When it comes to female cancers, breast cancer gets a lot of attention. That’s understandable – other than skin cancer, breast cancer is the most common cancer in U.S. women, accounting for around 30% of new cancers in women each year. However, it isn’t the only cancer that affects women.
Gynecologic cancers start in the female reproductive system. Two of the most common types are ovarian cancer and uterine cancers. Uterine cancers include endometrial cancer and uterine sarcoma, with the former being more common. Let’s take a closer look at ovarian cancer, endometrial cancer, and uterine sarcoma.
Ovarian cancer starts in the ovaries or the nearby fallopian tubes. It’s the second most common gynecologic cancer after uterine cancers (more on them below), according to the Centers for Disease Control and Prevention.
Many risk factors for ovarian cancer are outside of your control. For example, your ovarian cancer risk rises with age – most cases occurring after menopause. Other risk factors include:
- Certain genetic mutations. Changes to the BRCA1 or BRCA2 genes or to genes linked with Lynch syndrome, can raise your risk of ovarian cancer.
- Excess weight. Being overweight or obese may increase your risk.
- Family history. You’re more likely to develop ovarian cancer if a close relative, such as your mother or sister, had it.
- Having had certain cancers. You have a higher risk of ovarian cancer if you’ve had breast, colorectal, or uterine cancer.
- Never giving birth. Never carrying a pregnancy to full term or completing a first full-term pregnancy after age 35 can increase your risk.
- Hormone replacement therapy. Taking estrogen or progesterone after menopause can increase your risk.
Symptoms of ovarian cancer can be somewhat vague. Vaginal bleeding after menopause is one significant sign. Others include:
- Abdominal pain
- Abnormal vaginal discharge
- Back pain
- Frequent urges to urinate
- Pelvic pain or pressure
- Unusually swift feelings of fullness when eating
If you’re diagnosed with ovarian cancer, your cancer care team will create a treatment plan based on what type of tumor you have, the stage of the cancer, your overall health, and more. Patients with ovarian cancer usually undergo surgery to remove the tumor. Many patients also receive chemotherapy. Chemotherapy for ovarian cancer often consists of combination therapy, or two medications given simultaneously, according to the American Cancer Society. Typically, patients receive these medications intravenously. In some cases, women with ovarian cancer may benefit from hormone therapy, targeted therapy, or radiation therapy.
Uterine cancers affect more women than any other gynecologic cancer. Endometrial cancer is the most common form of uterine cancer (uterine sarcoma is the other). As its name suggests, endometrial cancer starts in the endometrium, which is the tissue that lines the uterus.
You have a higher risk of endometrial cancer if you’ve had breast cancer or ovarian cancer. Endometrial cancer shares certain risk factors with ovarian cancer, including obesity, use of hormone replacement therapy (estrogen only) after menopause, certain genetic mutations, and having never given birth. You’re also more likely to develop endometrial cancer if a close relative had it. Other factors that can increase your risk include:
- Endometrial hyperplasia. Endometrial hyperplasia is abnormal thickening of the endometrium.
- Metabolic syndrome. This group of risk factors includes high blood sugar, high blood pressure, unhealthy cholesterol levels, and a large waist circumference.
- Tamoxifen. Taking this medication to treat or prevent breast cancer can increase your risk of endometrial cancer.
- Type 2 diabetes. This common chronic disease is a risk factor for endometrial cancer.
Abnormal vaginal bleeding is the most common symptom of endometrial cancer. Other symptoms include:
- Difficulty with or pain during urination
- Pain during sex
- Pelvic pain
In many cases, physicians find and diagnose endometrial cancer early, which often leads to a cure, according to the National Cancer Institute. Several factors, including whether the cancer is confined to the uterus or has spread elsewhere in the body, will affect your treatment plan. Many women with endometrial cancer undergo surgery, such as a hysterectomy, which is the removal of the uterus and cervix. After surgery, external beam or internal radiation therapy may be necessary to destroy any remaining cancer cells.
Additional treatment options include:
- Chemotherapy, usually to treat cancers that have spread beyond the uterus
- Hormone therapy, typically used alongside chemotherapy to treat advanced cancer
- Immunotherapy, which can assist your immune system in fighting cancer
- Targeted therapy, which attacks particular cancer cells
Another type of uterine cancer, uterine sarcoma, is far less common than endometrial cancer. Uterine sarcoma develops in the muscles or supporting tissues of the uterus. Race is a key risk factor for uterine sarcoma – African American women are more likely to develop this disease than women of other races. Additional risk factors include past radiation therapy to the pelvis or having taken tamoxifen to treat breast cancer.
Like endometrial cancer, uterine sarcoma often causes unusual vaginal bleeding, including after menopause. Other possible signs of this cancer include:
- Abdominal pain or a feeling of fullness
- Frequent urination
- Pelvic pain, or a mass in the pelvis that you can feel
- Unusual vaginal discharge without blood
To decide how to treat uterine sarcoma, your cancer care team will take into consideration the cancer’s stage and type (whether it started in the uterine muscle or supporting tissues). Surgery – typically hysterectomy – is common.
Some patients receive radiation therapy before or after surgery, or as their main treatment. Radiation therapy or chemotherapy before surgery can reduce the size of the tumor, making it easier to remove. After surgery, these treatments can destroy any leftover cancer cells. Hormone therapy or targeted therapy may be an option for certain patients, but surgery, radiation therapy, and chemotherapy remain the most common forms of treatment.
You Are Not Alone
No matter what type of gynecologic cancer you are facing, you can count on the team at Rocky Mountain Cancer Centers to provide you with the guidance and support you need to manage the symptoms of gynecologic cancers and navigate the treatment journey.
Watch RMCC gynecologic oncology surgeon Dr. Daniel Donato discuss ovarian and uterine cancers.