The most difficult part of diagnosing uterine sarcoma is confirming the diagnosis prior to surgery. Most patients are diagnosed as an incidental finding during hysterectomy or morcellation of fibroids. Endometrial sampling is not highly sensitive and, as such, the correct preoperative diagnosis is achieved in less than 50% of symptomatic cases. In the majority of cases, the cancer develops in the myometrium, which is a layer of tissue in the uterus.
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Although most women do not experience vaginal bleeding or spotting after menopause, women with uterine sarcoma often experience pelvic pain or a mass in the uterus. Some women also report vaginal discharge without visible blood, though this can be a sign of an infection or non-cancerous condition. In addition to vaginal bleeding and pain, other symptoms of uterine sarcoma include fullness in the abdomen.
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In some women, a diagnosis of uterine sarcoma can be made after the cancer has spread beyond the uterus. A cancerous growth outside of the uterus is considered a recurrence of the disease. While it has not spread to the rectum, bladder, lymph nodes, or other distant sites, it may have affected the lining of the fallopian tubes, adnexa, or vagina.
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Chemotherapy works by killing cancer cells by decreasing their ability to divide. This type of treatment is often used after surgery and if cancer returns following surgery. Generally, chemotherapy consists of one or a combination of drugs and may be administered alone or in conjunction with radiation. Depending on the type of uterine cancer, patients may undergo chemotherapy in combination with radiation therapy. However, both of these treatments carry a risk of side effects.
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Despite the heterogeneity of uterine sarcomas, the World Health Organization has published a classification system based on cell origin, differentiation, and growth pattern. There are two types of uterine sarcomas, which are classified as either mesenchymal tumors or epithelial tumors. However, the two types are often difficult to differentiate.
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Although uterine sarcomas are usually diagnosed in post-menopausal women, they can also develop during menopause. During menopause, women often develop a fibroid in the abdomen, which may be a symptom of the disease. Although it is difficult to distinguish between a myoma and a sarcoma during the menopausal stage, a biopsy of the uterus can reveal an abnormal growth in the uterus and other organs.
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Treatment for uterine sarcoma depends on the stage of the cancer when it is detected. Early treatment is more likely to cure the disease than later treatment, which can include surgery or chemotherapy. Uterine sarcoma symptoms may also include pelvic radiation therapy. Combined with systemic therapy, pelvic radiation therapy can significantly improve outcomes. However, while surgery is the most common form of treatment, this method is not recommended for patients with advanced tumors.
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In addition to endometrial biopsy, a patient with uterine sarcoma will have a mass or abnormal bleeding in the pelvic area. A biopsy can confirm the diagnosis. A hysterectomy or myomectomy is typically required to cure uterine sarcoma. Surgical treatments may include chemotherapy and radiotherapy. Although a hysterectomy and/or myomectomy are the most common treatments for uterine sarcoma, a patient with advanced disease may also undergo adjuvant therapy.
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While endometrial cancer and uterine sarcoma are similar in their symptoms, they have different causes. In the former, the tumor develops in the tissue that connects the endometrium to the uterus, whereas in the latter, the tumor develops in the lining of the uterus. Symptoms are not common, but they should be suspected. The sooner treatment is received, the sooner it can be cured.
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Various types of immunotherapy are available for uterine sarcoma. In addition to traditional therapy, new treatments are being studied in clinical trials. Clinical trials can be entered into either a patient's treatment or after it has been completed. However, clinical trials are not always appropriate for everyone. While some cancer treatments are effective, there are always risks associated with each treatment. To make sure you are getting the best treatment, ask your healthcare provider for the available treatments.
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While the exact cause of uterine cancer is not known, the presence of certain risk factors increases the risk of a woman developing the disease. Although the exact cause is not known, some risk factors can be changed. Therefore, it's important to talk to your healthcare provider about any changes you can make in your lifestyle to decrease the chances of developing uterine sarcoma. If your doctor suspects a potential cause, they may prescribe treatments and follow-up tests.
