Are You At Risk for Uterine Cancer

Written by Christine Stoddard
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[dropcap]The threat of uterine cancer started haunting me in 2011, shortly after the death of a loved one. Until then, the only cancer that had preoccupied me was breast cancer. A laminated sheet with self-exam instructions hangs from the linen closet in my bathroom. Every month, I performed my self-exam religiously, aware that my great-grandmother met her fate after finding a lump in her breast a decade or so before I was born.
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Breast cancer, though scary, seemed like a known danger and one that could ultimately be tamed. Uterine cancer? Less so, mainly because I had never thought about it until my loved one was diagnosed in 2008. 

With its high publicity campaign, including marches and merchandise, breast cancer does not cower in the limelight. From a public awareness standpoint, uterine cancer sits somewhere in the shadows, even among educated women. And yet uterine cancer strikes about 40,000 American women and kills about 8,000 of them every year. While less prolific than breast cancer’s 230,000 annually diagnosed cases and 40,000 deaths, uterine cancer remains a menace.

“Uterine cancer deserves more press,” says Dr. Louis Thompson, M.D., of the Virginia Women’s Center in Richmond, Va. “It’s the most common gynecological cancer.”

Uterine cancer is the fourth most commonly diagnosed cancer in women overall. It usually hits menopausal or post-menopausal women. Thompson typically diagnoses about five to 10 women with uterine cancer every year.

“Bleeding after menopause is abnormal, but just because a women is bleeding doesn’t mean she has cancer,” says Thompson. “However, we always have to prepare patients for the possibility and then hopefully rule it out.”

In order to rule it out, Thompson and his colleagues perform a pelvic exam. If the patient has not recently had a Pap smear, they make sure to do one (even though the Pap smear screens for cervical, not uterine, cancer). An endometrial biopsy is the next step. Transvaginal ultrasound is an alternate test for women whose cervixes may be starting to close, which would make the endometrial biopsy a painful procedure.

“If uterine cancer is there, we typically catch it early, in Stage 1,” Thompson explains. “It’s rare that it’s spread if a woman comes in right after she’s noticed the bleeding. The five-year survival rate is 95 percent.”

Other than unusual vaginal bleeding, Thompson warns women to be “vigilant” for “watery, bloody discharge” and pelvic pain. Watching for these other signs may make a difference; after all, about one-fourth of women with uterine cancer are not menopausal. Obesity increases your risk of uterine cancer. 

Treatment generally involves hysterectomy, or the removal of the uterus, as well the ovaries and Fallopian tubes. Often no radiation is needed, but is sometimes necessary. Hormone therapy is another treatment option.

“The good news is that most of the women we screen for uterine cancer are not going to have cancer,” says Thompson. “But if they do, detecting it early makes all the difference.”

 

Correction: In the print edition, Dr. Louis Thompson, M.D., of the Virginia Women’s Center states that obesity and menopausal hormone therapies increase your risk of uterine cancer. It should be noted that menopausal hormone therapies are not a risk factor.