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The most common type of gynecologic cancer in the US has been on the rise in recent years — and there’s no standard screening for it.
Uterine cancer will affect about 66,200 women in the U.S. by 2023 — and about 13,000 will die from the disease, according to the American Cancer Society (ACS).
“While we see a downward trend in overall cancer cases, uterine cancer is one of the few types where we see an upward trend,” said Dr. Brian Slomovitz, director of gynecologic oncology and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach, Florida, in an interview with Fox News Digital.
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“We expect that the number of deaths in the United States from uterine cancer will soon surpass the number of deaths from ovarian cancer,” he added.
To raise awareness, the International Society of Gynecologic Cancer announced the first-ever Uterine Cancer Awareness Month in June.
Dr. Brian Slomovitz is director of gynecologic oncology and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach, Florida. He also chairs the Cancer Awareness Month initiative. (Mount Sinai Medical Center)
Slomovitz — who also chairs the Uterine Cancer Awareness Initiative — spoke to Fox News Digital about the state of uterine cancer and what women need to know.
Uterine Cancer and Endometrial Cancer: What’s the Difference?
The terms “uterine cancer” and “endometrial cancer” are often used interchangeably, but there is a difference, Slomovitz said.
The vast majority of these cancers occur in the outer and inner layers of the uterus, known as the endometrium – hence the term “endometrial cancer.”
About 4% to 5% of cancers occur in the muscle of the uterus. These are known as uterine sarcomas.
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“Sarcomas are aggressive diseases with a very high mortality rate,” Slomovitz explains. “But they all fall into the category of uterine cancer.”
The greatest risk factor of all
Obesity is the biggest risk factor for uterine cancer, Slomovitz said.
“Adipose tissue increases the amount of estrogen in the body, and endometrial cancer is a hyperestrogen,” he explained. “It stimulates the lining of the uterus to the point of uncontrolled proliferation into cancer.”
“There are some groundbreaking studies coming out as we try to address this unmet need to help our patients live longer,” said Dr. Slomovitz, pictured here. (Mount Sinai Medical Center)
Overweight women (with a body mass index of 25 to 29.9) have twice the risk of developing uterine cancer as women of a healthy weight, the ACS website states.
Obese women (BMI of 30 or higher) are at three times the risk.
People with diabetes, which is closely linked to obesity, are also at higher risk.
Obesity and age are two of the biggest risk factors for uterine cancer.
A less common risk factor may be polycystic ovary syndrome (PCOS), a hormonal disorder that can lead to enlarged ovaries and the formation of cysts.
PCOS leads to increased estrogen levels and lower progesterone levels, which can increase the risk of endometrial cancer, according to the American Cancer Society (ACS) website.
Some hereditary syndromes can make women more susceptible to uterine cancer.
Dr. Slomovitz has worked in the field of gynecologic oncology for over 20 years; he is currently director of gynecologic oncology and co-chair of the Cancer Research Committee at Mount Sinai Medical Center in Miami Beach. (Mount Sinai Medical Center)
“One is Lynch syndrome, which has often been associated with colon cancer,” Slomovitz said.
“We know that half of the women who develop cancer from Lynch syndrome develop endometrial cancer.”
Age is also a risk factor, as most patients are diagnosed between the ages of 50 and 60, the doctor said.
“The increase in cases may be due to obesity, but we are also seeing longer life expectancy,” he noted. “The older people get, the more likely they are to get endometrial cancer naturally.”
Symptoms and screening
While other cancers have specific, recommended screenings — such as mammograms for breast cancer and colonoscopies for colorectal cancer — there are no presymptomatic screenings for uterine cancer, according to the Centers for Disease Control and Prevention (CDC).
The Pap test (Pap test) checks for cervical cancer and precancerous cells in the cervix, but does not screen for uterine cancer.
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The most common sign or symptom of uterine cancer is abnormal bleeding, Slomovirz said.
“Most uterine cancer patients have postmenopausal bleeding as an early sign or symptom — but that’s not the case for everyone,” he said.
In premenopausal women, it can be more difficult to determine what constitutes “abnormal” bleeding, the doctor noted.
Uterine cancer will affect about 66,200 women in the U.S. by 2023 — and about 13,000 women will die from it, according to the American Cancer Society. (iStock)
“They shouldn’t just assume it’s changes in their menstrual cycle,” he said.
Because there was no formal screening process, Slomovitz emphasized the need to recognize symptoms and take prompt action.
“We need to better educate patients to see their doctor sooner if they have symptoms,” he told Fox News Digital.
“We need to better educate patients to come to their doctor sooner.”
In addition to bleeding, other symptoms may include pelvic pain or pelvic pressure.
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“We always tell people that if they have symptoms that get worse or if they persist beyond 10 to 14 days, they should see their doctor to make sure everything is okay,” Slomovitz said.
“We are still seeing a large number of patients diagnosed with advanced and recurrent disease.”
“We need to better educate patients to see their doctor sooner if they have symptoms,” Slomovitz said. (iStock)
The diagnosis process usually begins with an ultrasound to take images of the uterus, followed by a tissue biopsy — to diagnose or rule out the disease, Slomovitz said.
In cases of advanced cancer, patients usually get additional tests — such as chest X-rays, CT scans, MRIs, or PET scans — to determine whether the disease has spread.
“It traditionally spreads through the lymphatic system, which means lymph nodes can become enlarged,” explains Slomovitz. “It can also spread through the blood system to the liver or lungs.”
“Eighty percent of women recover with a hysterectomy.”
In patients who have had endometrial cancer in the past, a gynecologic oncologist will instruct them to rule out recurrent cancer for any future symptoms.
“They’re cancer patients — so even with the non-specific symptoms, it’s worth seeing their oncologist again to make sure it doesn’t come back,” Slomovitz said.
Treatment options: ‘An unmet need’
In women who have been diagnosed with uterine cancer, one of the first steps is usually a hysterectomy, the removal of the uterus.
“Eighty percent of women heal with a hysterectomy,” Slomovitz said.
To further minimize the risk, the doctor said medical professionals will often also take lymph node samples to make sure the cancer has not spread.
“But the additional 20% of patients with advanced or recurrent disease require systemic therapies,” he said. “We need to do better with treatment options for uterine cancer.”
For these aggressive cases, the systemic therapies have been chemotherapy or hormonal therapy, which uses progesterone to slow tumor growth.
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This year, Slomovitz said, some groundbreaking studies have shown that immunotherapy can be used in the first-line treatment of the disease.
Immunotherapy treatments work by helping the immune system slow, stop, or destroy cancer cells. It has been shown to be effective for lung cancer, oral cancer and melanoma, the doctor stressed.
Symptoms of uterine cancer include abnormal bleeding and pelvic pain. (iStock)
At the May 2023 conference of the American Society of Clinical Oncology, researchers presented promising results for a new class of drugs called antibody-drug conjugates (ADCS), a targeted therapy for cancer treatment, Slomovitz said.
Health professionals are trying to “fill this unmet need to help our patients live longer”.
Future studies will continue to look at these kinds of targeted drugs.
“One of my career goals is to use immunotherapy and targeted therapy to eliminate the need for chemotherapy and its associated toxicity and side effects,” Slomovitz said.
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Another “groundbreaking” advance that Slomovitz is particularly excited about is molecular classification, which divides uterine cancer into four distinct subtypes — allowing for more accurate, personalized treatment options.
“We are in a very exciting time,” he said. “There are some groundbreaking studies coming out as we try to address this unmet need to help our patients live longer.”
Melissa Rudy is a health editor and member of the lifestyle team at Fox News Digital.
