This topic provides
information about cancer of the lining of the uterus (endometrium).
This topic focuses on type I endometrial cancer, which is the most common kind.
Endometrial cancer is the
growth of abnormal cells in the lining of the uterus. The lining is called the
endometrium. Endometrial cancer is also called cancer of the uterus, or uterine
cancer.
Endometrial cancer usually occurs in women older than 50.
The good news is that it is usually cured when it is found early. And most of
the time, the cancer is found in its earliest stage, before it has spread
outside the uterus.
What causes endometrial cancer?
The most common
cause of endometrial cancer is having too much of the hormone
estrogen compared to the hormone
progesterone in the body. This hormone imbalance
causes the lining of the uterus to get thicker and thicker. If the lining
builds up and stays that way, then cancer cells can start to grow.
Women who have this hormone imbalance over time may be more likely to get
endometrial cancer after age 50. This hormone imbalance can happen if a
woman:
Is
obese. Fat cells make extra estrogen, but the body
doesn't make extra progesterone to balance it out.
Starts her
period before age 12 or starts menopause after age 55.
Has never been pregnant or had a full-term pregnancy.
Has never breast-fed.
What are the symptoms?
The most common symptom of
endometrial cancer is unexpected (abnormal) bleeding from the vagina after
menopause. (If you are taking hormone therapy, some
vaginal bleeding is expected.) About 20 out of 100 women who have abnormal
bleeding after menopause have endometrial cancer.1
That means that 80 out of 100 women with abnormal bleeding after menopause
don't have this cancer.
A woman with advanced endometrial cancer
may have other symptoms, such as losing weight without trying.
How is endometrial cancer diagnosed?
Endometrial
cancer is usually diagnosed with a
biopsy. In this test, the doctor removes a small
sample of the lining of the uterus to look for cancer cells.
How is it treated?
Endometrial cancer in its early
stages can be cured. The main treatment is surgery to remove the uterus plus
the
cervix,
ovaries, and
fallopian tubes. The doctor will also remove pelvic
and aortic lymph nodes to see if the cancer has spread.
It's common to feel scared, sad, or angry after finding
out that you have endometrial cancer. Talking to others who have had the
disease may help you feel better. Ask your doctor about support groups in your
area.
Estrogen makes the lining of the uterus (endometrium) grow thicker.
Progesterone "opposes" estrogen-your progesterone level goes up then drops at
the end of each
menstrual cycle, making the thick endometrium layer
shed away. This is what you know as
menstrual bleeding.
When there is too
much estrogen in the body, progesterone can't do its job. The endometrium gets
thicker and thicker. Over time, the endometrium cells can become
cancerous.
Symptoms
The most common symptom of
endometrial cancer is abnormal vaginal bleeding after
menopause. Up to 20% of women who have abnormal
bleeding after menopause will have endometrial cancer.1 "Abnormal" bleeding means unexpected bleeding. If you are
taking
hormone therapy after menopause, you can expect some
bleeding. But if you have irregular bleeding that continues for 3 months or
more, call your doctor.
Abnormal bleeding in women older than 35
who have not started menopause may also be a symptom of endometrial cancer,
though this is less common. In rare cases, an unexplained abnormal vaginal
discharge may be an early symptom.
Symptoms of more advanced
endometrial cancer include:
Normally, the lining of the
uterus (endometrium) builds up and then sheds every
month. You know this shedding as menstrual bleeding. In most cases of
endometrial cancer, the endometrium has built up, or
thickened, and has stayed that way. This is called
endometrial hyperplasia. From this "precancer" stage,
the cells can grow quickly and out of control. These fast-growing cells are
cancer cells.
As the cancerous cells multiply, they form a mass
of tissue. Some of this tissue mass passes out of the uterus through the cervix
and vagina as part of
abnormal bleeding. Abnormal bleeding occurs in 90% of
women with endometrial cancer.3
If endometrial cancer is not treated, it may spread from the uterus into
deeper layers of the connective tissue around the uterus. As it progresses, it
may spread to the
pelvic lymph nodes and other pelvic organs. Advanced-stage cancer may spread to
lymph nodes, to other organs in the pelvis, causing problems with kidney and
bowel function, or to other organs in the body, such as the liver and lungs.
