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The uterus, a pear-shaped organ located in a woman’s pelvis, is composed of three layers. The endometrium, or inner layer, is the tissue that thickens every month in preparation for a potential pregnancy. The myometrium is the middle layer of the uterus and the serosa, or outer layer, covers only the upper part of the uterus.
Symptoms and Diagnosis
The primary symptom of uterine cancer is vaginal bleeding. Approximately 90 percent of women with endometrial cancer will experience abnormal bleeding. About three quarters of those cancers will be confined to the uterus at the time of diagnosis, making endometrial cancer a relatively simply cancer to treat.
If you experience abnormal vaginal bleeding, including any vaginal bleeding after menopause, contact your physician immediately. An endometrial biopsy is necessary to confirm or rule out endometrial cancer.
Other symptoms of uterine cancer include pain during intercourse, when urinating or having a bowel movement, or pain in the pelvic or lower abdominal area.
Because uterine cancer is frequently diagnosed at an early stage, surgery to remove the uterus may result in a complete cure. However, proper diagnosis is crucial. A tissue biopsy will reveal the grade, or aggressiveness, of the cancer. The stage, or extent, of cancer is determined during surgery. The Gynecologic Cancer Program team includes pathologists who specialize in identifying gynecologic cancers. That expertise goes a long way toward increasing your chances of beating uterine and other types of gynecologic cancer, since treatment depends on accurate diagnosis. Read one woman’s story about how accurate diagnosis made a difference in her treatment – and her life.
At Froedtert & The Medical College of Wisconsin, a team of specialists design a treatment plan based on the grade and stage of the cancer, as well the patient’s overall health.
Hysterectomy. During a hysterectomy, a gynecologic oncologist removes the patient’s uterus, fallopian tubes and ovaries. Lymph node sampling may also be done to assess the extent of disease. Most patients are eligible for a laparoscopic , or minimally invasive, hysterectomy.
Vaginal brachytherapy (internal radiation therapy). Depending on the grade and stage of the cancer, radiation therapy may be recommended. In vaginal brachytherapy, small radioactive implants are placed in the vagina to prevent cancer recurrence. Because brachytherapy can be targeted to a very specific region, the healthy tissues of the bladder and rectum receive very little radiation. And because the radiation is concentrated, treatment only takes three weeks. Medical College of Wisconsin radiation oncologists have extensive experience with brachytherapy; Froedtert & The Medical College of Wisconsin were the first in the region to use high dose rate brachytherapy to treat gynecologic cancers.
External radiation therapy. If the cancer has spread beyond the uterus, external beam radiation may be required. At Froedtert & The Medical College of Wisconsin, many gynecologic cancer patients receive image-guided radiation therapy (IGRT), meaning that imaging scans are used to design the radiation fields. This allows the radiation oncologist to specifically target radiation to the desired area. Intensity modulated radiation therapy (IMRT) provides an even greater level of sparing normal tissues and preferentially treating the tumor tissues.
Chemotherapy. Chemotherapy may be used in conjunction with radiation for patients with advanced disease. Medical treatment may also be indicated for younger patients who hope to retain their fertility.