or both may be given to help keep the cancer from coming back. The chemo usually includes the drugs carboplatin and paclitaxel or possibly cisplatin and doxorubicin.

Someone with a stage II uterine carcinosarcoma often has the same type of surgery that's used for a high-grade cancer. After surgery, radiation, chemo, or both may be used. The chemo often includes paclitaxel and carboplatin but may instead include ifosfamide, along with paclitaxel or cisplatin.

Stage III cancers

Stage III endometrial cancers have spread outside of the uterus.

If the surgeon thinks that all visible cancer can be removed, a hysterectomy is done and both ovaries and fallopian tubes are removed. Sometimes women with stage III cancers need a radical hysterectomy. A pelvic and para-aortic lymph node dissection may also be done. Pelvic washings will be done and the omentum may be removed. Some doctors will try to remove any remaining cancer (called debulking), but it isn't clear that this helps patients live longer.

If tests done before surgery show that the cancer has spread too far to be removed completely, in rare cases, radiation therapy may be given before any surgery. It might shrink the tumor enough to make surgery an option. For advanced endometrial cancers that cannot be treated with surgery or radiation, treatment with the immunotherapy drug, pembrolizumab might be an option.

Stage IIIA: A cancer stage IIIA has spread to the tissue covering the uterus (the serosa) or to other tissues in the pelvis, like the fallopian tubes or the ovaries (the adnexa). For these cancers, treatment after surgery may include chemo, radiation, or both. Radiation is given to the pelvis or to both the abdomen (belly) and pelvis. Vaginal brachytherapy is often used, too.

Stage IIIB: In this stage, the cancer has spread to the vagina. After surgery, stage IIIB may be treated with chemo and/or radiation.

Stage IIIC: This includes cancers that have spread to the lymph nodes in the pelvis (stage IIIC1) and those that have spread to the lymph nodes around the aorta (stage IIIC2). Treatment includes surgery, followed by chemo and/or radiation.

For women with high-grade cancers, such as papillary serous carcinoma or clear cell carcinoma, the surgery may include omentectomy and peritoneal biopsies along with the total hysterectomy, removal of both ovaries and fallopian tubes, pelvic and para-aortic lymph node dissections, and pelvic washings. After surgery, chemo, radiation therapy, or both may be given to help keep the cancer from coming back. The chemo usually includes the drugs carboplatin and paclitaxel or cisplatin and doxorubicin.

Women with stage III uterine carcinosarcoma often have the same type of surgery that's used for a high-grade cancer. After surgery, radiation, chemo, or both may be used. The chemo often includes the drug paclitaxel and carboplatin, but ifosfamide, along with paclitaxel or cisplatin may be used. Targeted and/or immunotherapy may also be options for some women.

Stage IV cancers

Stage IVA: These endometrial cancers have grown into the bladder or bowel.

Stage IVB: These endometrial cancers have spread to lymph nodes outside the pelvis or para-aortic area. This stage also includes cancers that have spread to the liver, lungs, omentum, or other organs.

Some endometrial cancers are stage IV because they have spread to lymph nodes in the abdomen (and not just the pelvis and para-aortic area), but they haven't spread to any other areas. Women with this kind of cancer spread may have better outcomes if all the cancer that's seen can be removed (debulked) and biopsies of other areas in the abdomen do not show cancer cells.

In most cases of stage IV endometrial cancer, the cancer has spread too far for it all to be removed with surgery. A hysterectomy and removal of both fallopian tubes and ovaries may still be done to prevent excessive bleeding. Radiation therapy may also be used for this reason. When the cancer has spread to other parts of the body, hormone therapy may be used. But high-grade cancers and those without detectable progesterone and estrogen receptors on the cancer cells are not likely to respond to hormone therapy.

Combinations of chemo drugs may help some women for a time. The drugs used most often are paclitaxel, doxorubicin, and either carboplatin or cisplatin. These drugs are often used together in combination. Stage IV carcinosarcoma is often treated with much the same chemo. Cisplatin, ifosfamide, and paclitaxel may also be combined.

Targeted drugs and/or immunotherapy drugs may also be options for some women with advanced endometrial cancer.

Women with stage IV endometrial cancer should consider taking part in clinical trials of chemotherapy or other new treatments.

