Uterine Leiomyoma Vs. Leiomyosarcoma
Uterine leiomyomas and leiomyosarcomas arise from similar tissues, but their differences lie in their risk factors, symptoms and treatments. If you have questions about a symptom or risk factor you may have, or if you have questions about treatment, discuss your options with your doctor.
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Definitions
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Leiomyomas are benign tumors originating in smooth muscle tissue. The most common location for leiomyomas is the uterus. Uterine leiomyomas, usually known as uterine fibroids, are tumors that grow in, on or within the muscular walls of the uterus. Leiomyosarcomas are malignant smooth muscle tumors and, when found in the uterus, are called uterine sarcomas. Fewer than one in 1,000 leiomyomas turn into leiomyosarcomas.
Risk Factors: Uterine Leiomyoma
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Age is a risk factor for uterine leiomyomas, which are most common from the 30s through menopause. Fibroids tend to shrink following menopause. Overweight women and women who consume red meat and few green vegetables are at higher risk than women who have a different diet. Having a family member with fibroids raises risk, as does African ancestry.
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Risk Factors: Uterine Leiomyosarcoma
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The known risk factors for uterine leiomyosarcomas are few, and the presence of these risk factors, as with any risk factors, does not mean a patient will get the cancer. One such risk factor is previous radiation therapy to the pelvic region. Uterine sarcomas are also about twice as common in black women as in Asian or white women.
Symptoms: Uterine Leiomyoma
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While most uterine leiomyomas do not cause any symptoms, sometimes they can cause bleeding or heavier periods, pain during sex, lower back pain, frequent urination, or a feeling of fullness in or enlargement of the lower abdomen or pelvic area. For pregnant women, they can cause pregnancy or labor complications, including a six-times greater risk of cesarean section deliveries. In rare cases, fibroids can cause infertility or reproductive issues.
Symptoms: Uterine Leiomyosarcoma
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The symptoms for uterine leiomyosarcoma can also be symptoms of other, non-cancerous conditions, so any symptoms should be discussed with your doctor. Abnormal spotting or bleeding between periods or bleeding occurring after menopause should be examined, as should any bloodless discharge. Some women experience a feeling of fullness or pain in the pelvic area or find an abdominal mass, which should also be discussed with a doctor.
Treatments: Uterine Leiomyoma
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For women without symptoms, no treatment is generally required. Mild symptoms are usually controlled with a combination of over-the-counter and prescription medications. For moderate or severe symptoms, the most common treatment is surgery. There are many surgical options available, with varying degrees of invasiveness. Selecting surgical options depends on the location and severity of the fibroids and symptoms, as well as whether the patient wishes to have children.
Treatments: Uterine Leiomyosarcoma
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The most common treatments for uterine leiomyosarcoma are surgery, radiation therapy and chemotherapy. The goal of surgery is to remove all of the cancer, which can often involve a total or radical hysterectomy. Internal (brachytherapy) and external beam radiation therapy are radiation treatment options, and many different forms of chemotherapy are available for treatment. Hormone therapy is only used for a few specific kinds of uterine sarcomas.
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