The most common sites for spread (metastasis) of endometrial cancer are the
vagina, lungs, and abdominal cavity.4
The
stage and grade of your cancer is one of the most important factors in
selecting the treatment option that is right for you. The
long-term outcome (prognosis) depends on the stage of
your cancer. The stage of you cancer will be determined by what your doctor
finds at the time of surgery. The grade of your cancer is determined by how the
cancer cells look under the microscope.
Endometrial cancer is the
most common type of women's pelvic cancer.2 Uterine
sarcoma is a less common type of uterine cancer. For more information, see the
following topics:
The biggest risk factor for
endometrial cancer is having too much
estrogen and not enough
progesterone. This is called "unopposed estrogen."
(Your body makes progesterone. Man-made progesterone, as in birth control pills
or hormone therapy, is called a
progestin.)
Long-term exposure to
unopposed estrogen may occur as a result of:
Being
obese.1 Fat cells make extra
estrogen, but your body doesn't make extra progesterone to balance it out.
Taking
tamoxifen, a breast cancer treatment that acts like
estrogen in the uterus.1 If you are taking tamoxifen
for breast cancer, keep taking it as directed by your doctor. But be sure to
have a pelvic exam each year. The risk of endometrial cancer is small compared
to the risk of getting breast cancer again.5 If you
are worried about endometrial cancer risk, talk to your doctor. You might be
able to use another medicine, instead of tamoxifen, for breast
cancer.
Endometrial cancer has been linked to
hereditary nonpolyposis colon cancer (HNPCC). In
women, this cancer often starts in the uterus and ovaries before it grows in
the colon. The American Cancer Society recommends that a woman with a family
history of HNPCC talk to her doctor about annual screenings with endometrial
biopsy, starting at age 35.6
Reducing your risk
There are some measures that
can lower your risk for developing endometrial cancer.
Taking birth control pills that contain both
estrogen and progestin for longer than 1 year. Similarly, taking estrogen with
progestin for menopausal symptoms lowers your endometrial cancer risk. (You
have no risk for endometrial cancer if you have had your uterus removed, or
hysterectomy.)
Staying at a healthy body
weight.
Being physically active.
Eating a diet rich in
fruits, vegetables, and fiber.
Lowering the amount of animal fats
you eat.
When To Call a Doctor
Schedule an appointment with
your doctor if you have:
If you are concerned about your symptoms or
think you may have an increased risk for endometrial cancer, call and make an
appointment with your doctor.
Watchful waiting is not appropriate
if you have symptoms that do not go away.
Who To See
Health professionals who can evaluate your symptoms
and your risk for endometrial cancer include:
Most cases of
endometrial cancer are diagnosed in an early stage.
This is because women who have reached
menopause usually see their doctors when they have
vaginal bleeding. To check your symptoms, your doctor will perform a
medical history and physical exam. The physical exam
will include a
pelvic exam and
Pap test.
An
endometrial biopsy is needed to confirm a diagnosis of
endometrial cancer. A biopsy removes a small sample of the lining of the uterus
(endometrium) for examination under a microscope.
Additional tests
may include:
A
transvaginal pelvic ultrasound, which uses sound waves
to create images of the uterus. The images can show how thick the endometrium
is. A thick endometrium can be a sign of cancer in
postmenopausal women. Ultrasound also can help show
whether cancer has grown into the uterine muscle (myometrium).
A
hysteroscopy, which allows your doctor to view the
inside of the uterus and obtain an endometrial tissue sample.
Dilation and curettage (D&C), which is done to
obtain a sample of tissue from the inside of the uterus. A D&C is sometimes
done at the same time as a hysteroscopy.