Recurrent endometrial cancer

Cancer is called recurrent when it come backs after treatment. Recurrence can be local (in or near the same place it started) or distant (spread to organs such as the lungs or bone). Treatment depends on the amount of cancer and where it is, as well as the kind of treatment was used the first time.

For local recurrences, such as in the pelvis, surgery (sometimes followed with radiation therapy) is used. For women who have other medical conditions that make them unable to have surgery, radiation therapy alone or combined with hormone therapy tends to be used.

For a distant recurrence, surgery and/or focused radiation therapy may be used when the cancer is only in a few small spots (like in the lungs or bones). Women with more extensive recurrences (widespread cancer) are treated like those with stage IV endometrial cancer. Either hormone therapy or chemo is recommended. Low-grade cancers containing progesterone receptors are more likely to respond well to hormone therapy. Higher-grade cancers and those without detectable receptors are unlikely to shrink during hormone therapy but may respond to chemo. Targeted therapy and immunotherapy may be used in some cases. Clinical trials of new treatments are another good option.

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Treatment Choices for Endometrial Cancer, by Stage

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The stage (extent) of endometrial cancer is the most important factor in choosing treatment. But other factors can also affect your treatment options, including the type of cancer, your age and overall health, and whether you want to be able to have children.

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(pictured above is what the patient should look like everyday of treatment for efficient & effective dosage)

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What patient should expect when coming in for radiation treatment -->

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What patient should expect when coming in for radiation treatment -->

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Wear comfortable clothes that way radiation therapist can align to marks without the struggle of the patient lowering their bottoms, or lifting their shirts

Come in with full bladder & empty rectum

Required to help limit dose to the rectum & small intestine that could cause other unnecessary side-effects

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Cancer has changed the quality of my life in both good and bad ways. Although my productivity in my work had declined due to lack of energy.  I have become mentally strong. I disregard little stuff and try to build deeper relationships with the people I value most.
My outlook toward life has changed.  I value my life, my family, and my friends more than before. Now I think everyday of my life is blessing and meaningful. I have learn to enjoy today and not worry about tomorrow. I have joined a cancer survivor group and I want to be an inspiration to those who are undergoing suffering and become a source of hope and inspiration to them. I am actively participating in the activities organized by the society. I have been visiting my friends and relatives more often since then and we have been researching together better options to improve my physical and mental well-being. I have been taking advantage of nutritional and naturopathic therapies as my husband is quite supportive and knowledgeable about them.

I do have moderate anxiety and hard to believe that cancer will not comeback, but I believe I will have a positive outcome.

I believe that if the recurrence occurs the most common site is the vaginal vault within 3 years.

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Morice, P., Leary, A., Creutzberg, C., Abu-Rustum, N., & Darai, E. (2016). Endometrial cancer. The Lancet, 387(10023), 1094–1108. https://doi.org/10.1016/s0140-6736(15)00130-0

Endometrial carcinoma. (n.d.). Encyclopedia of Cancer, 973–973. https://doi.org/10.1007/978-3-540-47648-1_1882

William T Creasman, M. D. (2022, April 14). Endometrial carcinoma guidelines. Guidelines Summary, Prevention, Diagnosis. Retrieved March 2, 2023, from https://emedicine.medscape.com/article/254083-guidelines

Uterine cancer - types of treatment. Cancer.Net. (2022, April 29). Retrieved March 2, 2023, from https://www.cancer.net/cancer-types/uterine-cancer/types-treatment#surgery

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pain in the pelvic region

abnormal uterine bleeding or spotting- heavy or irregular menstruation

Anemia

Fatigue

Unusual vaginal discharge

Some patients aren’t diagnosed until after an abnormal Pap smear; can be the first presenting sign

Elevated estrogen levels, no or low progesterone

Pain during sexual intercourse

Unintentional weight loss

Difficult or painful urination

Early menstruation - before age of 12

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Like any cancer scare brought into a family, endometrial cancers often leave feelings of stress, panic, high anxiety, restlessness, impatience, scared, overwhelmed, frustration, and loss of control.
However, many resources are available to provide assistance to the patient and their families such as support groups, financial assistance programs, educational workshops, podcasts from other survivors and families, meal delivery services, transportation to and from treatments, resource navigation, counseling and therapy.
Having a positive support system makes for better recovery!

