Over 60,000 women in the U.S. get diagnosed with uterine cancer every year, making cancer of the uterus the 2nd most common female cancer. Recently, uterine cancer has been linked to exposure to certain chemicals putting this disease at the center of several mass torts including hair relaxer lawsuits and Camp Lejeune toxic water lawsuits. On this page we provide a simple overview of uterine cancer from a medical standpoint and look at how it has become involved in litigation.
The uterus is the largest female reproductive organ. This pear-shaped organ is often referred to as the “womb” and it is where human life begins in the form of fetal development during pregnancy. The uterus is comprised of 3 separate parts: (1) fundus, (2) isthmus, and (3) cervix.
The uterus is essentially a sac composed of 3 separate layers. The endometrium is the innermost layer on the inside of the uterine wall. The middle layer, the myometrium, is the thickest part of the of wall and is mostly muscle. The outermost layer is called the serosa.
During the female reproductive years, the inner endometrium layer of the uterus becomes thicker every month from hormones triggered by ovulation. This process is designed to prepare the uterus for pregnancy. When pregnancy does not occur, the thickened layer of the endometrium is shed resulting in the monthly bleeding of the menstrual cycle.
Cancer of the Uterus
Uterine cancer refers to cancer that originates in the tissue of the uterus. Approximately 65,000 women get diagnosed with uterine cancer on an annual basis, making it the most common type of female reproductive cancer. Uterine cancer actually refers to 2 distinct types of cancer originating in the uterine tissue: (1) endometrial cancer, and (2) uterine sarcoma.
Endometrial Cancer: endometrial cancer (adenocarcinoma) is the most common of the 2 types of uterine cancer, accounting for nearly 90% of uterine cancers. Endometrial uterine cancer develops when abnormal cells in the endometrial tissue (the inside layer of the uterus) form into cancerous tumors. There are different histologic subtypes of endometrial cancer based on the nature and characteristics of the cancer cells. Endometrioid carcinoma is the most common subtype of endometrial cancer.
Uterine Sarcoma: uterine sarcoma is the second type of uterine cancer. Uterine cancer classified as uterine sarcoma occurs when the cancer cells originate and lead to a tumor in the myometrium, which is the middle muscle layer of the uterus, or in the uterine glands. This type of uterine cancer is rare. Only about 1 in 10 uterine cancer cases are classified as uterine sarcoma. There are 3 recognized histologic subtypes of uterine sarcoma: leiomyosarcoma, endometrial stromal sarcoma, and undifferentiated sarcoma. Uterine sarcoma is much more aggressive and dangerous than endometrial.
Statistics on Uterine Cancer
In 2022, an estimated 65,950 women will be diagnosed with uterine cancer. This accounts for about 4 out of every 100 cancer cases (women and men) in the U.S. and for women uterine cancer is the 4th most common cancer type. In the U.S. and Europe, the rate of uterine cancer has been increasing by about 1% each year since the early 2000s.
The overall 5-year SEER survival rate for uterine cancer (all stages and types) is 81%. For the endometrial type of uterine cancer, however, the survival rate is even higher. The high survivability rates for uterine cancer are partly due to the fact that uterine cancer is generally diagnosed in its early stages. This is because one of the first symptoms of the disease is abnormal vaginal bleeding, which prompts most women to see a doctor right away.
When diagnosed in its early stages (Stage I or Stage II) before its spreads outside the uterus, uterine cancer is highly treatable and has a survival rate of 95%. At Stage III (where the cancer has spread regionally only) the survival rate drops to 69%.
Uterine Cancer Treatment Options
The available treatment options for uterine cancer include (1) surgery, (2) chemotherapy, (3) radiation therapy, and (4) hormone drugs. Most uterine cancer treatment plans involve some combination of these various options or all of them. Surgical removal of the uterus and cervix (a hysterectomy) is generally a required treatment for all uterine cancer cases no matter what stage. In certain cases, a radical hysterectomy (removal of the uterus, cervix, and upper section of the vagina) is recommended to prevent the spread of cancer.
Surgical removal of the ovaries and fallopian tubes is also common for most uterine cancer cases. This is an added defense against the cancer spreading to these other reproductive organs, which become unnecessary following the removal of the uterus anyway.
Pelvic radiation therapy uses targeted radiation beams to destroy free cancer cells inside the body. Radiation treatment is most often done after surgery to eliminate uterine cancer that may still be lingering in the pelvic region. Radiation therapy can also be used before surgery to shrink the tumor.