Testing for endometrial cancer may show that you have
endometrial hyperplasia. This is not cancer but may
develop into cancer. One type of hyperplasia, atypical adenomatous hyperplasia,
progresses to cancer in about 1 out of 3 women.7
Tests to determine the extent (stage) of endometrial cancer include:
Your doctor will determine the stage of your cancer at
the time of your surgery. Other tests done before surgery may include:
A
chest X-ray to check for cancer cells that have
metastasized from the cervix.
An imaging test may be done before surgery to look for
spread (metastasis) of cancer in the abdomen and pelvis. This helps with
planning for treatment. Imaging tests include the following:
There is no early detection test
for endometrial cancer. If you have
abnormal vaginal bleeding, schedule an appointment
with your doctor for a medical evaluation. Unexpected bleeding, or more
bleeding than normal, can be a symptom of endometrial cancer.
The American Cancer Society advises women who are nearing menopause to learn
about the risks and symptoms of endometrial cancer.6
Women are advised to report to their doctors
any unexpected bleeding or spotting or unusual vaginal
discharge.
Women at risk for
hereditary nonpolyposis colon cancer (HNPCC) are
advised to get checked every year starting at age 35.6 These women also have a high risk of getting ovarian and
uterine cancer. High-risk women who have no pregnancy plans can avoid these
cancers by having the uterus, fallopian tubes, and ovaries removed. This is
called a hysterectomy with bilateral salpingo-oophorectomy.8
Treatment Overview
Endometrial cancer detected in its early stages can be cured with surgery and close
follow-up. Treatment choices depend on where the cancer is and how much it has
grown. Treatment may include one or more of the following:
After a diagnosis of
endometrial cancer is confirmed, your doctor may
recommend surgery to remove the uterus, ovaries, and fallopian tubes (hysterectomy with bilateral salpingo-oophorectomy).
All tissues removed in surgery will be examined to determine the
stage and grade of the cancer.
Lymph nodes near the uterus will be examined to find out if cancer has spread
outside of the uterus.4
Treatment for
endometrial cancer depends on the size of the cancer, the extent of the
cancer's growth, and how the cancer cells look under the microscope.
Stage 1 is curable with a hysterectomy,
bilateral salpingo-oophorectomy, and lymph node biopsy. If you are
premenopausal and your cancer is in a very early
stage and grade, you may be able to have
progestin hormone therapy rather than a hysterectomy
and thus retain your ability to have children.9 But
the effectiveness of hormone therapy is not fully known, so it is not
considered a standard treatment for stage 1 cancer. If you choose this form of
treatment, your doctor will probably recommend a hysterectomy when you are done
having children. If cancer is found deep in the uterine muscle (myometrium), a
hysterectomy may be followed by
radiation therapy.
Stage 2 is treated with a radical hysterectomy. This removes the uterus,
cervix, ovaries, structures that support the uterus, and pelvic lymph nodes
(lymphadenectomy). If cancer is found in the connective
tissue of the cervix (stroma), radiation therapy may be used after surgery.
Radiation therapy may be used if you cannot have surgery, but the cure rate is
lower.
Stage 3 is treated with a
hysterectomy and radiation therapy. Sometimes, chemotherapy is used instead of
radiation.10 When cancer has spread to the wall of the
pelvis and cannot be removed during surgery, radiation therapy alone may be
used. In the rare case that radiation therapy is not recommended, progestin
hormone therapy may be used. Women with stage 3 endometrial cancer may be
candidates for
clinical trials of new treatment
options.
Stage 4 is treated with radiation
therapy if the spread of cancer (metastasis) is confined to the pelvic area. If
the cancer is in distant areas of the body, progestin hormone therapy may be
used.
Chemotherapy may also be used for treating stage 4
endometrial cancer.
Women who have a hysterectomy or radiation therapy to
treat endometrial cancer can no longer become pregnant.
Use home
treatment measures to help manage the side effects of treatment. For more
information, see the Home Treatment section of this topic. Your doctor also may
prescribe
medicines to control nausea and vomiting.
