• Ovarian Cancer
• Vulvar and Vaginal Cancer
• Urinary Incontinence and prolapse
• Uterine Cancer
• Genetic Testing
• Chemotherapy

   

Uterine Cancer

Uterine cancer ( endometrial cancer ) is the most common gynecologic malignancy with approximately 35,000 new cases each year in the United States alone. About 75% of these cases are diagnosed at  an early stage ( stage I ).  When diagnosed at an early stage, survival may be 75% or higher at 5 years.   A rare form of uterine cancer, uterine sarcoma accounts for only 1-2 cases per 100,000 women, comprising less than 5% of all uterine cancers. Unlike endometrial cancer, survival for sarcoma is much lower due to a more aggressive spread pattern and more common advanced stage disease at the time of diagnosis.

Risk factors

• Predisposing factors: obesity, unopposed estrogen, late menopause (>52 years), nulliparity, anovulatory cycles, tamoxifen use, endometrial hyperplasia, and previous history of radiation.
• Protective factors: oral contraceptives (relative risk (RR) = 0.5) with oral contraceptive use for at least 12 months.  This risk reduction may last 10 years.

Sings and symptoms

• Abnormal bleeding and/or discharge.
• Pelvic pain
• Uterine enlargement

Diagnosis

• Diagnosis is through endometrial sampling, performed as a biopsy or D&C procedure.
• A negative endometrial biopsy may be followed by a D&C, with hysteroscopy for patients with persistent symptoms since endometrial biopsies can have a false negative rate of 5% to 10 %.

Treatment

• Surgery: total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) pelvic lymph node removal, abdominal washings, omental sampling, peritoneal biopsies.
• Combined surgery and radiation: preoperative or postoperative radiation therapy
•  Medical therapy:

• Cytotoxic Chemotherapy
• Hormonal therapy such as progesterone

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