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Uterine Sarcoma

Description

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.


Stage Explanation

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:

Stage I

Cancer is found only in the main part of the uterus (it is not found in the cervix).

Stage II

Cancer cells have spread to the cervix.

Stage III

Cancer cells have spread outside the uterus but have not spread outside the pelvis.

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.

Recurrent

Recurrent disease means that the cancer has come back (recurred) after it has been treated.


Treatment Option Overview

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 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 is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. Some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working.

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.


Stage I Uterine Sarcoma

Treatment may be one of the following:

  1. 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

    ).

  2. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection, followed by

    radiation therapy

    to the pelvis.

  3. Surgery followed by

    chemotherapy.

  4. Surgery followed by radiation therapy.


Stage II Uterine Sarcoma

Treatment may be one of the following:

  1. 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

    ).

  2. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection, followed by

    radiation therapy

    to the pelvis.

  3. Surgery followed by

    chemotherapy.

  4. Surgery followed by radiation therapy.


Stage III Uterine Sarcoma

Treatment may be one of the following:

  1. 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.

  2. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and lymph node dissection, followed by

    radiation therapy

    to the pelvis.

  3. Surgery followed by

    chemotherapy.


Stage IV Uterine Sarcoma

Treatment will usually be a clinical trial using chemotherapy.


Recurrent Uterine Sarcoma

If the cancer has come back (recurred), treatment may be one of the following:

  1. A

    clinical trial

    of

    chemotherapy

    .

  2. External radiation therapy

    to relieve

    symptoms

    such as pain,

    nausea

    , or

    abnormal bowel

    functions.

  3. Hormone therapy

    .


Changes to This Summary (08/19/2005)

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, and links to the NCI Dictionary of Cancer Terms were added.


To Learn More

Call

For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.

Web sites and Organizations

The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. There are also many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment.

Publications

The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.

LiveHelp

The NCI's LiveHelp service, a program available on several of the Institute's Web sites, provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.

Write

For more information from the NCI, please write to this address:

  • NCI Public Inquiries Office

  • Suite 3036A

  • 6116 Executive Boulevard, MSC8322

  • Bethesda, MD 20892-8322


About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.

The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.

PDQ also contains information on clinical trials.

Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."

Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.