If you have recently been diagnosed with endometrial
cancer, you may experience a wide variety of emotions in reaction to your
diagnosis. Most women will feel some denial, anger, and grief. There is no
"normal" or "right" way to react to a diagnosis of cancer. You can take steps,
though, to manage your
emotional reactions to learning that you have
endometrial cancer. Some women find that talking with family and friends is
comforting, while others may need to spend time alone to understand their
feelings about their disease.
If your emotions are interfering
with your ability to make decisions about your health and to move forward with
your life, it is important to talk with your doctor. Your cancer treatment
center may offer counseling services. You may also contact your local chapter
of the American Cancer Society to help you find a support group. Talking with
other women who have had similar feelings after a diagnosis such as yours can
help you accept and deal with your disease.
What to think about during initial treatment
Most treatments for endometrial cancer cause side effects. Side effects
may differ, depending on the type of treatment used and your age and overall
health. Your doctor can talk to you about your treatment choices and the side
effects associated with each treatment.
Your surgeon and oncologist will explain
the possible side effects of your surgery. A hysterectomy means you will no
longer be able to become pregnant. Surgery to your lower abdomen may cause
difficulty with urination or bowel problems, such as constipation or diarrhea.
Your ability to have or enjoy sexual intercourse may also be
affected.
Side effects of chemotherapy may include loss of
appetite, nausea, vomiting, diarrhea, mouth sores, hair loss, anemia, or
infections.
Your quality of life becomes a critical issue when
considering your treatment options. Be sure to discuss your personal
preferences with your
oncologist when he or she recommends treatment.
Some women with endometrial cancer may be interested in participating in
research studies called
clinical trials. Clinical trials are designed to find
better ways to treat cancer patients and are based on the most up-to-date
information. Women who do not want standard treatments or are not cured using
standard treatments may want to participate in clinical trials. These are
ongoing in most parts of the United States and in some other countries for all
stages of endometrial cancer.
Ongoing treatment
After your initial treatment for
endometrial cancer, it is important to receive
follow-up care.
Schedule checkups every 3 to 4 months for the
first 2 years following your diagnosis. This will ensure that changes in your
health are noted and problems are treated early. Most experts recommend
checkups every 6 months thereafter for up to 5 years after
diagnosis.
Checkups include physical exams and pelvic exams and may
include blood and urine tests, chest X-rays, and other laboratory tests. A
Pap test may indicate recurrence of cancer in the
vagina, which is highly curable.
Treatment if the condition gets worse
Endometrial cancer may come back (recur). But this is not likely when the first
cancer is caught early and is low-risk. Of those cancers that do come back,
nearly all do so within 3 years of the first diagnosis. This is why regular
follow-up is extremely important after initial treatment.7
Cancer that comes back only in the pelvic area
sometimes is treated with
radiation therapy. This may stop the progress of
cancer and may even cure it if it is only in the vagina. If cancer has spread
to other parts of the body, radiation therapy often provides relief (palliation) from symptoms. Chemotherapy may also be
used.10 And
progestin hormone therapy often is used to slow the
growth of cancer that has recurred or spread. Survival is significantly
improved in up to 30% of women who receive progestin hormone therapy.11
Participation in
clinical trials to test new treatments may be
appropriate if cancer has spread to other parts of the body and hormonal
therapy is ineffective in stopping the growth.
What To Think About
If you are perimenopausal or
have not yet reached
menopause, your menstrual period will end immediately
after most treatments for endometrial cancer. If your uterus and ovaries have
been removed or have had radiation therapy, your body will have a decrease in
estrogen. Estrogen normally prevents:
Your bones from becoming thin and brittle
(osteoporosis). Several medicines are available to
prevent or treat osteoporosis. For more information, see the topic
Osteoporosis.
Menopausal symptoms, such as
hot flashes and insomnia. Talk with your doctor about how to manage your
symptoms if they are bothersome. For more information, see the topic
Menopause and Perimenopause.
