Cancer of the Uterus
(Uterine Cancer or Endometrial Cancer)
Weight Gain & Cancer Risk
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
Excess weight is a known risk factor for many chronic diseases, such as
diabetes and heart disease. Obesity has also been linked an increased risk for
developing some cancers. To clarify the effects of weight gain on cancer risk,
researchers in 2007 conducted an analysis of many studies reported in medical
journals that describe 282,137 cases of cancer. The researchers wanted to see if
weight gain had an effect on the risk for certain cancer types.
In particular, the researchers looked at the risk of cancer associated with a
weight gain corresponding to an increase of 5 kg/m2 in body mass index (BMI). In
terms of actual pounds gained, a man with a normal-range BMI of 23 would need to
gain 15 kg (33 lbs.) of weight, while a woman with a BMI of 23 would need to
gain 13 kg (28.6 lbs.) to correspond to an increase of 5 in the BMI.
The results, published in the Lancet in February 2008, revealed that weight
gain is positively associated with the risk of developing a variety of types of
cancer as described below.
For women, a weight gain corresponding to an increase of 5 in the BMI
resulted in a significant increase in risk for developing four cancer types:
The uterus
The uterus is part of a woman's reproductive system. It is the hollow,
pear-shaped organ where a baby grows. The uterus is in the pelvis between the
bladder and the rectum.
The narrow, lower portion of the uterus is the cervix. The broad, middle part
of the uterus is the body, or corpus. The dome-shaped top of the uterus is the
fundus. The fallopian tubes extend from either side of the top of the uterus to
the ovaries.
The wall of the uterus has two layers of tissue. The inner layer, or lining, is the endometrium. The outer layer is muscle tissue called the myometrium.
In women of childbearing age, the lining of the uterus grows and thickens each month to prepare for pregnancy. If a woman does not become pregnant, the thick, bloody lining flows out of the body through the vagina. This flow is called menstruation.
Understanding cancer
Cancer is a group of many related diseases. All cancers begin in cells, the
body's basic unit of life. Cells make up tissues, and tissues make up the organs
of the body.
Normally, cells grow and divide to form new cells as the body needs them.
When cells grow old and die, new cells take their place.
Sometimes this orderly process goes wrong. New cells form when the body does
not need them, and old cells do not die when they should. These extra cells can
form a mass of tissue called a growth or tumor.
Tumors can be benign or malignant:
- Benign tumors are not cancer. Usually, doctors can remove them. Cells
from benign tumors do not spread to other parts of the body. In most cases,
benign tumors do not come back after they are removed. Most important, benign
tumors are rarely a threat to life.
Benign conditions of the uterus
- Fibroids are common benign tumors that grow in the muscle of the
uterus. They occur mainly in women in their forties. Women may have many
fibroids at the same time. Fibroids do not develop into cancer. As a woman
reaches menopause, fibroids are likely to become smaller, and sometimes they
disappear.
Usually, fibroids cause no symptoms and need no treatment. But depending on
their size and location, fibroids can cause bleeding, vaginal discharge, and
frequent urination. Women with these symptoms should see a doctor. If fibroids
cause heavy bleeding, or if they press against nearby organs and cause pain, the
doctor may suggest surgery or other treatment.
- Endometriosis is another benign condition that affects the uterus. It
is most common in women in their thirties and forties, especially in women who
have never been pregnant. It occurs when endometrial tissue begins to grow on
the outside of the uterus and on nearby organs. This condition may cause painful
menstrual periods, abnormal vaginal bleeding, and sometimes loss of fertility
(ability to get pregnant), but it does not cause cancer. Women with
endometriosis may be treated with hormones or surgery.
- Endometrial hyperplasia is an increase in the number of cells in the lining
of the uterus. It is not cancer. Sometimes it develops into cancer. Heavy
menstrual periods, bleeding between periods, and bleeding after menopause are
common symptoms of hyperplasia. It is most common after age 40.
To prevent endometrial hyperplasia from developing into cancer, the doctor
may recommend surgery to remove the uterus (hysterectomy) or treatment with
hormones (progesterone) and regular followup exams.
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- Malignant tumors are cancer. They are generally more serious and may be life
threatening. Cancer cells can invade and damage nearby tissues and organs. Also,
cancer cells can break away from a malignant tumor and enter the bloodstream or
lymphatic system. That is how cancer cells spread from the original (primary)
tumor to form new tumors in other organs. The spread of cancer is called
metastasis.
When uterine cancer spreads (metastasizes) outside the uterus, cancer cells
are often found in nearby lymph nodes, nerves, or blood vessels. If the cancer
has reached the lymph nodes, cancer cells may have spread to other lymph nodes
and other organs, such as the lungs, liver, and bones.
When cancer spreads from its original place to another part of the body, the
new tumor has the same kind of abnormal cells and the same name as the primary
tumor. For example, if cancer of the uterus spreads to the lungs, the cancer
cells in the lungs are actually uterine cancer cells. The disease is metastatic
uterine cancer, not lung cancer. It is treated as uterine cancer, not lung
cancer. Doctors sometimes call the new tumor "distant" disease.
The most common type of cancer of the uterus begins in the lining (endometrium).
It is called endometrial cancer, uterine cancer, or cancer of the uterus. In
this booklet, we will use the terms uterine cancer or cancer of the uterus to
refer to cancer that begins in the endometrium.
A different type of cancer, uterine sarcoma, develops in the muscle (myometrium).
Cancer that begins in the cervix is also a different type of cancer. This
booklet does not deal with uterine sarcoma or with cancer of the cervix. The
Cancer Information Service (1-800-4-CANCER) can provide information about these
types of cancer. Also, National Cancer Institute publications may be viewed or
ordered on the Internet at http://www.cancer.gov/publications.
Next: What causes cancer of the uterus? Who is at risk for
uterine cancer? »
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