Dr. M.J. Bazos, MD. Patient Handout


About Your Diagnosis
The uterus (womb) is located between the bladder and rectum. It is made up of the cervix, which connects the uterus to the vagina, and the body (corpus), from which the fallopian tubes extend. Cancer of the uterus can start from the cervix or from the inner layer of the uterus (the endometrium). Malignant tumors of the uterus also can start from the muscular body of the uterus or from its connecting tissue and are called uterine sarcoma. Uterine sarcoma is rare, occurring among 1 in 100,000 women. The cause of uterine sarcoma is unknown. Uterine sarcoma can be divided into one of three types, which can be diagnosed only by means of a biopsy and tissue examination. Uterine sarcoma is difficult to cure, but if detected early, the chance for cure is better than if the cancer has spread.

Living With Your Diagnosis
Uterine sarcoma usually becomes apparent with abnormal vaginal bleeding among women who have gone through menopause. Other symptoms include abdominal fullness, bloating, and pain. Urinary symptoms of frequency, urgency, and discomfort can occur. Uterine sarcoma usually spreads local and invades nearby organs, such as the vagina, ovaries, rectum, and bladder.

To confirm the diagnosis a D & C is performed to remove tissue for examination with a microscope. D & C means to dilation (widening) of the cervix for insertion of a curette (a spoon-shaped instrument with sharp edges) to remove tissue. Once the diagnosis is made, the physician determines the extent of disease by staging the cancer. Staging tells whether the disease has spread. Blood tests, radiographs (x-rays) of the chest, and computed tomography (CT) of the abdomen and pelvis are performed to look for disease outside the uterus. Stage I means the sarcoma is confined to the uterus. Stage II means the sarcoma extends to the cervix. Stage III means the sarcoma extends to structures in the pelvis. Stage IV means the sarcoma extends beyond the pelvic structures. Treatment depends on the stage of the disease and can be surgical, radiation, hormonal, or chemotherapy. A surgical procedure is the main treatment. It consists of removing the uterus, fallopian tubes, and ovaries (hysterectomy with bilateral salpingo-oophorectomy). A surgical procedure is
generally performed for early-stage disease. The decision to use radiation or chemotherapy depends on the type of uterine sarcoma and the stage of disease. The type of radiation or combination of chemotherapy should be discussed with an oncologist (physician specializing in cancer). Side effects of surgical treatment are pain and soreness in the pelvic area and problems emptying the bladder or moving the bowels. Side effects of radiation therapy are dry, red, itchy skin, nausea, vomiting, diarrhea, vaginal dryness, pain with intercourse, and frequency, urgency and discomfort with urination. Side effects from chemotherapy are nausea, vomiting, easy bruising and bleeding, infections, fever, and hair loss.

The DOs
• Find a surgeon and oncologist who have experience in the treatment of uterine sarcoma. This cancer is so rare you should seek a cancer center with a team of physicians and healthcare personnel who deal with all aspects of treatment.
• Keep your appointments during and after treatment to monitor for side effects and determine whether the cancer has returned.
• Remember that you will no longer have periods (menstrual cycles) after your operation. If your ovaries are removed or if damage is caused by irradiation, menopause occurs, and you may experience symptoms of menopause such as hot flashes.

The DON’Ts
• Do not ignore any vaginal bleeding after menopause.
• Do not ignore abnormal vaginal bleeding (excess bleeding or bleeding between periods) if you have not gone through menopause.
• Do not believe you will have no sexual desire or not be able to have sexual intercourse after surgical treatment. Sexual intercourse and normal activity can be resumed 4 to 8 weeks after the operation.

When to Call Your Doctor
• If you have any vaginal bleeding or abnormal vaginal bleeding.
• If you have any abnormal vaginal discharge (smell, quantity, color).
• If you need emotional support.
• If you have any side effects of treatment (surgical, radiation, or chemotherapy).