Complementary therapies
Complementary therapies
are not a substitute for the standard treatment recommended for endometrial
cancer. But for some people, they can play an important part in managing stress
and pain.
In addition to conventional medical treatment, you may
wish to try complementary therapies, such as:
Before you try any of these therapies, discuss their
possible benefits and side effects with your doctor. Let him or her know if you
are already using any such therapies. For more information, see the topic
Complementary Medicine.
End-of-life issues
Cancer treatment has two main
goals: curing cancer and making your quality of life as good as possible. For
some people with advanced-stage cancer, a time comes when treatment to cure
cancer no longer seems like a good choice. This can be because the side
effects, time, and costs of treatment are greater than the hope of cure or
relief. But this isn't the end of treatment.
Palliative care of cancer can improve your quality of
life.
It can be difficult to decide when to stop treatment aimed
at prolonging life and shift the focus to end-of-life care. For more
information, see the topics:
While some risk factors for
endometrial cancer are inherited, such as a family
history of endometrial or
colon cancer, other risk factors are under your
control. You can reduce your risk for developing endometrial cancer if
you:
Use birth control pills that contain both
estrogen and
progestin, if you need birth control. Protection from
combined hormonal pills lasts for 10 or more years after you stop taking the
medicine if the medicine is taken for 1 year or longer.1
Use progestin along with estrogen if you decide
to try
hormone therapy for symptoms of
menopause. Taking progestin with estrogen will not
increase your risk for endometrial cancer, but it has other risks you may want
to consider. For more information, see the topics
Menopause and Perimenopause and
Osteoporosis.
Stay at a healthy body
weight. Overweight women are more likely to have high levels of estrogen in
their bodies, because some estrogen is produced in the body's fat cells. For
more information on controlling your weight, see the topic
Weight Management.
Breast-feed if you are
able. This decreases ovulation and estrogen activity.
Recognize and
get treatment for abnormal or unexpected bleeding. (Endometrial hyperplasia, which may develop into endometrial cancer, is one cause of
abnormal bleeding.) Heavy menstrual periods, bleeding between periods, and
bleeding after menopause are symptoms of hyperplasia.
Exercise
regularly. Physical activity may reduce unhealthy weight and may reduce
estrogen levels.
Eat a diet rich in fruits, vegetables, fiber, and
phytoestrogens, such as soy.12
Decrease your intake of animal fats.
You have no risk for endometrial cancer if you have had
your uterus removed (hysterectomy).
Home Treatment
During medical treatment for any stage
of
endometrial cancer, you can use home treatment to help
manage the side effects that may accompany endometrial cancer or cancer
treatment. Home treatment may be all that is needed to manage the following
common problems. If your doctor has given you instructions or medicines to
treat these symptoms, be sure to follow them. In general, healthy habits such
as eating a balanced diet and getting enough sleep and exercise can help
control your symptoms.
Home treatment includes the
following:
For
nausea or vomiting, watch for and treat early signs of
dehydration, such as a dry mouth, sticky saliva, and
reduced urine output with dark yellow urine. Older adults can quickly become
dehydrated from vomiting. Your doctor also may prescribe
medicines to control nausea and vomiting. For more
information on how to deal with these side effects, see:
For
diarrhea, rest your stomach, get enough fluids, and be
alert for
signs of dehydration. Check with your doctor before
using any nonprescription medicines for your diarrhea.
Constipation
includes ensuring that you drink enough fluids and include fruits, vegetables,
and fiber in your diet each day. Do not use a laxative without consulting your
doctor.
Other issues that may arise include:
Sleep problems. If you find you have trouble sleeping, some tips
for
managing sleep problems may be helpful, such as having
a regular bedtime, getting some exercise during the day, and avoiding caffeine
late in the day.
Fatigue. If you feel as though you do not have any
energy and tire easily, try some
measures to manage fatigue, such as getting extra
rest, eating a balanced diet, and reducing your stress.
