The most common kind of uterine cancer is the endometrical cancer which accounts for 95% the other is uterine sarcoma which develop in the
muscle and accounts for only 59% of uterine cancer.
 Endometrical cancer usually adenocarcinoma of the endometrium of the fundus or body of the uterus is the most common gynecologic cancer.
Most patients are post menopausal with average age of 61 at the time of diagnosis.
Endometrial cancer can be caused by hormonal imbalance; when there is unopposed oestrogen circulation with no or low progesterone in the uterus to grow thicker; if this build up continues, and stays that way, cancer cells can start to grow.
RISK FACTORS
Family history of cancer
Diabetes mellitus
Previous radiation therapy
Obesity hypertension, nulliparity, low parity
  CLINICAL MANIFESTATION
In over 90% of cases there is abnormal uterine bleeding this could be pre or postmenopausal.
Watery usually malodorous (unpleasant smelling) vaginal discharge
Pain during sexual intercourse
Pelvic pain, bowel and bladder dysfunction are late signs
Anaemia secondary to bleeding
DIAGNOSTIC EVALUATION
·           On pelvic and rectovaginal examinations, enlarged uterus may be palpated
·           Endocervical aspirations shows abnormal cell growth
·           Endometrial biopsy result may be false (negative)
·           Dilation and curettage most accurate diagnostic tool; hysteroscopy and transvaginal ultrasound may be helpful.
MEDICAL MANAGEMENT
•        Staging for endometrical cancer is based on surgical aspects vs clinical staging.
            a.    Emphasis is placed on histologic grade, depth of myometrial invasion and cervical involvement. 
              b.These parameters assist in prediction of lymph node involvement and help determine need for lymph         node dissection.
•      Stage I: requires total abdominal hysterectomy with bilateral salpingo – oophorectomy (TAH/BSO)
•      Advanced stage I and stage II requires (TAH /BSO) and selective lymphonode dissection.
•      Radiation therapy (intracavitary or external) may be added after surgery or chosen instead of surgery for more advanced stages or for patients who are high-risk surgical candidates.
 
Complications of Radiation Therapy
Hemorrhagic cystitis, virginities, vaginal dryness, vaginal stenosis, bladder  dysfunction fistulas strictures leg oedema. 
•      Hormonal therapy:- progestational agents magatte receptor sites in endometrial for oestrogen and thus decrease growth/metastesis may provide stabilization to disease.

•      Chemotherapy for metastatic and recurrent disease