Cancer Care

Uterine Cancer | Endometrial Cancer

Uterine cancer is the most common cancer of the female reproductive system. Uterine cancer often starts in the endometrium, which is the lining of the uterus. A uterus is the place where a baby grows during pregnancy. Your uterine cancer care team may include:

  • Medical oncologists treating uterine cancer use medicine (chemotherapy, targeted therapy, biotherapy and/or immunotherapy) rather than radiation.
  • Gynecological oncologists focus on cancers of the reproductive organs in women, including uterine cancer.
  • Radiation oncologists use high energy X-rays to destroy cancer cells while sparing surrounding tissue.
  • Cancer Patient Navigators make sure you have everything you need to make informed decisions about your care.

What is uterine cancer surgery?

Surgery is the main treatment for uterine cancer but it may be done in combination with other cancer treatments, including chemotherapy, radiation therapy and hormone therapy. Surgery can include a total hysterectomy, which is a removal of the uterus. It also may include a radical hysterectomy, which is removal of the uterus, cervix and upper vagina.

What is endometrial cancer?

Endometrial cancer starts in the lining of the uterus, and most often occurs in women over 55. It is a type of uterine cancer. Endometrial cancer also is the most common gynecologic cancer in women in the U.S. Endometrial cancer is curable. It is important to get an early diagnosis before the cancer has spread to other parts of the body.  Stages of endometrial cancer are:

  • Stage 1: Cancer is only in the uterus
  • Stage 2: Cancer is in the uterus and cervix
  • Stage 3: Cancer is spread beyond the uterus to the pelvic area
  • Stage 4: Cancer is spread to the bowel, bladder, stomach and other organs.

Uterine Cancer Testing Types

Uterine cancer diagnostic tests can include:

  • Biopsy: A thin tube is placed through the cervix to remove tissue from the uterus for sampling
  • D&C (dilation and curettage): This form of biopsy lets doctors remove cells from the uterine lining
  • Imaging tests may include an ultrasound, CT scan, MRI, PET or X-ray
  • Blood tests

Risks, Signs & Symptoms

Any woman could develop uterine cancer, but there are some things that may make you more likely. Here are a few: 

  • Older age

  • Being extremely overweight

  • Having diabetes

  • Exposure to estrogen (women are exposed to increased estrogen if they start their periods at a young age, go through menopause at a late age, never get pregnant, or take estrogen containing hormonal medications)

  • Exposure to tamoxifen, which is a drug used to treat some types of breast cancer

  • Family history of uterine cancer

  • African-American ancestry

  • If you have had retinoblastoma (eye cancer), you are at a higher risk for uterine sarcoma

There are some common signs and symptoms of uterine cancer that you can watch out for. If you notice any of these symptoms, see your doctor:

  • Unusual vaginal bleeding, especially in a postmenopausal woman

  • Vaginal bleeding between periods

  • Pelvic pain

  • Watery or bloody discharge from your vagina

  • Pain during sexual intercourse

  • You or your doctor feel a growth or tumor in your vagina

Screening for uterine cancer is not done routinely. If your doctor feels that you are at particularly high risk, you can have samples of your uterus tested every year after you turn 35 years old.  Sometimes there are signs that may indicate uterine cancer on a routine PAP smear and further testing is done. Uterine cancer is usually diagnosed when patients experience symptoms and tell their doctor. Your doctor might do any of the following tests to decide whether you have uterine cancer:

  • Physical exam and health history review

  • Pelvic exam

  • Endometrial biopsy: testing a sample of your uterus lining

  • Imaging using an ultrasound, CAT scan or MRI

  • Blood tests

  • Hysteroscopy: using a small camera to look at the inside of your uterus

Treatment of uterine could include any of the following:

  • Surgery: removing your uterus, some of its lining or a tumor

  • Drug therapy

  • Radiation therapy

  • Hormone therapy

  • Immunotherapy

  • Palliative care: a supportive care that works to help reduce pain and side effects from a serious illness. It can be used while you are having treatment for that illness.

Getting a second opinion is not uncommon in cancer care. At MaineHealth, we know how important it is to be confident in the approach to your uterine cancer treatment. We want to make every effort to facilitate a second opinion, whenever the patient – and in many situations, the provider – wants to seek a second opinion. This is important to us, and our focus on patient-centered care.

What is a second opinion?

A second opinion is when a patient or physician seeks another physician specialist’s review of a patient’s diagnosis or recommended treatment. It is common in cancer, especially if a patient has an unusually complicated condition or rare form of the disease.

When you choose to obtain a second opinion, your physician forwards test results such as radiology images, blood work and pathology slides. The physician may recommend another physician specializing in gynecological cancers, or the patient may find a specialist through a primary care physician, online research or a relative or friend’s recommendation.

To confirm that insurance will cover the cost of second opinion visits, it is recommended that you verify by contacting your insurance company directly.

Preparing for your visit

Like all visits for cancer care, when you are getting a second opinion, it’s helpful to write down your questions in advance and take notes during the conversation. Physicians often recommend that you bring someone with you to help you recall the discussion later. It can be difficult to process what you’re hearing especially if you’re scared or anxious about your condition.

Physicians also may seek another physician’s opinion either on a one-on-one basis, or by asking a multidisciplinary group of cancer specialists to review and weigh in on a patient’s diagnosis or treatment. This team of specialists includes medical oncologists, radiation oncologists and surgical oncologists, as well pathologists, pharmacists and patient navigators. They meet regularly to review patients’ cases.

Where to go for a second opinion?

MaineHealth has sites where patients and their physicians may obtain second opinions. Each site includes uterine cancer experts with advanced training and experience.

MaineHealth Maine Medical Center

MaineGeneral Medical Center’s Harold Alfond Center for Cancer Care

Linda's Endometrial Cancer Story

Linda is proud of her French Canadian heritage. It's why she decided to live and build her career in Aroostook County. When she was diagnosed with endometrial cancer, staying in Maine for care was important to her.