Urinary
problems, which can be caused by both endometrial cancer and its treatment. It
may help to eliminate caffeinated drinks from your diet and to establish a
schedule of urinating every 3 to 4 hours, regardless of whether you feel the
need.
Hair loss. Hair loss may be unavoidable, but using
mild shampoos and avoiding damaging hair products will decrease irritation of
your scalp.
Many women with endometrial cancer face emotional issues as
a result of their disease or its treatment.
Finding out that you have cancer and undergoing
treatment is stressful.
Managing stress may include expressing your feelings
to others. Learning relaxation techniques may also be helpful. Relaxation
techniques, such as meditation, and support groups may be
helpful.
Your feelings about your body and your sexuality may
change following treatment for cancer. It may help to talk openly about your
feelings with your partner and to discuss your concerns with your doctor. Your
doctor may be able to refer you to groups that can offer support and
information.
Not all forms of cancer or cancer treatment cause pain. If
pain occurs, many options are available to relieve it. If your doctor has given
you instructions or medicines to treat pain, be sure to follow them.
Home treatment for pain such as a
nonsteroidal anti-inflammatory drug (NSAID) or an
alternative therapy like
biofeedback may improve your physical and mental
well-being. Be sure to discuss any home treatment you use for pain with your
doctor.
Cancer treatment has two main goals: curing cancer and
making your quality of life as good as possible. For some people with
advanced-stage cancer, a time comes when treatment to cure cancer no longer
seems like a good choice. This can be because the side effects, time, and costs
of treatment are greater than the promise of cure or relief. But this isn't the
end of treatment.
Palliative care of cancer can improve your quality of
life.
It can be difficult to decide when to stop treatment aimed
at prolonging life and shift the focus to end-of-life care. For more
information, see the topics:
Medicines, such as
chemotherapy, may be given after surgery for
endometrial cancer, depending on the
stage and grade of the cancer and the risk for the cancer to spread
(metastasis) or recur. Progestin hormone therapy may be used if your cancer has
recurred or spread or you are unable to have surgery or radiation
therapy.
Medication Choices
Medication treatment for endometrial cancer may include
hormone therapy or chemotherapy.13
Serotonin antagonists, such as
ondansetron (Zofran), granisetron (Kytril, Sancuso), or dolasetron (Anzemet).
These medicines more effectively prevent nausea and vomiting caused by
chemotherapy when they are combined with
corticosteroids, such as dexamethasone.
Aprepitant (Emend), which is used in combination with
ondansetron and dexamethasone as part of a 3-day program.
Phenothiazines, such as promethazine or
prochlorperazine.
A premenopausal woman whose
cancer is in a very early stage and is slow-growing (low-grade) may be a
candidate for progestin hormone therapy rather than hysterectomy and thus may
be able to keep her uterus for childbearing.9
There is limited information on the effectiveness of progestin therapy
compared to other treatments, so currently it is not considered a standard
treatment.
One study has shown that chemotherapy may work better
than radiation against stage 3 and stage 4 endometrial cancer. Chemotherapy can
have severe side effects.10
Surgery
Surgery to remove the uterus (hysterectomy) is
the most common treatment for
endometrial cancer. The surgeon will also remove the
fallopian tubes, ovaries, and often the
pelvic lymph nodes, which are examined to find out the extent of the cancer and
to help plan your treatment. If examination of tissue determines that more
aggressive cancer still may be in the lymph system, a lymphadenectomy may be
done to remove and examine additional lymph nodes. Surgery has the highest cure
rate of all treatments for endometrial cancer.
Surgery Choices
Hysterectomy
with removal of the fallopian tubes and ovaries (bilateral
salpingo-oophorectomy)
Laparoscopic surgery is an option
for treating your endometrial cancer. This surgery is done with a tiny camera
and special instruments. The surgeon puts these tools through several small
incisions (cuts) in the belly. Some surgeons do this surgery by guiding robotic
arms that hold the surgery tools. This is called robot-assisted
laparoscopy.
