Endometrial cancer, or uterine cancer, is the most common cancer of the female reproductive organs. About 60,000 new cases of cancers involving the uterus are reported in the U.S. each year, according to the American Cancer Society. Nearly 9,000 women die each year from the disease.
A missed or delayed diagnosis of uterine cancer can decrease a patient’s chance of recovery and survival and may cause the patient to undergo harsher treatments for a longer period of time.
What is Uterine Cancer?
The uterus is a hollow organ the size and shape of a medium-sized pear, and is comprised of the cervix (lower part) and corpus (upper part). It has three layers:
- Endometrium (inner)
- Serosa (outer)
- Myometrium (muscular middle layer).
Nearly all uterine cancers start in the endometrium cells that line the inner part of the uterus. The most common type of uterine cancer is endometrioid adenocarcinoma (about 80 percent of cases). A less common form of uterine cancer starts in the squamous cells. Uterine sarcoma – cancer of the muscle and supporting tissues of the uterus – involves about two percent of uterine cancer cases.
How Is Uterine Cancer Diagnosed?
Estrogen and progesterone are the two primary hormones related to the menstrual cycle. A shift in the hormonal balance toward estrogen increases the chance of developing endometrial cancer. After menopause, the ovaries stop making these hormones, but a small amount of estrogen is still made naturally in fat tissue.
Women in menopause who undergo estrogen therapy to reduce hot flashes, improve vaginal dryness, and help prevent bone degeneration (osteoporosis), can be exposed to an increased risk of uterine cancer if they don’t take progesterone drugs to balance the estrogen intake.
No screening test exists for this type of cancer. The cause of uterine cancer is not known, although certain risk factors, particularly a hormonal imbalance, can lead to the disease. Risk factors for developing uterine cancer include:
- Prior breast or ovarian cancer
- High-fat diet
- Sedentary lifestyle.
Women who have used birth control pills lower their risk of uterine cancer. Women who have had fewer menstrual cycles due to pregnancies, and/or starting menstruation after the age of 12 also have a lower risk of getting uterine cancer.
Symptoms of uterine cancer include abnormal vaginal bleeding or discharge, pelvic pain, an abdominal mass, and/or rapid weight loss. The early stages of the cancer may not cause any symptoms. A regular pelvic exam is helpful in detecting endometrial cancer.
A biopsy is the only method for obtaining a definitive diagnosis. An endometrial biopsy involves a flexible tube that is inserted into the uterus through the cervix. The tube uses suction to remove a small amount of the endometrium. A hysteroscopy involves inserting a tiny telescope into the uterus through the cervix. The uterus is filled with salt water to allow the doctor to see and remove anything appearing abnormal for microscopic examination. Another biopsy method is known as dilation and curettage, involving enlarging the cervix to allow scraping of tissue from inside the uterus.
If uterine cancer is detected, further procedures are usually undertaken to determine if the disease has spread to the bladder, rectum or other organs. A cystoscopy involves placing a lighted tube into the bladder through the urethra, and a proctoscopy involves a lighted tube placed into the rectum. CT scans, MRIs, ultrasounds, and/or PET scans are also used to help assess the spread of the cancer.
Missed or Delayed Diagnosis of Uterine Cancer
A uterine cancer misdiagnosis or a delayed diagnosis can occur in a variety of ways, such as:
- A treating physician’s delay in referring a patient to a specialist (gynecologist), especially when a patient presents with symptoms and has high risk factors such as obesity or diabetes
- An incomplete physical examination when symptoms are present such as failing to take a detailed medical history or thorough summary of all symptoms, or failing to conduct a thorough pelvic exam to check for any lumps or masses
- Misdiagnosing symptoms without ordering follow up tests for a more definitive diagnosis
- Failing to recognize the significance of symptoms warranting referral to a specialist for a proper evaluation and management of a patient’s care
- Failing to order a biopsy to rule out cancer
- An improperly conducted biopsy
- Misreading biopsy results
- Mislabeling or mishandling biopsy specimens obtained for examination
- Failing to mandate adequate follow up in the absence of definitive findings
- Failing to communicate test results to a patient
- Failing to obtain test results previously ordered.
Consequences of Missed or Delayed Diagnoses of Uterine Cancer
Like other cancers, early detection of uterine cancer greatly increases the likelihood of survival and recovery. When the cancer cells are only in the surface layer of cells of the endometrium (Stage 0/pre-cancerous lesion), the five-year survival rate is 90 percent.
If the cancer is only in the body of the uterus and has not spread into the supportive or connective tissues of the cervix (Stage 1), the five-year survival rate is 75-88 percent.
Stage II of the disease is when it has spread into the supportive or connective tissues of the cervix. The survival rate for Stage II is 69 percent.
When the cancer has spread outside the uterus or into nearby tissues in the pelvic region (Stage III), the five-year survival rate drops to 47-58 percent.
Stage IV of the disease involves the spread of the cancer to the inner surface of the bladder or rectum, lymph nodes in the groin, and/or to distant organs. The five-year survival rate is 15-17 percent.
Surgery is the main treatment for uterine cancer. A hysterectomy involves removal of the uterus and cervix. Sometimes a procedure (bilateral salpingo-oophorectomy) is undertaken at the same time to remove the ovaries and fallopian tubes. A surgeon may also remove lymph nodes in the pelvic region to determine if the uterine cancer has spread. Surgery is sometimes combined with radiation therapy, chemotherapy, or hormonal therapy.
Our Delayed Uterine Cancer Diagnosis Attorneys Can Help You
The medical malpractice lawyers of Powers & Santola, LLP, are dedicated to helping those who have suffered undue harm as the result of a missed or delayed diagnosis of uterine cancer. We serve clients throughout Albany, Syracuse, Rochester, and across New York State. Call or contact us online today to receive a free and confidential consultation.