Our Gyno Health

Rare Uterine Fibroids are Actually A Cancer

Benign uterine leiomyomas (fibroids) are the most common gynecologic tumor growth, with about a lifetime risk 70 to 80 percent). Uterine sarcoma, the cancerous form of uterine cancer is rare: 3 to 7/100,000 in the United States population according to UpToDate. If you are told you have a fibroid, you can assume your do not have a cancer since only 0.1 percent are cancerous. If you have ‘uterine cancer’ in your family it is most likely lining cancer and cancerous fibroids are not really thought to ‘run in families.’ We aren’t sure if diet, smoking, exercise, or hormone use affects any risk of changing fibroids into cancer, but we always suggest maximizing your health to improve your chances of avoiding treatments and surgeries.

●Most physicians will say rapid growth is the sign of cancer, not just a fibroid. So getting yearly pelvic exams does help determine if there has been a rapid change in the size of your uterus. Both non-cancerous fibroids also called leiomyomas, and the cancers uterine sarcomas, both typically cause with abnormal uterine bleeding, pelvic pain/pressure, and a pelvic mass.

●A rapidly enlarging uterine mass is not a uniformly reliable sign of a uterine cancer in a young women, but as we get older, past menopause a new or growing uterine mass warrants further evaluation. Hormone therapy may cause a small increase in the size of a pre-existing fibroid. leiomyoma, so it’s important to be monitored when starting hormone therapy for the presence of a fibroid.

●Fibroid size is not always a good predictor, most very large uterine fibroids are not at any different risk of cancer than a smaller uterus.

●Getting a D and C or an endometrial biopsy usually only samples the lining of the uterus looking for uterine endometrial cancers, and yet rare cases of cancer of the actual uterine wall can be found. Even if you think you have an explanation for an unusual period (stress, hormone treatment) endometrial sampling is important.

●Ultrasounds are the best test of uterine fibroids, but other tests can be used. These imaging studies cannot reliably differentiate between cancer and non-cancer.

●Magnetic resonance imaging (MRI) with contrast may be helpful to determine whether you have cancer.

●There are many reasons to have surgery, including hysterctomy, if you have fibroids, but most women with fibroids do not need surgery, just watching.

●Leiomyomas rarely can change into a cancer, which is why they need to be watched so carefully.


Suzanne Trupin, MD, Board Certified Obstetrician and Gynecologist and owner of Women's Health Practice, Hada Cosmetic Medicine, and Hatha Yoga and Fitness

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