Most women have their ovaries removed after a
diagnosis of endometrial cancer to make sure the cancer has not spread to the
ovaries, to reduce the production of
estrogen, and to slow cancer growth. And some women
who have had endometrial cancer may be at greater risk of developing
ovarian cancer.
You will not be able to
become pregnant or continue to menstruate after a hysterectomy. If you have not
yet gone through
menopause, it will begin as soon as your ovaries are
removed. For more information, see the topic
Menopause and Perimenopause.
Other Treatment
Radiation therapy
may be used to treat
endometrial cancer. Radiation may be given internally
by placing radioactive substances in the uterus or area of cancer
(brachytherapy). Or it may be given externally by delivering radiation from an
outside source (external beam X-ray).
Radiation treatment of
premenopausal ovaries will cause
menopause and infertility. Other side effects of
radiation can include:14
Bowel obstruction.
Abdominal
cramps.
Frequent bowel movements or diarrhea.
Chronic
bladder irritation.
Vaginal scarring (vaginal fibrosis).
Studies called
clinical trials are being conducted to find ways to
prevent, detect, diagnose, and treat endometrial cancer. Talk with your doctor
to see whether clinical trials are available and whether you are a good
candidate.
Other Places To Get Help
Organizations
American Cancer Society
Phone:
1-800-ACS-2345 (1-800-227-2345)
TDD:
1-866-228-4327 (toll-free)
Web Address:
www.cancer.org
The American Cancer Society conducts educational programs and
offers many services to people with cancer and to their families. Staff at the
toll-free numbers have information about services and activities in local areas
and can provide referrals to local ACS divisions.
National Cancer Institute (NCI)
NCI Publications Office
6116 Executive Boulevard
Suite 3036A
Bethesda, MD 20892-8322
Phone:
1-800-4-CANCER (1-800-422-6237) 9:00 a.m. to 4:30 p.m. EST, Monday through Friday
TDD:
1-800-332-8615
E-mail:
cancergovstaff@mail.nih.gov
Web Address:
www.cancer.gov (or
https://cissecure.nci.nih.gov/livehelp/welcome.asp# for live help
online)
The National Cancer Institute (NCI) is a U.S. government agency
that provides up-to-date information about the prevention, detection, and
treatment of cancer. NCI also offers supportive care to people with cancer and
to their families. NCI information is also available to doctors, nurses, and
other health professionals. NCI provides the latest information about clinical
trials. The Cancer Information Service, a service of NCI, has trained staff
members available to answer questions and send free publications.
Spanish-speaking staff members are also available.
Mutch DG (2008). Uterine cancer. In RS Gibbs et al.,
eds., Danforth's Obstetrics and Gynecology, 10th ed.,
pp. 1002-1021. Philadelphia: Lippincott Williams and Wilkins.
American College of Obstetricians and Gynecologists
(2005, reaffirmed 2007). Management of endometrial cancer. ACOG Practice
Bulletin No. 65. Obstetrics and Gynecology, 106(2):
413-425.
Burke TW, et al. (2001). Cancers of the uterine body.
In VT DeVita Jr et al., eds., Cancer: Principles and Practice of Oncology, 6th ed., chap. 36-3, pp. 1573-1594. Philadelphia:
Lippincott Williams and Wilkins.
American Joint Committee on Cancer (2002). Corpus uteri. In AJCC Cancer Staging Manual, 6th ed., pp. 267-273. New York: Springer-Verlag.
Cannistra SA (2007). Gynecologic cancer. In DC Dale,
DD Federman, eds., ACP Medicine, section 12, chap. 10.
New York: WebMD.
Smith RA, et al. (2008). Cancer screening in the
United States, 2008: A review of current American Cancer Society guidelines and
cancer screening issues. CA: A Cancer Journal for Clinicians, 58: 161-179.
Chu CS, et al. (2008). Cancers of the uterine body.
In VT DeVita et al., eds., DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 7th ed., vol. 2, pp.
1543-1563. Philadelphia: Lippincott Williams and Wilkins.