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Cancer Basics – Coping when you’re first diagnosed with cancer

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How to talk to someone with cancer | Top tips from patients | Cancer Research UK

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Glancing at our schedule for today & noticing we only have one new start, Caroline Smith. I log in Mosaiq to double-check she has been approved to begin treatment. The time has come, 1:30 P.M. our new patient has arrived and has been queued in. I go grab her from the waiting room & introduce myself as one of her therapists that will be treating her throughout her radiation treatment. We make our way to the room & explain to her how she’ll come every day for her treatment, get changed into a gown & sit down in the waiting area until we call her back. I briefly stop at the console & explain to her this is where we deliver the treatment from outside the room where we can see & hear her at all times. I ask her to verify her name, date of birth & what we are treating for safety protocols & let her know we will ask for those things every time she comes in. I give a brief description of the gantry, imagers & how the radiation is delivered for her reassurance & knowledge. I instruct her to lay down on the table that has her immobilization devices & that she will lay in the same position everyday & we will adjust her to her marks that were made in CT as it assures we are treating & imaging the correct area everyday. Once we get her aligned to her marks I then explain how the gantry will rotate around her & will get close but she shouldn’t worry about it coming too close, how the imagers on the side come out when we perform her daily imaging. As well as the gantry shouldn’t make any noise but maybe some beeping throughout her treatment, she shouldn’t feel anything nor see anything but the gantry move around her. I ask her to remain still throughout the treatment & that today will take a bit longer since it is her first day & the physician needs to come & approve her images once we image her so we can then proceed to treat her. I reassure her we can see & hear her so if she needs anything to just call out for us. I step outside the room & being driving on the patient starting with taking her CBCT, image matching & calling the physician for approval, then treat her, once its done I go in & mark her new isocenter's.
I lower her down & explain to her some side effects she should expect to see soon including skin changes that can be treated with some cream that can be provided by the nurse, discomfort of the vagina, fatigue, urgency to urinate as we advance in her treatment. Some of the acute side effects & remind her that we are here to support & comfort her throughout her journey.

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Endometrial cancer treatment (PDQ®)–patient version. National Cancer Institute. (n.d.). Retrieved April 6, 2023, from https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq#:~:text=Endometrial%20cancer%20is%20a%20disease,the%20risk%20of%20endometrial%20cancer.

Radiation therapy for endometrial cancer. American Cancer Society. (n.d.). Retrieved April 6, 2023, from https://www.cancer.org/cancer/endometrial-cancer/treating/radiation.html

Radiation therapy for endometrial cancer. Patient Care at NYU Langone Health. (n.d.). Retrieved April 6, 2023, from https://nyulangone.org/conditions/endometrial-cancer/treatments/radiation-therapy-for-endometrial-cancer

Vann, A. M., & Dasher, B. G. (2013). Portal design in radiation therapy. Phoenix Printing.

Washington, C. M., Leaver, D. T., & Trad, M. (2021). Washington and Leaver's Principles and Practice of Radiation Therapy, 5th Edition . Elsevier.

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https://www.youtube.com/watch?v=bat0uVxNUJ4

https://www.youtube.com/watch?v=BSaBgb2niOo

https://www.youtube.com/watch?v=V7gPi8-i7lQ

https://www.cancer.org/cancer/endometrial-cancer/about/what-is-endometrial-cancer.html

https://www.cancer.org/cancer/uterine-sarcoma/about/what-is-uterine-sarcoma.html

https://www.youtube.com/watch?v=RrIX3y5htWY

https://www.youtube.com/watch?v=VCvDes_AZm4

https://www.youtube.com/watch?v=npQ2fcxZ6jU

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The uterus

The uterus is a hollow organ, normally about the size and shape of a medium-sized pear.

The lower end of the uterus is the cervix, which sits above the vagina.

The upper part of the uterus is the body, and is also known as the corpus.

The body of the uterus has 3 layers.

The inner layer or lining is the endometrium.

The serosa is the layer of tissue coating the outside of the uterus.

In the middle is a thick layer of muscle known as the myometrium. This muscle layer is needed to push a baby out during childbirth.

