What is the difference between endometrial cancer and uterine sarcoma?

"Uterine cancer" is a medical umbrella term for various types of malignant tumors that affect the uterus, the organ where a fetus grows during pregnancy. Distinguishing between endometrial cancer and uterine sarcoma is essential, as they differ in tissue origin, biological behavior, and the therapeutic approach followed [1].

The Fundamental Difference in Origin

The primary difference lies in the type of cells from which the cancer originates:

• Endometrial Cancer: This is the most common type by far. It arises in the cells lining the uterus, known as the "endometrium" [1]. The common type is often associated with changes in hormone levels and grows more slowly compared to other tumors [2].
• Uterine Sarcoma: This type is rare and more aggressive. The cancer here starts in the muscles or connective supporting tissues of the uterine wall, not in the inner lining [1]. Due to its nature, it can be more difficult to diagnose and treat [1].

Differing Risk Factors

Factors that increase the likelihood of developing these cancers vary based on the type. In the case of endometrial cancer, hormonal changes play a pivotal role; the risk increases with estrogen-only hormone replacement therapy (without progesterone), having polycystic ovary syndrome (PCOS), type 2 diabetes, overweight or obesity (BMI of 25 or higher), or a family history (including Lynch syndrome) [1], [2]. In contrast, risk factors for uterine sarcoma are concentrated on prior pelvic radiation therapy or the use of "tamoxifen" to treat or prevent breast cancer [1].

Shared Symptoms and the Necessity of Diagnosis

Although their origins differ, both types share a set of symptoms that require immediate medical attention. Abnormal vaginal bleeding is the most common symptom. For premenopausal women, this includes irregular bleeding or spotting between periods; for postmenopausal women, any bleeding or spotting is considered abnormal and must be examined immediately [2]. Other symptoms that may appear as the condition progresses include pelvic pain or a feeling of pressure in the pelvic area, unusual vaginal discharge, or the sensation of a mass or uterine enlargement [1].

Specialized Treatment Approach

The treatment plan is determined based on an accurate diagnosis and the stage of the disease. A hysterectomy is the primary surgical procedure for both types and may involve removing the ovaries and fallopian tubes [1], [2]. In certain cases, physicians may resort to additional therapies such as chemotherapy or radiation. Radiation therapy may include "brachytherapy," where the radiation source is placed directly inside the body near the tumor to eliminate cancer cells [3].

There are no guaranteed ways to prevent these cancers, but maintaining a healthy lifestyle may reduce the risks. If you would like to know more about this subject, you can view our detailed article on Endometrial Cancer: Risk Factors, Early Symptoms, and Treatment Options (Arabic). Periodic follow-up with a gynecologist is the most important step for prevention and early detection, especially upon noticing any abnormal symptoms.

Medical references

• Uterine Cancer
• Endometrial Cancer
• Brachytherapy to Treat Cancer