Uterine Sarcoma

Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Uterine sarcoma is a type of cancer that starts in the muscular wall of the uterus (myometrium). 

The uterus is made up of three layers:

• Endometrium. This is the inner lining.

• Myometrium. This is the middle muscle layer.

• Serosa. This is the outer smooth layer.

Most cancers in the uterus are not uterine sarcoma. They are endometrial cancers. They start in the inner lining of the uterus.

The uterus is an organ that is part of the female reproductive system. You may know it as the womb. The uterus is usually pear-shaped and about the size of a fist. It is located in the lower belly (pelvic area), between your bladder and your rectum. The uterus protects a growing baby during pregnancy. During labor, the myometrium muscle tissue helps push the baby out through the cervix. The smooth serosa makes it easy for the uterus to move in the pelvis as needed.

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. Risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

The risk factors for uterine sarcoma include:

• Radiation therapy to the pelvis.

• Being African American.

• Having had retinoblastoma.

Talk with your healthcare provider about your risk factors for uterine sarcoma and what you can do about them.

Researchers don’t yet know how to prevent this type of cancer.

Some types of cancer may be found with a screening test. Screening means checking for a health problem before a person has symptoms. It may find some types of cancer early, when they’re often easier to treat. There are no screening tests for uterine sarcoma for women who don’t have symptoms. But regular pelvic exams and Pap smears can help find problems. If your healthcare provider thinks you are at high risk, he or she can check for uterine sarcoma in these two ways:

• Endometrial sampling.

• Transvaginal ultrasound.

The main symptom you may notice is unusual vaginal bleeding or other vaginal discharge. After menopause, it’s not normal for any amount of vaginal bleeding to occur. Other rare but possible symptoms include:

• Pain or a feeling of fullness in the pelvic area or lower abdomen.

• A mass or tumor that can be felt.

These may be caused by other health problems. It is important to see your healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

If your healthcare provider thinks you may have uterine sarcoma, you will need exams and tests to be sure. Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. He or she will also give you a physical exam. You may also have one or more of these tests:

• Pap test.

• Pelvic exam.

• Transvaginal ultrasound.

• Endometrial biopsy.

• Dilation and curettage (D&C).

• Hysteroscopy.

A biopsy can show if you have cancer and, if so, the type of cancer. Small pieces of tissue are taken out and checked for cancer cells.

After a diagnosis of uterine sarcoma, you may have other tests. These help your healthcare providers learn more about the cancer. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

Your treatment choices depend on the type of uterine sarcoma you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Systemic treatments are used to destroy or control cancer cells that may have traveled around your body. 

Local treatments for uterine sarcoma include:

• Surgery.

• Radiation therapy.

Systemic treatments include:

• Hormone therapy.

• Chemotherapy.

You may have just one treatment or a combination of treatments.

Treatments before surgery are called neoadjuvant treatment. For example, you may have radiation, chemotherapy, or hormone therapy before surgery. These treatments may help shrink the tumor and make it easier to remove completely.

You may have other treatments after surgery. This is called adjuvant treatment. For example, you may have radiation or hormone therapy after you have healed from surgery. The goal is to kill any cancer cells that may be left in your body. Even if there is no sign of cancer cells, your doctor may still advise adjuvant treatment. It helps reduce the risk that the cancer may come back or spread.

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, and vomiting. Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have.  Work together to ease the effect of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with as many protein foods as possible.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as a fever.

• Side effects of treatment that affect your daily function or don't get better with treatment.

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.