Uterine Cancer

The uterus can be divided into two main parts:

• The cervix, which is the lower end of the uterus and opens into the vagina
• The body, which can be further divided into two parts: the uterine muscle (myometrium) and the uterine cavity (endometrium)

Uterine cancer occurs most frequently, but not exclusively, in women after menopause. Several risk factors have been clearly identified:

• Obesity caused by increased estrogen levels
• Diabetes and high blood pressure
• Personal or family history of uterine or colorectal cancer (such as Lynch syndrome)
• Tamoxifen, a drug used to treat breast cancer
• Post-menopausal hormone replacement therapy (prescribed by doctors to relieve the symptoms associated with menopause) that does not combine estrogens and progesterone
• Atypical endometrial hyperplasia
• Absence of pregnancy
• Personal or family history of ovarian or breast cancer
• Abdominal or pelvic radiation therapy to treat cancer, which can increase the risk of uterine sarcoma

Often the cancer begins with a disorder called endometrial hyperplasia, characterized by a thickening of the endometrium.

In general, uterine cancer is suspected when a woman experiences abnormal bleeding after menopause. Pain can also be a symptom.
If these symptoms occur, women should quickly schedule an appointment with their gynecologist.

The doctor will perform an endometrial biopsy. During this painless exam, a small plastic tube is inserted into the uterus to collect a tissue sample. If an endometrial biopsy cannot be done, a hysteroscopy and dilation and curettage (D&C) can be performed. A pelvic ultrasound will be ordered to measure the thickness of the endometrium.

If cancer is diagnosed, the doctor will order a pelvic MRI to evaluate the extent of the disease.

A PET scan might be prescribed if the cancer is at an advanced stage.

You will receive customized, multidisciplinary care at the American Hospital of Paris.
Decisions relating to therapy are made collaboratively by a team of doctors specialized in treating uterine cancer.

Treatment differs depending on the extent or stage of the disease:

• Stage 1: The cancer is contained within the endometrium (most frequent)
• Stage 2: The cancer has advanced to the cervix
• Stage 3: The cancer has advanced to the vagina
• Stage 4: The cancer has metastasized

Surgery: 

The main treatment for this type of cancer is surgery:

• Hysterectomy including ablation of the ovaries and fallopian tubes
• Sometimes combined with the ablation of the pelvic lymph nodes

This type of surgery can be performed using laparoscopic or robotic techniques or by opening up the abdominal cavity.
Our surgeons are experienced in all of these techniques and systematically opt for the least invasive ones whenever possible.

Radiation techniques:

Radiation therapy and vaginal brachytherapy can be used depending on the stage of the cancer. The American Hospital of Paris has its own radiation therapy facility staffed by doctors specialized in this type of treatment.
Chemotherapy and hormone therapy are rarely used to treat this type of cancer.