Uterine Sarcoma

What is Uterine Sarcoma?

Sarcoma is a malignant tumor that arises from a smooth muscle which is basically pertains to sarcoma that arose from the lining of the uterus. It can be mistaken as pregnancy, the only difference is that the womb will enlarge more quickly. The chance of recovery of a patient who is diagnosed with Uterine Sarcoma depends on the overall health of the person, the stage of the cancer, the time of diagnosis (later or early), and the status of the tumor.

Image 1 – Uterine Sarcoma Picture

Uterine Sarcoma Signs and Symptoms

Abnormal vaginal bleeding is the most common symptom of Uterine Sarcoma. However, please note that this can also be caused by any other medical condition. Any vaginal bleeding after menopause should be reported to your doctor immediately.

• Lump – The tumor can be palpable in the vagina. If a lump is present, contact your doctor immediately.
• Bloatedness – Patient can feel this discomfort if the tumor is already causing an abdominal distension.
• Polyuria – Frequent urination occurs if the tumor is compressing the bladder. This is caused by the decreased compartment size of the bladder to hold urine.
• Pain – Pain at the site is a common symptom of this condition, but please note that this is not a definitive symptom as this can also be caused by many other medical conditions.

Uterine Sarcoma Causes and Risk Factors

As of now there are no known cause of Uterine Sarcoma, provided below is a list of common risk factors:

• Drug for other cancers – Tamoxifen is a drug used to treat breast cancer and is associated with the said condition.
• Radiation – Radiation can cause mutations to our normal body cells, this mutation can be a cause of many types of cancers. This may also come from a radiation therapy of previous cancers.
• Race – There are no plausible reasons why, but statistics have shown that Uterine Sarcoma is common in women with African-American descent.

Staging of Uterine Sarcoma

Stage I (T1, N0, M0)

• Stage IA (T1a, N0, M0)
• Stage IB (T1b, N0, M0)

Stage II (T2, N0, M0)

• Stage IIA (T2a, N0, M0)
• Stage IIB (T2b, N0, M0)

Stage III

• Stage IIIA (T3a, N0, M0)
• Stage IIIB (T3b, N0, M0)
• Stage IIIC (T1 to T3, N1, M0)

Stage IV

• Stage IVA (T4, any N, M0)
• Stage IVB (any T, any N, M1)

LEGEND:

Tumor extent (T)

• T0: No signs of a tumor in the uterus can be found.
• T1: The tumor is growing in the uterus, but has not started growing outside the uterus.

1. T1a: The cancer is only in the uterus and is not larger than 5 cm across (5 cm is about 2 inches).
2. T1b: The cancer is only in the uterus and is larger than 5 cm across.

• T2: The tumor is growing outside the uterus, but is not growing outside the pelvis.

1. T2a: The tumor is growing into the adnexa (the ovaries and fallopian tubes).
2. T2b: The tumor is growing into tissues of the pelvis other than the adnexa.

• T3: The tumor is growing into tissues of the abdomen.

1. T3a: The tumor is growing into tissues of the abdomen in one place only.
2. T3b: The tumor is growing into tissues of the abdomen in 2 or more places.

• T4: The tumor is growing into the bladder or rectum.

Lymph node spread (N)

• NX: Spread to nearby lymph nodes cannot be assessed.
• N0: No spread to nearby lymph nodes.
• N1: Cancer has spread to nearby lymph nodes.

Distant spread (M)

• M0: The cancer has not spread to distant lymph nodes, organs, or tissues.
• M1: The cancer has spread to distant organs (such as the lungs or liver).

Diagnosis of Uterine Sarcoma

Your doctor may order the following:

• Physical Exam – This is an initial diagnostic test to see if there are anything unusual with the patient’s body.
• Pelvic Exam – This is to feel and estimate the shape, size, and the position of the tumor.
• Biopsy – Biopsy will be used to extract specimens from the tumor itself and it will be used to diagnose the condition of the patient.
• Dilatation and Curettage – This is a diagnostic and a surgical procedure that will be used to scrape the cells of the uterus. The specimen will be used to know the overall state of the condition.
• Ultrasound Imaging – This can be used to determine the location, size, and shape of the tumor.
• Advanced Imaging Tests – This includes MRI and CT Scan of the tumor, they are both specialized imaging test that is used to scan the tumor deeper with cross sectional view. Also, it can produce a detailed result about the status of the tumor. It is also used to check for the effectiveness of the treatment provided.

Image 2 – CT scan Imaging for determination of local advanced uterine sarcoma

Image source: aboutcancer.com

Treatment of Uterine Sarcoma

• Hormonal Therapy – Since hormone can be the cause of the growth of the tumor, treating the tumor with hormones are also proven to be effective in halting the growth of the tumor. Hormones can block other hormones function that is why this is a good treatment method for Uterine Sarcoma which can be caused by hormone instability.
• Radiation Therapy – This therapy is often used to destroy cancer cells locally. This procedure can be successful if the cancer is at its early stage and the tumor is still developing.
• Chemotherapy – This therapy is used to systemically kill cancer cells. This therapy is usually the first line of treatment in patients who are diagnosed with cancer. This is also very important in killing the remnant cancer cells after a surgery or a radiotherapy. This is often used in combination with Radiotherapy and Surgery for effective results.
• Surgery – This involves the removal of the uterus itself, this way, there can be no recurrence. Although there will be a certain impact to the woman’s sexual life, this procedure’s goal is to save the life of the patient.

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