Uterine Sarcoma
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Description
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What is sarcoma of the uterus?
Sarcoma of the uterus, a very rare kind of cancer in women, is a disease in
which cancer (malignant) cells start growing in the muscles or other supporting
tissues of the uterus. The uterus is the hollow, pear-shaped organ where a
baby grows. Sarcoma of the uterus is different from cancer of the endometrium,
a disease in which cancer cells start growing in the lining of the uterus
(refer to the PDQ summary on Endometrial Cancer Treatment for information).
Women who have received therapy with high-dose x-rays (external-beam radiation
therapy) to their pelvis are at a higher risk to develop sarcoma of the uterus.
These x-rays are sometimes given to women to stop bleeding from the uterus.
A doctor should be seen if there is
bleeding after menopause (the time when a
woman no longer has menstrual periods) or bleeding that is not part of
menstrual periods.
Sarcoma of the uterus usually begins after menopause.
If there are signs of cancer, a doctor will do certain tests to check for
cancer, usually beginning with an internal (pelvic) examination. During the
examination, the doctor will feel for any lumps or changes in the shapes of the
pelvic organs. The doctor may then do a Pap test, using a piece of cotton, a
small wooden stick, or brush to gently scrape the outside of the cervix (the
opening of the uterus) and the vagina to pick up cells. Because sarcoma of the
uterus begins inside, this cancer will not usually show up on the Pap test.
The doctor may also do a dilation and curettage (D & C) by stretching the
cervix and inserting a small, spoon-shaped instrument into the uterus to remove
pieces of the lining of the uterus. This tissue is then checked under a
microscope for cancer cells.
The prognosis (chance of recovery) and choice of treatment depend on the stage
of the sarcoma (whether it is just in the uterus or has spread to other
places), how fast the tumor cells are growing, and the patient’s general state
of health.
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Stage Explanation
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Stages of sarcoma of the uterus
Once sarcoma of the uterus has been found, more tests will be done to find out
if the cancer has spread from the uterus to other parts of the body (staging).
A doctor needs to know the stage of the disease to plan treatment. The
following stages are used for sarcoma of the uterus:
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Stage I
Cancer is found only in the main part of the uterus (it is not found in the
cervix).
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Stage II
Cancer cells have spread to the cervix.
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Stage III
Cancer cells have spread outside the uterus but have not spread outside the
pelvis.
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Stage IV
Cancer cells have spread beyond the pelvis, to other body parts, or into the
lining of the bladder (the sac that holds urine) or rectum.
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Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has
been treated.
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Treatment Option Overview
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How sarcoma of the uterus is treated
There are treatments for all patients with sarcoma of the uterus. Four kinds
of treatment are used:
- Surgery (taking out the cancer in an operation).
- Radiation therapy (using high-dose x-rays or other high-energy rays to kill
cancer cells and shrink tumors).
- Chemotherapy (using drugs to kill cancer cells).
- Hormone therapy (using female hormones to kill cancer cells).
Surgery is the most common treatment of sarcoma of the uterus. A doctor may
take out the cancer in an operation to remove the uterus, fallopian tubes and
the ovaries, along with some lymph nodes in the pelvis and around the aorta
(the main vessel in which blood passes away from the heart). The operation is
called a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and
lymphadenectomy. (The lymph nodes are small bean-shaped structures that are
found throughout the body. They produce and store infection-fighting cells,
but may contain cancer cells.)
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells
and shrink tumors. Radiation therapy for sarcoma of the uterus usually comes
from a machine outside the body (external radiation). Radiation may be used
alone or in addition to surgery.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by
pill, or it may be put into the body by a needle in a vein or a muscle.
Chemotherapy is called a systemic treatment because the drugs enter the
bloodstream, travel through the body, and can kill cancer cells outside the
uterus.
Hormone therapy uses female hormones, usually taken by pill, to kill cancer
cells.
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Treatment by stage
Treatment of sarcoma of the uterus depends on the stage and cell type of the
disease, and the patient’s age and overall condition.
Standard treatment may be considered because of its effectiveness in patients
in past studies, or participation in a clinical trial may be considered. Not
all patients are cured with standard therapy and some standard treatments may
have more side effects than are desired. For these reasons, clinical trials
are designed to find better ways to treat cancer patients and are based on the
most up-to-date information. Clinical trials are ongoing in most parts of the
country for most stages of sarcoma of the uterus. To learn more about clinical
trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237);
TTY at 1-800-332-8615.
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Stage I Uterine Sarcoma
Treatment may be one of the following:
- Surgery to remove the uterus, fallopian tubes and the ovaries, and some of
the lymph nodes in the pelvis and abdomen (total abdominal hysterectomy,
bilateral salpingo-oophorectomy, and lymph node dissection)
- Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph
node dissection, followed by radiation therapy to the pelvis.
- Surgery followed by chemotherapy.
- Surgery followed by radiation therapy.
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Stage II Uterine Sarcoma
Treatment may be one of the following:
- Surgery to remove the uterus, fallopian tubes and the ovaries, and some of
the lymph nodes in the pelvis and abdomen (total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection)
- Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph
node dissection, followed by radiation therapy to the pelvis.
- Surgery followed by chemotherapy.
- Surgery followed by radiation therapy.
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Stage III Uterine Sarcoma
Treatment may be one of the following:
- Surgery to remove the uterus, fallopian tubes and the ovaries, and some of
the lymph nodes in the pelvis and abdomen (total abdominal hysterectomy
bilateral salpingo-oophorectomy, and lymph node dissection). Doctors will also try to remove as much of the cancer that has spread to nearby
tissues as possible.
- Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph
node dissection, followed by radiation therapy to the pelvis.
- Surgery followed by chemotherapy.
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Stage IV Uterine Sarcoma
Treatment will usually be a clinical trial using chemotherapy.
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Recurrent Uterine Sarcoma
If the cancer has come back (recurred), treatment may be one of the following:
- Clinical trials of chemotherapy or hormone therapy.
- External radiation therapy to relieve symptoms such as pain, nausea, or
abnormal bowel functions.
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Changes to This Summary (06/06/2003)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
This information is provided from the PDQ® database in collaboration with the NCI.
