A type of cancer that develops in the muscles or tissues of the uterus is called uterine sarcoma. It occurs very rarely and may cause abnormal bleeding and pain. Usually, doctors treat this type of cancer with radiation therapy, chemotherapy, surgery, or hormone therapy.
Generally, uterine sarcoma develops in the muscle layer of the uterus (also known as the myometrium). However, most cancers that develop in the uterus appear in the lining of the uterus (endometrium) and are called endometrial cancers or carcinomas. On the other hand, sarcomas develop less commonly, but may also develop in the supportive cells of the uterus.
Furthermore, most uterine sarcomas usually grow and spread faster compared to endometrial ones. In any case, some types of uterine sarcoma are not aggressive.
This type of cancer is considered very rare because it accounts for 3% to 7% of all uterine cancers.
Symptoms
The primary symptoms of uterine sarcomas are very similar to endometrial cancers and benign (noncancerous) growths (such as fibroids). However, it is recommended to see a doctor if any of the following symptoms occur. Examples include:
- Abnormal bleeding that is not related to menstrual periods or menopause
- A lump or growth in the vagina or pelvic area
- Vaginal bleeding with a smelly discharge
- Pelvic pain
- A feeling of fullness in the belly (abdomen)
- Frequent urination
- Constipation
While some people with a uterine sarcoma do not experience any symptoms, others identify the condition in its advanced stages.
Causes
This type of cancer occurs like other cancers when cells specific part of the body develop DNA changes. As a result, these abnormal cells begin to multiply and grow abnormally and may form a mass called a tumor. In such cases, the abnormal cells begin to multiply in the muscular wall of the uterus.
However, experts do not understand what exactly causes these DNA changes.
Risk Factors
While it is not clear what causes uterine sarcomas, physicians have identified some factors that could elevate your risk of developing them. Examples include:
- Pelvic radiation – If you get radiation therapy to treat another type of cancer, it may increase the risk of uterine sarcoma.
- Tamoxifen – This is a medicine used to treat breast cancer, but if it is used for long periods, the risk of uterine sarcoma may increase.
- Genetics – There is a gene that causes an eye cancer (retinoblastoma) that may also elevate the risk of some types of uterine sarcoma.
Furthermore, Black people are twice as likely to develop this type of cancer compared to white people. Mostly, this type of cancer is diagnosed in females over 40 years old, but it may also happen in their 20s.
Complications
Usually, people with uterine sarcoma do not experience complications. However, if the cancer is not treated and the tumor breaks, it may spread to other structures and organs in the body. Some people may have complications after cancer treatments. For example, fatigue (extreme tiredness), nausea, vomiting, skin changes, bladder irritation, edema (swelling), and others.
How to Prevent Uterine Sarcoma?
Generally, there is no way to prevent this type of cancer because healthcare providers do not fully understand why it happens. However, you can take steps to reduce the risk of developing it. For example, reduce the dose of Tamoxifen if you are treating breast cancer, quit smoking, regularly perform physical exercise, and others. For more details, discuss it with your healthcare professional.
Diagnosis
If your doctor suspects uterine sarcoma, he/she may perform a physical examination and may ask some questions about symptoms and medical history. They may also perform a pelvic examination of the cervix, vagina, uterus, fallopian tubes, ovaries, and rectum for irregularities linked to the disease. Check below for other tests that may also help diagnose uterine sarcoma:
- Transvaginal ultrasound – This test uses sound waves to make pictures of soft tissue structures and reproductive organs. It may help identify the size and location of the tumor.
- Endometrial biopsy – During this procedure, doctors will take a small sample of the uterus lining for testing. However, this is the only test that can confirm uterine sarcoma.
Once you are diagnosed with uterine sarcoma, physicians often perform additional imaging tests to determine the stage (extent) of the cancer. For example, chest X-rays, MRI (magnetic resonance imaging) scans, CT (computed tomography) scans, or PET (positron emission tomography) scans.
Treatment
Physicians usually recommend different treatments for people with uterine sarcoma because it depends on several factors. These include the severity, size, and location of the tumor, overall health, age, and preferences. Check below some treatments often recommended for people with uterine sarcoma:
Surgery
The following procedures are often recommended to remove the tumor. In some cases, surgeons may also remove some healthy tissue near the tumor. Check below some types of surgery:
- Hysterectomy – During this procedure, surgeons use a laparoscope to remove a part or all of the cervix and uterus.
- Total hysterectomy with salpingo-oophorectomy – This surgery is used to remove the uterus and one or both ovaries. Sometimes, surgeons may also remove one of the fallopian tubes.
- Radical hysterectomy – This type of surgery is often recommended when is needed to remove the uterus, cervix, both fallopian tubes, and some healthy tissue (including a part of vagina).
- Lymphadenectomy – This procedure is used to remove lymph nodes for testing to check for cancerous cells.
- Laparotomy – This treatment involves an incision (cut) in the abdominal area. Sometimes, surgeons may remove the tissue or organs that are affected by cancer.
Radiation Therapy
This treatment uses powerful energy beams to destroy cancer cells. This energy usually comes from X-rays, protons, and other sources. There are 2 types of radiation therapy such as internal (placed in the body) and external (in such cases, the energy is delivered by a machine from outside the body). However, this treatment may cause some adverse reactions, including diarrhea, skin changes, and others.
Chemotherapy
This cancer treatment involves strong medications given often intravenously (IV) to destroy cancer cells throughout the body. When surgery is not an option, radiation therapy and chemotherapy may be the only treatments needed. Sometimes, physicians may prescribe chemotherapy drugs to shrink large tumors or kill cancer cells that may remain even after surgery. The most common adverse reaction to chemotherapy is hair loss.
Hormone Therapy
In general, hormones (such as Estrogen or Testosterone) are substances that play an important role in regulating certain functions in the body. Unfortunately, there are some cancer types that can grow with the help of some hormones. Thus, doctors may recommend hormone therapy to reduce the production of certain hormones that help cancer cells grow and multiply. Physicians usually recommend progestins, gonadotropin-releasing hormone agonists, and aromatase inhibitors.
Frequently Asked Questions
Is uterine sarcoma cancer curable?
Yes, especially if it is detected in the early stages. It means the tumor is localized and has not spread to other parts of the body. In some cases, doctors may prescribe chemotherapy or radiation therapy that may remain after the tumor removal.
What is the survival rate of uterine sarcoma?
Generally, if the cancer has not spread, the 5-year survival rate is approximately 66%. When the cancer spreads, the same survival rate decreases to 34%. For more details, discuss it with your doctor.
What are the first signs of sarcoma?
These include:
- A lump or mass that can be felt through the skin
- Abdominal (belly) pain
- Unusual weight loss
If any of the previous symptoms occur or any others that cause concerns, immediately contact your physician. Ask your healthcare professional if you have any other questions.
