Cancer InDepth: Uterine (Endometrial) Cancer

Cancer is a disease in which cells grow in an abnormal way. Normally, the cells divide in a controlled manner to replace old or damaged cells. If cells keep dividing when new cells are not needed, a mass of tissue called a tumor forms.

A tumor can be benign or malignant. A benign tumor is not cancer and will not spread to other parts of the body. A malignant tumor is cancer. Cancer cells invade and damage tissue around them. They can also enter the lymph and blood streams, spreading to other parts of the body. Uterine cancer is the development of malignant cells in the uterus.

Cancer Cell Growth

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Normal Anatomy and the Development of Uterine Cancer

The uterus is part of the female reproductive system. It is a hollow, muscular organ in the pelvis. It sits near the bladder and in front of the colon. The ovaries are two, small oval-shaped organs. They sit on each side of the uterus. The ovaries produce eggs, and hormones that changes how the uterus works.

The uterus is made up of 2 parts:

  • Body—main part of the uterus
  • Cervix—lower part of the uterus that connects to the vagina

The wall of the uterus is made up of 3 layers:

  • Endometrium—thin, inner layer that changes in thickness with the menstrual cycle
  • Myometrium—the thicker layer of muscle
  • Serosa—thin layer of tissue that surrounds the outside of the uterus

Cancer growth starts when the DNA of the cells is damaged. The damaged DNA tells the cells to divide and grow out of control. Its not always clear why the DNA changes occur. Hormones may play a role in encouraging cancer growth. Endometrial cancer starts in the endometrial layer. Uterine sarcoma develops in the muscle layer of the uterus.

Uterine cancer can cause bleeding outside of menstruation. If cancer spreads beyond the uterus, it can affect nearby areas such as the cervix and vagina. It can lead to pain in the pelvis and pain with sex. Cancer can also spread to lymph nodes or blood vessels. The growth of uterine cancer in other areas of body is called metastatic cancer. The first areas that uterine cancer may spread are the ovaries, bladder, and belly organs such as the colon. It can cause problems passing urine or stool. Other organs may include lymph nodes in other parts of the body, the lungs, liver, brain, and bones.

Uterine Cancer

Uterine Cancer
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Types of Uterine Cancer

There are different types of uterine cancer based on where they start and appearance under a microscope. Most uterine cancers are endometrial carcinomas. Cancer starts and grows in the endometrium that lines the inside of the uterus. There are 2 types of endometrial carcinomas:

  • Type 1 —often associated with exposure to too much estrogen. Genetic changes may also be found. Type 1 tumors tend to grow slowly. Others include squamous cell, secretory, or ciliated cell carcinomas.
  • Type 2 —Tend to be aggressive and grow quickly. Type 2 tumors are more likely to spread beyond the uterus. These include clear cell, serous, and carcinosarcomas.

Some endometrial cancers may be a combination of type 1 and type 2.

Uterine sarcomas tend to be aggressive and more likely to invade other tissue.

This fact sheet focuses on endometrial cancer.

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References:

Endometrial cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113952/Endometrial-cancer. Updated May 24, 2017. Accessed December 13, 2017.
Endometrial cancer. Merck Manual Professional Version website. Available at:
...(Click grey area to select URL)
Updated March 2017. Accessed December 13, 2017.
General information about endometrial cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/uterine/patient/endometrial-treatment-pdq. Updated October 13, 2017. Accessed December 13, 2017.
What is endometrial cancer? American Cancer Society website. Available at: https://www.cancer.org/cancer/endometrial-cancer/about/what-is-endometrial-cancer.html. Updated February 29, 2016. Accessed December 13, 2017.
Last reviewed December 2017 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 12/13/2017

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