Cancers of the uterus and endometrium

Sarcomas are cancers that start from tissues like muscle, fat, bone, and fibrous tissue (the material that forms tendons and ligaments). Cancers that start in epithelial cells, the cells that line or cover most organs, are called carcinomas.

More than 95% of uterine cancers are carcinomas. If a carcinoma starts in the cervix, it is a cervical carcinoma. Carcinomas starting in the endometrium, the lining of the uterus, are endometrial carcinomas. Information for these types of cancer is in Cervical Cancer and Endometrial (Uterine) Cancer.

Another type of cancer that starts in the uterus is called carcinosarcoma. These cancers start in the endometrium and have features of both sarcomas and carcinomas. These cancers were known as malignant mixed mesodermal tumors or malignant mixed mullerian tumors. Uterine carcinosarcomas are covered in Endometrial (Uterine) Cancer.

Types of uterine sarcoma

Most uterine sarcomas are put into a category, based on the type of cell they start in:

Uterine leiomyosarcoma(LMS)

These tumors start in the muscle layer of the uterus (the myometrium). They are the most common type. These tumors can grow and spread quickly.

Endometrial stromal sarcoma (ESS)

ESS tumors start in the supporting connective tissue ( stroma) of the lining of the uterus (the endometriu m).

ESS tumors are often given a grade which helps to understand how fast it's likely to grow and spread.

If the tumor is low grade, the cancer cells only look slightly different from normal cells and the tumor tends to grow slowly. Women with low-grade ESS tumors tend to have a better outlook (prognosis) than women with other kinds of uterine sarcomas. Most low-grade ESS tumors also have proteins called estrogen receptors (ER) and/or progesterone receptors (PR), like some breast cancers. Having these proteins often means certain hormone drugs can help treat these types of uterine sarcomas.

A high-grade ESS tumor means the cancer cells look very different from normal cells, and the tumor is growing quickly. This type of ESS tumor is most often found when the tumor is already large and/or has spread. These tumors are often harder to treat.

Undifferentiated sarcoma

These cancers start in the endometrium or the myometrium. They grow and spread quickly and tend to have a poor outlook.

Adenosarcoma

This type of sarcoma has normal gland cells that are mixed with cancer cells of the stroma (supporting connective tissue). These are generally low-grade cancers and usually have a good prognosis (outlook).

Benign uterine tumors

Several types of benign (not cancer) tumors can also develop in the connective tissues of the uterus. These tumors, such as leiomyomas, adenofibromas, and adenomyomas are also known as types of fibroid tumors. In many people, these tumors don't need to be treated. But treatment may be needed if they start causing problems, like pelvic pain, heavy bleeding, frequent urination, or constipation.

In some cases, only the tumor is removed, leaving the rest of the uterus in place. This surgery is called a myomectomy. Other treatments destroy these benign tumors, by blocking the blood vessels that feed them, by killing the tumor cells with electric current, or by freezing them with liquid nitrogen.

Another option is to remove the entire uterus with a type of surgery called a hysterectomy.

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What is Uterine Sarcoma? | Types of Uterine Sarcoma

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The uterus is a hollow organ, normally about the size and shape of a medium-sized pear. The lower end of the uterus is the cervix, which sits above the vagina. The upper part of the uterus is the body, and is also known as the corpus. The body of the uterus has 3 layers.

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I was diagnosed with stage 2 endometrial cancer in March 2020. After discussing it with my doctor, I decided to have a hysterectomy, followed by several sessions of radiation therapies. After the hysterectomy, I have been experiencing lots of physical and mental changes in my life. I have lifelong pelvic floor disorder problems like frequent UTI, constipation, and urinary incontinence. Whenever I cough, sneeze, or laugh, I have been experiencing urine leaks. It makes my daily life a little bit uncomfortable. But this cancer journey has brought positive changes simultaneously. Now my thinking about life has changed. I feel life is valuable; I want to make it inspiring and meaningful. I have realized that life is uncertain and transient. Unexpected things can happen anytime. So, I enjoy every second of it. I want to share deep love with family, friends, and relatives. My principle in life is to accept whatever comes and try my best to make it better.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198052/
https://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/endometrial-cancer
https://connect.mayoclinic.org/discussion/adenocarcinoma-of-the-endometrium/
https://www.cancer.org/support-programs-and-services.html
http://www.cancercare.org/diagnosis/uterine_cancer