Sarcoma is a rare cancer that develops in tissues of the body, such as bones or muscles. One of the types of sarcoma we treat at CTCA is uterine sarcoma. Dr. Justin Chura, Medical Director of Gynecologic Oncology and Medical Director of Robotic Surgery at CTCA in Philadelphia, recently answered our questions about the disease, which the American Cancer Society estimates 1,600 women will be diagnosed with this year.
How is uterine sarcoma different from other types of uterine cancer?
In simple terms, some cancers are “carcinomas” and some are “sarcomas.” When considering the uterus, a carcinoma is a cancer of the glandular tissue of the lining of the uterus. This lining is also known as the endometrium. The most common gynecologic cancer is endometrial or uterine cancer. When the cancer starts in the smooth muscle or connective tissue of the uterus, it is called a sarcoma.
Is there more than one type of uterine sarcoma?
There are several types. Sarcomas of the uterus can be associated with fibroids, and are known as a leiomyosarcoma. Other types include undifferentiated sarcomas and endometrial stromal sarcomas. Carcinosarcomas have both elements of a carcinoma and a sarcoma, but are counted with uterine carcinomas even though they have a sarcoma element.
How is uterine sarcoma diagnosed?
Frequently, uterine sarcomas are diagnosed unexpectedly. For example, a woman will undergo surgery for what are thought to be fibroid tumors (which are non-cancerous) and instead a leiomyosarcoma is detected. Patients can have abnormal bleeding, vaginal discharge or a mass that’s found on an exam (or ultrasound). However, all of these symptoms can be caused by other gynecologic conditions.
What are the risk factors for uterine sarcoma?
Prior radiation to the pelvis for treatment of other cancers can be a risk factor for uterine sarcoma. African American women are also at higher risk.
Who should women seek treatment from for uterine sarcoma?
Gynecologic oncologists are best suited to treat uterine sarcomas because of their expertise in the field. Unfortunately, many patients are diagnosed after surgery. When this happens, those patients should still see a gynecologic oncologist. In addition, if a woman is undergoing a hysterectomy for suspicious fibroids, the surgery should probably be performed by a specialist.
What treatment options are available for uterine sarcoma?
Surgery is usually the first step in treating a uterine sarcoma. Not only does it remove the primary site of the cancer, it also provides information about the stage (which is determined, in part, on whether the cancer has spread to other areas). Stage of cancer is one of the key factors to determine if more treatment is necessary after surgery. Additional treatment can often involve chemotherapy. In the past, radiation was routinely used after surgery, but we have learned that radiation is good at controlling the cancer in one area, but still leaves the rest of the patient’s body vulnerable to cancer recurrence. Hormone therapy may also be used for certain types of sarcoma. Deep tissue hyperthermia can be used to treat certain patients with recurrent uterine sarcoma, but this is done on a very individualized basis.
Learn more about soft tissue sarcoma and uterine cancer.
Hear the personal story of Melanie Cooke, a survivor of uterine carcinosarcoma.