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Uterine and Endometrial Cancer

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Uterine and Endometrial Cancer

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Uterine cancer affects almost 66,000 women a year. About 80 percent of uterine tumors are endometrial adenocarcinomas, cancers that start in the endometrium (the inner lining of the uterus). What many professionals call uterine cancer is uterine sarcoma, which makes up about two to four percent of uterine cancers.

Other rarer types of uterine cancers include:

  • Stromal tumors: Endometrial stromal sarcomas develop in the supporting connective tissue (stroma) of the endometrium. These cancers represent less than one percent of all uterine cancers. These tumors are low grade and tend to grow slowly.

  • Gestational trophoblastic tumors: This rare cancer develops inside the uterus in the tissues formed following conception.

Why Choose Sylvester Comprehensive Cancer Center?

Sylvester is an NCI-designated cancer center. The National Cancer Institute has reaffirmed us as South Florida’s only NCI-designated cancer center. We have been recognized for our scientific leadership, our commitment to training the next generation of cancer researchers and providers, as well as our engagement with the communities that we serve. For patients, this designation translates into greater access to leading-edge treatment options, including clinical trials that prioritize your specific cancer.

More experienced physicians to care for you. Sylvester treats more than 5,000 patients with cancer each year. Your dedicated team of physicians at Sylvester have a huge depth and breadth of experience treating your unique cancer.

Multidisciplinary care teams provide nationally recognized expertise. Your physician experts talk to each other, face-to-face, on a regular basis and plan the right care for you and your specific cancer. And you can expect that caliber of care in years to come. Sylvester also has the only gynecologic oncology fellowship in South Florida training the next generation of doctors.

Fertility preservation experts. You don’t have to choose between future fertility and cancer treatment. Specialists at the University of Miami Fertility Center in the Department of Obstetrics and Gynecology offer fertility counseling for male and female cancer patients to help you explore your options and make decisions regarding fertility preservation before you undergo treatments such as chemotherapy or radiation therapy.

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Treatments

  • Hysterectomy

    Depending on the extent of your cancer, a hysterectomy removes all or part of the uterus and may include surrounding structures. Currently, 80 to 90 percent of hysterectomies are done robotically. Depending on your individual situation, your surgeon may recommend that you receive radiation therapy or hormone therapy to kill any remaining cancer cells.

  • Sentinel Node Biopsy

    The cancer is most likely to spread from the tumor to the sentinel lymph node. A dye is injected near the tumor and flows through the lymph ducts to the lymph nodes. Because the dyes make the sentinel nodes glow under special goggles, sentinel node detection has risen to 95 percent or greater. Researchers at Sylvester are leading international trials to validate the role of sentinel node biopsy in vulvar cancer.

  • External Radiation Therapy 

    This therapy sends high levels of radiation straight to the cancer cells. Since radiation is used to kill cancer cells and to shrink tumors, your specialist will use special shields to protect the tissue surrounding the treatment area.

  • Internal Radiation Therapy 

    Radiation therapy is given as close to the cancer as possible, at times inside the body. For low-risk tumors, vaginal brachytherapy may be used. Intermediate risk may require both brachytherapy and some external radiation therapy. In high-risk patients, radiation therapy may be given with chemotherapy. That's why you want gynecologic radiation specialists at Sylvester planning your treatment.

  • Chemotherapy

    This therapy is a combination of cancer-fighting drugs that can be administered intravenously to kill any remaining cancer cells in the body.

  • Hormone Therapy

    Some cancer cells require hormones to grow. Hormone therapy is used to stop that growth. Medicines can reduce these hormones in the body. Medicines may block these hormones and keep them from working in cancer cells.

  • Targeted Therapy

    Drugs are used to identify and attack specific cancer cells without harming normal cells. Several targeted therapies have been approved by FDA and may include:

    • Antiangiogenesis Agents: These are agents that prevent the tumor from forming new blood vessels to feed it. Several are being studied in clinical trials.

