Cancer of the uterus
Cancer of the uterus is the most common gynaecological cancer affecting women in Australia. Most cancers of the uterus are cancers of the lining of the uterus (the endometrium). Cancers can also develop in the muscle layers of the uterus. Knowing which type of cancer you have is important because it affects the decisions you and your doctor will make about treatment.
Adenocarcinoma of the endometrium
An adenocarcinoma is a cancer that starts in glandular tissue. Most women (about 85%) who are diagnosed with cancer of the uterus have this type of cancer.
Other types of cancer of the uterus
The less common types of cancer of the uterus are adenosquamous carcinoma, papillary serous carcinoma and, rarely, clear cell carcinoma or uterine sarcoma. These cancers are called high risk cancers because they are more likely to spread.
Sometimes women develop a very thick lining of the uterus (endometrial hyperplasia). This can mean that they have very heavy periods or bleeding at irregular times or have a watery, bloody discharge, even if they have gone through menopause.
Some types of endometrial hyperplasia may later become cancerous. If you have finished having children, your doctor may advise you to have a hysterectomy.
Unusual bleeding (such as frequent spotting) before and after menopause must be investigated. Usually an ultrasound test and/or a biopsy is done to assess the thickness of the endometrium. In a biopsy, a sample of the endometrium is taken to be looked at under a microscope. This is usually done by dilatation and curettage (D&C) under anaesthetic or using a small sampling device in the doctor's rooms.
Causes of cancer of the uterus
The exact cause of cancer of the uterus is not known. Some things seem to put women at more risk:
- age: it is more common in women aged over 50 years
- endometrial hyperplasia
- menopause, never having children or being infertile
- being overweight
- high blood pressure and diabetes
- a family history of endometrial, breast or bowel cancer
- being on oestrogen hormone replacement without progesterone
- being on tamoxifen or anastrozole for treatment of breast cancer. If you are taking tamoxifen or anastrozole, you should discuss this risk with your doctor.
Uterine cancer is not caused by sexual activity and cannot be passed on this way.
Remember, most women who have known risk factors do not get cancer of the uterus. Many women who do get cancer of the uterus have none of these risk factors.
How common is cancer of the uterus?
In Victoria each year, over 470 women are diagnosed with cancer of the uterus. It is more common in women over the age of 50 than younger women.