If you have been diagnosed with uterine cancer and had a hysterectomy, the doctors will know your grade and stage of cancer. This is very important because with this information they can discuss with you all the statistics and recommend further treatment plans. In this post I will be discussing the different types, grades, and stages of endometrial cancer and uterine sarcoma. I will also cover survival statistics based on the stages of cancer.
I want to encourage you not to panic and jump into a major treatment plan before you have all the information you need. I hope these posts will help you with that. It is now known that when a person is first diagnosed with cancer, it has likely been growing for years before symptoms showed up.
You have time. It is not a dire emergency to start chemotherapy this minute. Take a little time to research and process all the information so you can make the best decisions for you and your life. In fact, in my next post, I will be going over even more important testing that should be done after surgery to help determine what treatments may or may not be effective for your particular tumor.
So please stop, take a deep breath and a little time, read these posts and more, ask questions, pray and then make an informed decision that fits in with your beliefs, your wishes and your quality of life with what you have learned.
UTERINE CANCER IS FIRST DIVIDED INTO TYPE 1 AND TYPE 2
- Type 1 – cancers include grade 1 and 2 endometrial adenocarcinoma or carcinoma for short (common). These tumors are thought to be due to too much estrogen. They are slow-growing, are not considered aggressive, don’t typically spread quickly if at all and carry a good prognosis.
- Type 2 – cancers include grade 3 endometrial carcinoma (which is what I had), serous cell, clear cell, undifferentiated and mixed. Uterine sarcomas are in this category as well. These tumors are rare and not thought to be caused by too much estrogen. They grow rapidly and are aggressive, spreading to other areas more quickly and carry a poor prognosis.
GRADES OF ENDOMETRIAL CANCER
If the tumor is diagnosed as an endometrial carcinoma (the most common type), this is further divided into grades. These are determined by FIGO, the International Federation of Gynecology and Obstetrics. The FIGO grade is based on how much the cancer cells resemble the normal glandular tissues of the endometrium where they originated from.
- Grade 1– is where 95% or more of the cancerous cells resemble normal glands. These are considered low-grade and have the best prognosis. They don’t typically spread to other tissues very quickly, if at all.
- Grade 2 – is where 50-94% of the cancer cells resemble normal glands. Grade 2 are more likely to spread outside of the uterus, but are still considered lower grade and type 1.
- Grade 3 – is where <50% of the cancer cells resemble normal glands. These are very abnormal cells and they grow and spread rapidly. These fall into the category of Type 2 along with serous cell, clear cell, mixed, undifferentiated and carcinosarcoma.
STAGES OF ENDOMETRIAL CANCER
The stage of cancer is based on the findings in surgery, which include the tumor size, if it has spread to the lymph nodes and if it has spread (metastasized) to other tissues around the uterus, or other parts of the body such as the lungs, bone, or liver.
Stages are divided into one, two and three with subtypes of a and b and sometimes c. These stages are the same for endometrial carcinoma, serous cell carcinoma and clear cell carcinoma. Uterine sarcomas have different staging and I will give more information on that towards the end of this post.
- Stage 0 is considered a pre-cancerous lesion. There are cancerous cells in the very top layer of the endometrium (lining of the uterus), but they have not spread deeper. This is also sometimes called carcinoma in-situ.
- Stage I is when cancer cells are only present inside the uterus.
a. The cancer cells have spread <50% of the way through the myometrium (muscle layer) of the uterus
b. The cancer cells have spread >50% of the way into the myometrium, but are still confined inside the uterus
- Stage II is when the cancer has spread to the connective tissue of the cervix, but there is no spread to the lymph nodes or distant sites.
- Stage III is when the cancer has spread outside the uterus, but not to the inner lining of the bladder or rectum.
a. Spread to the outer surface of the uterus and/or the fallopian tubes or ovaries. There is no lymph node involvement
b. Spread to the vagina or other tissues around the uterus, but not in the lymph nodes.
c. Spread to the lymph nodes around the uterus
- Stage IV is similar to stage III however,
a. There is spread to the inner lining of the rectum or bladder and may or may not have spread to the lymph nodes
b. Spread to the inguinal lymph nodes and elsewhere in the body, for example the abdomen, lungs, liver and possibly other lymph nodes.
5 YEAR RELATIVE SURVIVAL FOR ENDOMETRIAL CANCER BY STAGE
Relative survival takes into account that some women will die of other causes. It compares the survival expected for a woman without endometrial cancer to someone with endometrial cancer.
