Inside your pelvis is an organ that plays an important role in your period, ability to get pregnant, and carry a pregnancy. As with other parts of your body, sometimes cancer cells can grow there.
The uterus is a hollow, lightbulb- or pear-shaped organ between your rectum and bladder. It’s made up of three parts: the fundus, the body, and the cervix, which connects the uterus to the vagina.
It has three tissue layers. The inner lining is endometrium. If you’re pregnant, the lining, or endometrium, grows thicker. This is where the fertilized egg implants and where your baby grows until delivery. If you don’t become pregnant, the uterus sheds the endometrial lining when you have your period.
The thick center layer of the uterus is the myometrium, which is made of smooth muscle cells. The outer layer is called the perimetrium or serosa and is made of thin epithelial cells.
Cancers that form in the uterus can affect any of the different layers.
Is endometrial cancer the same as uterine cancer?
"When you think about cancer, it's described based on location,” explains Faith Ohuoba, MD, an OB/GYN at Memorial Hermann Health System in Houston. “Endometrial cancer is cancer of the endometrium, which is the lining of the uterus. Uterine cancer is any cancer of the uterus, which is going to be defined by the lining and everything else, like the muscle or connective tissue. So while endometrial cancer is a type of uterine cancer, there are other types of uterine cancer that are not the endometrial type.”
Types of Uterine Cancer
There are two types of uterine cancer:
Endometrial carcinoma (cancer)
This form is the most common, making up 95% of cases. It happens in the inner lining of your uterus (endometrium).
There are two types of endometrial cancer:
Type I endometrial cancer. People with endometrial cancer are most likely to have this type, called endometrioid adenocarcinoma. It usually forms from the lining of your uterus, and doctors link it to high levels of estrogen. These cancers tend to grow slowly and are less likely to spread.
Type II endometrial cancer. This form is not related to estrogen levels. It grows faster and has a higher chance of spreading. This group includes more aggressive cancers like uterine serous carcinoma and clear cell carcinoma.
Uterine sarcoma
This rare type forms in the muscle wall of your uterus (myometrium).
Uterine Cancer vs. Endometrial Cancer: Symptoms
Uterine cancer symptoms
Uterine cancer symptoms can be similar to those of other reproductive health conditions. Possible signs include:
- Vaginal bleeding between periods (before menopause)
- Any vaginal bleeding or spotting after menopause, even a small amount
- Pain or cramping in your lower belly
- Thin, white, or clear discharge from your vagina after menopause
- Very heavy, lengthy, or repeated bleeding if you’re over 40
If you have unusual pain or irregular vaginal bleeding, see a doctor for an accurate diagnosis and the right treatment.
"When a woman has abnormal bleeding, it needs to be investigated," Ohuoba says. "Look at abnormal bleeding in terms of flow. How often are you getting your cycle, and for how many days? If any of those factors are off, go get checked out." She also advises seeing your doctor for heavy periods and clotting.
Endometrial cancer symptoms
Endometrial cancer has similar symptoms as that of the uterus. They may include:
- Bleeding from your vagina after menopause
- Bleeding between periods
- Pain in your lower belly
Uterine Cancer vs. Endometrial Cancer: Risk Factors
A hormone imbalance is the main risk factor for both uterine and endometrial cancers. Having more estrogen than progesterone raises your chances, which can happen if you have certain conditions, including:
- Obesity
- Diabetes
- Polycystic ovary syndrome (or other illness that causes irregular ovulation)
- Certain ovarian tumors
Taking estrogen without progesterone (called unopposed estrogen) also raises your odds of getting endometrial or uterine cancer.
Other risk factors for endometrial and uterine cancer are based on your age, lifestyle, menstrual and reproductive history, and other things. They include:
Older age. As you get older, your chances of forming uterine cancer rise. Most cases happen after age 50 or after menopause.
No pregnancies. You’re more likely to get one of these conditions than someone who’s had one or more pregnancies.
Longer menstruation. The more years you’re exposed to estrogen through menstruation, the higher your chances of uterine cancer. So, if you started your period before age 12 and menopause after age 50, you’re at a higher risk.
A high-fat diet. Doctors have linked several cancers to a diet high in animal fat, including uterine cancer. Plus, fatty, high-calorie foods may also cause obesity.
Family history. If you have Lynch syndrome or hereditary nonpolyposis colorectal cancer (HNPCC), your chances of endometrial cancer go up.
Race. Although endometrial cancer is more common in White women or people assigned female at birth, those who are Black are almost twice as likely to lose their lives to the disease. And doctors often diagnose this group with rarer, more aggressive forms of endometrial cancer.
Medical treatment. Certain medical treatments also raise your risk of uterine cancer, such as radiation therapy to your pelvis, estrogen replacement therapy (ERT), and the breast cancer drug tamoxifen.
Uterine Cancer vs. Endometrial Cancer: Treatment
Treatment for endometrial and other types of uterine cancer involves surgery, strong cancer-killing medicines, and support to soothe pain and other symptoms.
