Uterine (endometrial) cancer - General
CANCER OF THE UTERUS (ENDOMETER) - GENERAL
UTERUS CANCER (ENDOMETER) CAUSES SYMPTOMS EXAMINATIONS TREATMENTS
Different types of cancer can develop in the uterus. Depending on their starting point in the various anatomical areas of this organ, two types are distinguished: cancer of the body of the uterus (also called endometrial cancer) and cancer of the cervix. This part of the site is devoted to endometrial cancers.
Anatomy of the uterus
The uterus is the female organ in which a fetus develops during pregnancy. Outside of pregnancy, the uterus is small: it measures about 10 cm and is located in the small pelvis, between the bladder and the rectum.
The main part, called the body of the uterus, is extended by two tubes. The lower part of the uterus, the cervix, opens into the vagina.
The muscular wall of the uterus surrounds a cavity (the uterine cavity) lined with a lining called the endometrium. From puberty to menopause, the endometrium goes through periodic changes under the influence of hormones produced by the ovaries. Its surface layer is eliminated during menstruation. The mucous membrane cells are then eliminated via a blood stream.
Reproductive system
Uterine cancer in numbers
The infographic below has been produced based on figures from the Cancer Registry. The figures are transposed there in the form of graphs representing the number of new cases per year, the age groups most affected and the number of deaths due to this type of cancer.
Cancer of the uterus should not be confused with cancer of the cervix.
2 kinds of uterine cancer
Cancer of the uterine body (endometrium)
This cancer starts in the lining of the uterine cavity. There are two main histological types of this uterine cancer, defined according to the type of cells that compose them:
Classical endometrial or endometrioid adenocarcinoma (type I)
It represents 85% of endometrial cancers. The treatments presented here relate to this uterine cancer.
So-called non-endometrioid adenocarcinomas (type II)
They include serous carcinomas, clear cell carcinomas and adenosquamous carcinomas. All three require the establishment of specific treatment regimens which we will not discuss here.
Endometrial cancer spreads by different routes:
Direct extension to neighboring structures
It is the most common route of spread of endometrial cancer. Can be directly invaded:
the cervix
the appendages (ovaries and tubes)
parameters (membranes crossed by the ureter and the vessels of the uterus)
the vagina
the peritoneal cavity (through the tube opening)
Lymphatic dissemination
Via the lymphatics, endometrial cancer can spread to the lymph nodes.
Dissemination by blood
This spread is very rare at the early stage of the disease. When it does occur, it mainly causes pulmonary metastases, but sometimes also hepatic, cerebral or bone metastases.
Cervical cancer
Cervical cancer starts in cells that line the lower, narrow part of the uterus (the cervix) that connects the uterus to the vagina. The main risk factor for cervical cancer is chronic infection with human papillomavirus (HPV). These viruses are sexually transmitted (STIs). However, this cancer, as such, is not contagious.
Cervical cancer is different from endometrial cancer and is described in another part of the site: cervical cancer.
Uterine cancer staging
The surgery can assess the level of invasion of endometrial cancer.
Stage I
Stage Ia: Tumor limited to the endometrium
Stage Ib: Invasion of less than half of the uterine muscle
Stage Ic: Invasion of more than half of the uterine muscle
Stage II
Stage IIa: Endocervical glandular invasion
Stage IIb: Invasion of cervical stroma
Stage III
Stage IIIa: Tumor invading the uterine serosa and / or the appendages, and / or positive peritoneal cytology
Stage IIIb: Vaginal metastases
Stage IIIc: Metastases in the pelvic and / or para-aortic lymph nodes
Stage IV
Stage IVa: Tumor invasion of the bladder wall or intestine
Stage IVb: Distant metastases including inguinal lymph nodes and / or intra-abdominal metastases
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