- 90% for women with stage 0
- 88% for women with stage IA
- 75% for women with stage IB
- 69% for women with stage II
- 58% for women with stage IIIA
- 50% for women with stage IIIB
- 47% for women with stage IIIC
- 17% for women with stage IVA
- 15% for women with stage IVB
5 YEAR SURVIVAL BASED ON REGION
- Localized is when the cancer has not spread outside the uterus.
- Regional is when the cancer has spread to nearby areas such as the fallopian tubes, ovaries, cervix, and nearby lymph nodes.
- Distant cancer has spread to other body parts such as the bladder, rectum, liver, or bone and distant lymph nodes.
Localized endometrial cancer: 96 percent
Regional endometrial cancer: 72 percent
Distant endometrial cancer: 20 percent
UTERINE SARCOMA INFORMATION
Uterine sarcomas include leiomyosarcoma (most common), endometrial stromal sarcoma and carcinosarcomas. These cancers are more rare and aggressive. Unfortunately, sarcomas occur two times more frequently in black women than white women and carry a worse prognosis. These tumors can appear similar to a benign leiomyoma, also called a fibroid. They come from the smooth muscle layer of the uterus called the myometrium.
- Stage I the tumor is confined to the uterus
a. The tumor is < or = 5cm
b. The tumor is > or = 5cm
- Stage II the tumor has extended beyond the uterus, but is still within the pelvis
a. Involves the uterine adnexa, which includes ovaries, fallopian tubes, and connective tissues
b. Has spread to other tissues in the pelvis
- Stage III the tumor infiltrates other abdominal tissues
a. 1 site
b. > 1 site
c. Local lymph node spread (metastasis)
- Stage IV the same as stage III, but
a. the tumor has invaded the bladder or rectum
b. Distant metastasis and includes other lymph nodes
FIVE YEAR SURVIVAL FOR UTERINE SARCOMA BASED ON REGION
Localized uterine sarcoma: 60 percent
Regional uterine sarcoma: 37 percent
Distant uterine sarcoma: 12 percent
DON’T GET DISCOURAGED BY SURVIVAL STATISTICS
As you can see, the higher the type, grade and stage the survival rate goes down according to the statistics. Depending on where you look, the statistics can also vary.
I want to encourage you not to look too hard at the statistics though, because every one of us is different. Statistics are based on large groups of people and cannot predict what might happen with an individual person.
We can all be survivors and a big part of that is what we feed our minds. I learned early on that it did me no good to fill my mind with all the doom and gloom because I would have been dead by now according to the medical literature and my doctors and I’m still here.
It’s very important to start believing in yourself. Our bodies are meant to heal themselves. God has given us incredible healing powers if we would only use them! I needed to get the basic knowledge of what was going on, but after that, I refused to keep reading all the bad news and instead focus on what I could do to get well.
I decided early on that my body needed to heal this, not kill it. It was a part of me that was alerting me to the fact that I was not taking care of myself, my life was out of balance and I needed to change in a big way. That is what I set out to do and you can too!
ONE THING YOU CAN DO TODAY TO CONTINUE ON YOUR HEALING JOURNEY
Today’s tip is to have your doctor check your Vitamin D level. Vitamin D is very important in our bodies for numerous functions including our immune system, bone health and fighting off disease and cancer. Laboratory studies show that vitamin D can reduce cancer cell growth, help control infections and reduce inflammation.
Animal studies have found that vitamin D seems to change the way tumors behave, affecting the biology of their cells and making them less aggressive or likely to spread. Past research has also linked higher vitamin D levels at the time of a cancer diagnosis to longer survival, according to the study authors. Read More
Almost all people living in North America are deficient in Vitamin D. We just can’t get enough sunlight exposure to produce adequate levels. The therapeutic level should be 80-100 mg/dl, which is higher than the standard lab values. However, it has been shown to be very beneficial to have higher levels of Vitamin D.
I personally have to take 10,000 IU per day to keep my Vitamin D levels up in that range. Most doctors don’t routinely check this so please ask for it. Then get on an appropriate amount of supplementation and more sunshine (if possible) to raise your levels to that therapeutic range.
One other point is to always take a Vitamin K2 supplement along with Vitamin D. Vitamin D3 and vitamin K2 ensure that calcium is absorbed and reaches the bones, while preventing arterial calcification. Separately, K2 regulates normal blood clotting, while D3 supports a healthy immune system and supports muscle function. I take them as separate supplements, not combined into one so I get adequate levels of each.
Here are two products my naturopathic doctor recommends that I personally use. It beats swallowing pills and they last a long time!
O’ Lord my God, I cried unto Thee, and Thou hast healed me. – Psalm 30:2