Chemotherapy treatment is also aimed at eliminating remaining free cancer cells in the body. Chemo can be done instead of or in addition to radiation treatment. For uterine cancer subtypes that are hormone-positive, hormone therapy medication to control the production of estrogen is also utilized in the treatment plan.
Diagnosing Uterine Cancer
The early symptoms of uterine cancer almost always include abnormal vaginal bleeding and/or severe abdominal pain. The doctor will perform a pelvic exam and if uterine cancer is suspected an endometrial biopsy will be performed. This involves taking a small tissue sample from the endometrial layer of the uterus. The tissue sample is then examined by a trained pathologist who looks for indicators of cancer cells. The endometrial biopsy is a very accurate diagnostic tool for uterine cancer.
Transvaginal ultrasound, a CT scan, or MRI are alternative diagnostic imaging tools that can be used to diagnose uterine cancer. Usually, however, the biopsy is the initial diagnostic method and these imaging tools are used to assess the extent of the disease after diagnosis.
Uterine Cancer Risk Factors
Certain factors or circumstances are known to make some women more likely to develop uterine cancer compared to other. The accepted risk factors for uterine cancer include:
- Obesity: women who are chronically overweight are at higher risk for uterine cancer. This is because fat tissue stimulates the production of estrogen and most types of uterine cancer (as well as other female reproductive cancers) are fueled by estrogen.
- Age: older women are more likely to get uterine cancer. Uterine cancer is very rare among women under 50 and the average age at time of diagnosis is around 60.
- Genetics: some women are genetically pre-disposed to uterine and other cancers. Signs of genetic predisposition include a family history of uterine cancer (or other female cancers) and colon cancer.
- Hormones: new research has revealed that prolonged exposure to estrogen or an overproduction or imbalance of this key hormone has a direct correlation with increased rates of uterine cancer.
Hair Relaxer and Straightener Linked to Uterine Cancer
The latest scientific and medical evidence has shown that the use of chemical hair relaxer or hair straightener products for long periods of time can significantly increase the risk of developing uterine cancer. Hair relaxers or hair straighteners are products primarily used by Black women in the U.S. to force their hair to lay flat. Hair relaxer products use strong chemicals that disrupt the endocrine system which produces hormones like estrogen.
In October 2022, the National Institutes of Health (NIH) released the results of a decade-long study called the “Sister Study” which looked at the potential health impact of long-term exposure to chemicals in hair relaxers. The results of the Sister Study were published in a major medical journal and they caused shockwaves in the scientific and healthcare communities.
The Sister Study reported that women who used chemical hair relaxers or hair straighteners at least 4 times a year over several years were 4 times more likely to be diagnosed with uterine cancer compared to women who never used these products. Women who occasionally used relaxers were 2 times more likely to get uterine cancer. The groundbreaking results of the Sister Study have already prompted the start of what could be thousands of hair relaxer lawsuits.
Settlement Value of Uterine Cancer in Tort Cases
There average settlement value of uterine cancer as the primary injury tort cases is between $400,000 to $1,800,000. The reason for the wide value range is that the prognosis and circumstances of an individual uterine cancer case can vary significantly. If uterine cancer is diagnosed early the survival rate is very high and if the woman is postmenopausal there is no loss of fertility. By contrast, if uterine cancer is caught in a later stage or if the woman is still in her reproductive years, the potential value of the case can be very high.
Uterine Cancer Settlements and Verdicts
Summarized below are recent tort cases (mostly medical malpractice) in which the plaintiff’s primary injury was uterine cancer.
- $1,800,000 Settlement (Illinois 2020): delay in diagnosis of endometrial uterine cancer by doctor caused 4-year delay in treatment allowing cancer to progress and spread. Plaintiff was only 41 years old which increased the value of the case.
- $500,000 Settlement (Washington 2018):negligent failure to diagnosis case involving a 5-month delay in treatment of uterine cancer in a 71-year-old plaintiff with a previous history of cancer. Age and history of plaintiff reduced the value of this case.
- $600,000 Settlement (New York 2015):relatively short delay in uterine cancer diagnosis of 35-year-old woman. Although plaintiff was only 35, she did not plan on having more children so no tragic loss of reproductive capacity.
- $430,000 Settlement (Minnesota 2014):2-year delay in diagnosis of uterine cancer in 61-year-old patient caused the cancer to progress to Stage 3C resulting in worse survival rate.
- $1,750,000 Settlement (Massachusetts 2013): doctor failed to timely diagnose uterine cancer and delay allowed cancer to spread to lungs and progression to terminal stage in 51-year-old plaintiff.