    • Mammalian Target of Rapamycin (mTOR) Inhibitors: In cancer, mTOR is frequently hyper-activated which promotes cancer development and progression. In certain cancers, it creates resistance to chemotherapy. Research on this therapy looks promising.

Tests 


Every new patient exam at Sylvester starts with a detailed history. That may be followed by the following exams or tests:

  • Physical Examination, Including a Pelvic Examination 

    During this exam, the doctor checks the vagina, rectum, and lower abdomen for masses or growths. Since this cancer originates inside the uterus, a Pap test may not be as effective for detection.

  • Transvaginal Ultrasound Exam

    This test examines the vagina, uterus, fallopian tubes, and the bladder, using. An ultrasound transducer (probe) which bounces high-energy sound waves off internal tissues or organs. The echoes form a picture of body tissues called a sonogram. The doctor may do a biopsy if the endometrium looks too thick.

  • Dilatation and Curettage

    A D&C is a kind of biopsy. During this procedure, samples of tissue are removed from the inner lining of the uterus. The cervix is dilated, and your doctor uses a curette (spoon-shaped instrument) or a thin, flexible tube to remove tissue. It is often performed when larger amounts of tissue samples are needed. It is usually done in the hospital or surgical center under a general or local anesthesia. Tissue for biopsy can also be obtained with an endometrial biopsy, a simple office procedure.

  • Endometrial Biopsy

    A biopsy is the best way to confirm a cancer diagnosis. An endometrial tissue sample is collected and is examined to see if there are abnormal or cancerous cells in it. This biopsy is often performed in a doctor's office. It may also be done as part of a D&C.

  • Hysteroscopy

    During this procedure, your doctor takes a biopsy of the endometrial tissue, while looking inside the uterus through a thin telescope-like tool. Any growths are removed and examined for cancer cells. Hysteroscopy may be done in your doctor's office with a sedative, or as an outpatient procedure with general anesthesia.

    When the surgeon has the needed tissue, the pathology team will run additional tests on the biopsied tissue to determine if the growth is cancerous or pre-cancerous, how quickly the cancer may grow and spread, and how well certain treatments might work.

  • Genomic Tumor Profiling

    Also called somatic DNA testing, this is the driver for precision medicine. It looks at your tumor’s molecular signature to identify characteristics indicating how aggressive it is and what types of treatment will work best.

    If cancer is detected, additional tests might be used to determine the extent, or stage of the cancer:

    • CA 125 assay: This is a blood test that measures the level a substance released by cells into the bloodstream. An increased level of CA 125 is may be a sign of cancer or other condition.

    • Immunohistochemistry (IHC): This screening will be performed on newly diagnosed endometrial cancer patients as part of the pathology evaluation to decide if your endometrial disease may be due to an inherited condition, and if genetic testing is needed. There are red flags for possible hereditary cancers, including having a mother, daughter, or sister who has had a gynecologic cancer. Also, having a family history of breast or colon cancer is also associated with an increased risk of developing endometrial cancer. The hereditary risk for uterine cancer is about five percent. We can help you make decisions about approaches to screening and treatment. If you think you fall into one of these categories, ask your doctor about a referral to the cancer genetics clinic, or call (305) 243-6006 to ask for an appointment in the cancer genetics clinic.

    • Computed Tomography (CT or CAT) Scan: A series of detailed pictures of areas inside the body are taken from different angles. The procedure may be combined with injection or oral intake of a dye to help the organs or tissues show up more clearly to look for other organ involvement.

    • PET (positron emission tomography) scan: A small amount of radioactive glucose (sugar) is injected into a vein. Then, the PET scanner rotates around your body and creates a picture of where your body is holding the sugar. Malignant tumor cells appear brighter in the images because they are more active and use more glucose than normal cells.

    • Magnetic Resonance Imaging (MRI): For this test, experts use a magnet, radio waves, and a computer to make a series of extremely detailed pictures of areas inside the body.

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

Accepted Insurance