Schmeler KM, et al. (2006). Prophylactic surgery to reduce the risk of gynecologic cancers in the Lynch syndrome. New England Journal of Medicine, 354(3): 261-269.
Ramirez PT, et al. (2004). Hormonal therapy for the management of grade I endometrial adenocarcinoma: A literature review. Gynecologic Oncology, 95: 133-138.
Randall ME, et al. (2006). Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: A gynecologic oncology group study. Journal of Clinical Oncology, 24(1): 36-44.
National Cancer Institute (2008). Endometrial Cancer Treatment (PDQ): Health Professional Version. Available online:
http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/healthprofessional.
Horn-Ross PL, et al. (2003). Phytoestrogen intake and
endometrial cancer risk. Journal of the National Cancer Institute, 95(15): 1158-1164.
Abramowicz M (2003). Treatment guidelines: Drugs of
choice for cancer. Medical Letter on Drugs and Therapeutics, 1(7): 41-52.
Creutzberg CL, et al. (2000). Surgery and
postoperative radiotherapy versus surgery alone for patients with stage-1
endometrial carcinoma: Multicentre randomised trial. Lancet, 355: 1404-1411.
This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
Mutch DG (2008). Uterine cancer. In RS Gibbs et al.,
eds., Danforth's Obstetrics and Gynecology, 10th ed.,
pp. 1002-1021. Philadelphia: Lippincott Williams and Wilkins.
American College of Obstetricians and Gynecologists
(2005, reaffirmed 2007). Management of endometrial cancer. ACOG Practice
Bulletin No. 65. Obstetrics and Gynecology, 106(2):
413-425.
Burke TW, et al. (2001). Cancers of the uterine body.
In VT DeVita Jr et al., eds., Cancer: Principles and Practice of Oncology, 6th ed., chap. 36-3, pp. 1573-1594. Philadelphia:
Lippincott Williams and Wilkins.
American Joint Committee on Cancer (2002). Corpus uteri. In AJCC Cancer Staging Manual, 6th ed., pp. 267-273. New York: Springer-Verlag.
Cannistra SA (2007). Gynecologic cancer. In DC Dale,
DD Federman, eds., ACP Medicine, section 12, chap. 10.
New York: WebMD.
Smith RA, et al. (2008). Cancer screening in the
United States, 2008: A review of current American Cancer Society guidelines and
cancer screening issues. CA: A Cancer Journal for Clinicians, 58: 161-179.
Chu CS, et al. (2008). Cancers of the uterine body.
In VT DeVita et al., eds., DeVita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology, 7th ed., vol. 2, pp.
1543-1563. Philadelphia: Lippincott Williams and Wilkins.
Schmeler KM, et al. (2006). Prophylactic surgery to reduce the risk of gynecologic cancers in the Lynch syndrome. New England Journal of Medicine, 354(3): 261-269.
Ramirez PT, et al. (2004). Hormonal therapy for the management of grade I endometrial adenocarcinoma: A literature review. Gynecologic Oncology, 95: 133-138.
Randall ME, et al. (2006). Randomized phase III trial of whole-abdominal irradiation versus doxorubicin and cisplatin chemotherapy in advanced endometrial carcinoma: A gynecologic oncology group study. Journal of Clinical Oncology, 24(1): 36-44.
National Cancer Institute (2008). Endometrial Cancer Treatment (PDQ): Health Professional Version. Available online:
http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/healthprofessional.
Horn-Ross PL, et al. (2003). Phytoestrogen intake and
endometrial cancer risk. Journal of the National Cancer Institute, 95(15): 1158-1164.
Abramowicz M (2003). Treatment guidelines: Drugs of
choice for cancer. Medical Letter on Drugs and Therapeutics, 1(7): 41-52.
Creutzberg CL, et al. (2000). Surgery and
postoperative radiotherapy versus surgery alone for patients with stage-1
endometrial carcinoma: Multicentre randomised trial. Lancet, 355: 1404-1411.