Surgery
The first step in your treatment plan for uterine cancer will likely be surgery. A surgeon will remove your uterus and cervix, a procedure called a hysterectomy. There are four types:
Total abdominal hysterectomy. The surgeon makes a cut in your belly area to remove your uterus.
Vaginal hysterectomy. The surgeon removes your uterus through your vagina.
Radical hysterectomy. If cancer has spread to the cervix, the surgeon removes the uterus, nearby tissues, and the upper part of your vagina.
Minimally invasive hysterectomy. This is when a surgeon makes several small cuts to remove your uterus.
To find out if the cancer has spread, your doctor will also remove lymph nodes with a procedure called lymph node dissection (lymphadenectomy).
They may also remove your ovaries and fallopian tubes (called a bilateral salpingo-oophorectomy, or BSO) to be sure all of the cancer is gone. This surgery will trigger menopause. If you were assigned female at birth, are younger than 45, and haven’t yet gone through menopause, talk to your doctor about keeping your ovaries.
Other treatments
Other uterine and endometrial cancer treatments include:
Radiation therapy. This treatment uses powerful energy. You could have it before surgery to shrink the tumor or as a substitute for surgery. You can get radiation therapy externally from a machine that sends it to your body, or from a device your doctor places inside your vagina (brachytherapy).
Chemotherapy. You may take cancer-killing drugs through an IV or as a pill before surgery to shrink the tumor or after to lower the chance of the cancer returning.
Hormone therapy. Hormone-lowering medicines kill cancer cells that depend on hormones to thrive. Your doctor may suggest hormone therapy if you have advanced endometrial cancer that has spread to other parts of your body.
Targeted therapy. This involves medicines that home in on certain chemicals in cancer cells. This treatment is for those with advanced endometrial cancer, and you may have it along with chemotherapy.
Immunotherapy. You take medicine to help your immune system destroy cancer cells. Doctors use this treatment for advanced endometrial cancer or when other treatments aren’t working.
Palliative care. This is health care to help ease pain and other symptoms. Trained experts will support you and your family to enhance your quality of life. You may have palliative care along with other treatments like surgery, chemo, and radiation therapy.
Uterine Cancer vs. Endometrial Cancer: Prognosis
Cancer survival rates depend on whether the cancer has spread and how far, your age, general health, treatment response, and other things.
Uterine and endometrial cancer typically have high survival rates, especially when doctors diagnose them early and they haven’t spread to other parts of your body. Doctors usually diagnose these cancers early on because people spot unusual bleeding. Here’s a closer look at the numbers:
Uterine/endometrial cancer prognosis
The five-year survival rate for localized cancers of the uterus and endometrium is 95%. This means that this percentage of women diagnosed with the disease is alive five years later. If the cancer has spread from the uterus to nearby structures or lymph nodes (regional), the five-year survival rate drops slightly to 70%. And when it spreads to distant parts of the body, such as your lungs or bones (distant), the survival rate falls to 19%. The overall survival rate is 81%.
These statistics are different for Black women. For this group, the overall five-year survival rate is much lower, at 62%. They’re more likely to face disparities of care: They often have less access to quality care, so they get their diagnosis at a later stage, when it’s harder to treat. They are also more likely to have the more aggressive types of the disease that spread more quickly.
It’s important to note that these numbers only refer to the cancer stage at first diagnosis. They may be different if it grows, spreads, or returns after treatment.
With these types of cancers, early diagnosis is key to effective treatment. "Don't be afraid to talk to your OB/GYN," Ohuoba says. "If you have abnormal bleeding, advocate for imaging studies to see what's going on. And understand the possibility of [needing a] biopsy. Patients get scared or refuse, but just know when dealing with gynecological cancers, especially of the uterus, biopsies and imaging are some of the things that you should make sure to have."
Takeaways
Endometrial cancer is a form of uterine cancer. Uterine cancer refers to any cancer in the uterus, including both the lining (endometrium) and other tissues, like muscle. Endometrial cancer affects only the lining of the uterus and is the most common type, making up 95% of cases.
Symptoms for both cancers are unusual vaginal bleeding, especially after menopause, and pelvic pain.
Risk factors include obesity, hormonal imbalances, a high-fat diet, family history, race, and certain medical treatments. Your doctor may suggest surgery, radiation, chemotherapy, hormone therapy, or immunotherapy, depending on the cancer’s stage and spread. When diagnosed early, both cancers have high survival rates.
Uterine Cancer vs. Endometrial Cancer FAQs
What is the difference between the endometrium and the uterus?
The uterus is the hollow, pear-shaped organ where a baby grows, while the endometrium is the inner lining of your uterus.
What is the difference between endometrial cancer and uterine sarcoma?
Endometrial cancer forms in the inner lining of your uterus (endometrium), while uterine sarcoma is a rare form of cancer that develops in the muscle wall of your uterus (myometrium). Both are types of uterine cancer.