ENDOMETRIAL & UTERINE CANCER (con't)
Overview of Endometrial Cancer
Endometrial cancer begins in the lining (endometrium) of the uterus. Endometrial cancer is sometimes called uterine cancer, although technically uterine cancer begins in the muscle of the uterus and is different from endometrial cancer. Endometrial cancer is the most common type of gynecologic cancer.
Cancer that starts in the muscle layers of the womb or uterus is called uterine sarcoma.
Types of Endometrial Cancer:
- Adenocarcinomas. Seventy-five to ninety-five percent of all endometrial cancers are adenocarcinomas.
Subtypes of adenocarcinomas include:
- Adenosquamous endometrial tumors contain adenocarcinoma and squamous cells.
- Adenocanthoma endometrial tumors contain malignant adenocarcinomas cells and benign squamous cells.
Two additional subtypes which are more aggressive are:
- Papillary serous adenocarcinomas of the endometrium.
- Clear cell adenocarcinomas of the endometrium.
- Uterine sarcomas are rare. They are responsible for only one to five percent of all cancers of the uterus.
Types of uterine sarcoma include:
- Carcinosarcoma or malignant mixed mesodermal tumors may combine features of endometrial carcinoma and those of sarcomas (bone and soft tissue tumors).
- Leiomyosarcomas begin in the muscular wall of the uterus.
- Endometrial stromal sarcomas start in the supporting connective tissue (stroma) of the endometrium.
Stages of Endometrial Cancer:
Stage I
Stage I (stage 1) endometrial cancer is contained within the endometrium (uterine lining).
- Stage IA endometrial cancer is limited to the endometrium
- Stage IB cancer invades the uterine wall but less than half of its thickness
- Stage IC cancer invades the uterine wall but less than half of its thickness
Stage II
Stage II (stage 2) endometrial cancer has spread into the cervix.
- Stage IIA endometrial cancer indicates the glands that line the cervix are involved.
- Stage IIB endometrial cancer indicates the tumor cells invade the cervix.
Stage III
Stage III (stage 3) endometrial cancer has spread outside of the uterus but is confined to the true pelvis. The tumor may have invaded nearby tissues such as the supporting membranes in the pelvic area, the vagina, or nearby lymph nodes.
- Stage IIIA endometrial cancer indicates is involvement of the uterine surface and/or the fallopian tubes and ovaries and/or the presence of malignant cells in the abdominal fluid (positive peritoneal washings)
- Stage IIIB endometrial cancer has spread to the vagina
- Stage IIIC endometrial cancer has spread to the pelvic and/or aortic lymph nodes
Stage IV
Stage IV (stage 4) endometrial cancer involves the bladder and/or bowel or has spread to distant sites. Stage IV endometrial cancer is also known as metastatic endometrial cancer. Depending on the sites of spread, the cancer may now be called endometrial cancer with lung metastases, endometrial cancer with liver metastases, endometrial cancer with bone metastases, endometrial cancer with liver metastases, etc.
- Stage IVA endometrial cancer involves the bladder or rectum.
- Stage IVB endometrial has spread to sites outside the abdomen such as the bones, lungs, liver, and brain.
Grade of Endometrial Cancer:
Grade indicates how quickly or slowly cancer cells grow. The grade is determined by the appearance of the cells under the microscope. Tumors are graded on a scale of 1 to 3.
Grade 1 - cells look most like normal tissue (called well differentiated). Grade 1 cancers grow and spread somewhat slowly.
Grade 2 - cells look somewhat like normal tissue (called moderately well differentiated). Grade 2 cancers grow and spread quickly.
Grade 3 - cells appear very abnormal (called poorly differentiated or undifferentiated). Grade 3 cancers grow and spread very quickly. They are considered "aggressive.
