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National Cancer Institute

PDQ® bullet Treatment  bullet Patients

Uterine sarcoma


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is sarcoma of the uterus?
STAGE EXPLANATION
Stages of sarcoma of the uterus
Stage I
Stage II
Stage III
Stage IV
Recurrent
TREATMENT OPTION OVERVIEW
How sarcoma of the uterus is treated
Treatment by stage
STAGE I UTERINE SARCOMA
STAGE II UTERINE SARCOMA
STAGE III UTERINE SARCOMA
STAGE IV UTERINE SARCOMA
RECURRENT UTERINE SARCOMA
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


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 (see the PDQ summary on cancer of the endometrium for information on that disease).

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 uses female hormones, usually taken by pill, to kill cancer cells.


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. Clinical trials of chemotherapy or hormone therapy.

2. External radiation therapy to relieve symptoms such as pain, nausea, or abnormal bowel functions.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about sarcoma of the uterus, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, you can speak with a trained information specialist who can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following booklet about cancer of the uterus may be helpful:

What You Need To Know About Cancer of the Uterus

The following general booklets on questions related to cancer may also be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 08/1998


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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