Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Nell Suby

Nell Suby, MD

Gyn Oncology

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Sacramento Medical Center
Appt/Advice: 916-614-4055

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Uterine sarcoma is a rare form of cancer. The term “uterine sarcoma” includes a group of cancers that grow in the uterine wall muscles and other tissues. 

The uterus (womb) is a pear-shaped organ located in the middle of a woman’s pelvis. This is where a baby grows when a woman is pregnant. 

If abnormal cells build up in the uterine wall or lining, they can form a tumor. A tumor can be:

  • Noncancerous (benign), which is usually not harmful and is easy to treat.
  • Cancerous/malignant, which damages the tissues where it develops.
  • Cancerous/metastatic, which spreads to and damages other parts of the body.

Treatment is usually successful if uterine sarcoma is caught early.

Uterine sarcoma is different from the other, more common type of uterine cancer, called endometrial cancer. That cancer develops in the lining of the uterus (endometrium).

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There are 4 main types of uterine sarcoma. Each type acts differently and requires its own method of treatment.

  • Two of the types develop in the uterine lining (endometrium). These are endometrial stromal sarcoma and adenosarcoma.
  • Two types develop in the muscular wall of the uterus (myometrium). These are leiomoysarcoma and undifferentiated sarcoma.

Risk Factors

We don’t know exactly what causes uterine sarcoma. Specific factors may increase your risk for this cancer. These include:

  • Tamoxifen. This medication is used to treat or prevent breast cancer. For most women, the benefits of taking tamoxifen are greater than the risks.
  • Radiation therapy. Radiation in the pelvic area is sometimes used to treat abnormal vaginal bleeding. This treatment can also damage the DNA (genetic material) of normal cells. 

Having risk factors does not mean that you will get uterine sarcoma. Some women have no risk factors but still develop this cancer.


We don’t have a screening test to catch uterine sarcoma before symptoms appear. So it’s important that you know what signs to watch for.

Please contact us if you have any of the symptoms listed here, especially if they continue over time.

The most common sign of uterine sarcoma is unusual vaginal bleeding. This can include bleeding that:

  • Occurs between your periods.
  • Is unusually heavy, during your periods.
  • Occurs after you’ve been through menopause (even just spotting). 

Be sure to let us know if you have an unusual vaginal discharge (with or without blood).

Other symptoms can include:

  • Frequent need to urinate.
  • A mass or tumor growing in the vagina.
  • Pain in the pelvic or abdominal area. 

Some of these symptoms are similar to other, less serious illnesses. Having symptoms is not a sure sign that you have uterine sarcoma.


Your gynecologist will ask about your medical history and symptoms. A women’s cancer specialist (gynecologic oncologist) may also see you.

We may use one or more of these methods:

  • Pelvic exam. We look for any unusual changes in your uterus, vagina, ovaries, and nearby tissues. We may do a Pap test during the exam.
  • Biopsy. We insert a thin tube through your vagina into the uterus. We collect tissue samples, which are checked for signs of cancer.
  • Dilatation and curettage (D and C). We open (dilate) your cervix and insert an instrument (curette) into your uterus. We remove tissue from the uterine lining, which is checked for signs of cancer.

We may use image studies to look for abnormalities in your uterus. The images may be taken by:

  • Transvaginal ultrasound. A narrow wand inserted into your vagina takes images and sends them to a screen.
  • CT (computed tomography) scan.
  • MRI (magnetic resonance imaging).

Diagnosis Based on Biopsy or Surgery

Your biopsy or D and C tissue samples will be checked by a specialist (pathologist). Sometimes the pathologist finds cancer in the muscle layer of the uterus, even though the uterine lining is normal.

Often, a uterine sarcoma is found when a woman has a hysterectomy due to another disease. If this happens to you, we will:

  • Ask you to talk with a women’s cancer specialist.
  • Discuss if you’ll need additional surgery.


If your biopsy or surgery shows cancer, we then determine its stage. The stage is based on tumor size and how far the cancer has spread in your body. 

We may need to do additional tests to determine the cancer spread. These may include:

  • Blood tests
  • Chest X-ray, CT scan, or MRI


We recommend treatment based on the type of uterine sarcoma you have and its stage (spread). Treatment options include:

  • Surgery
  • Radiation therapy
  • Chemotherapy
  • Hormone therapy

Uterine sarcoma usually occurs in women who have gone through menopause. If you are younger and may want to become pregnant, let us know. We’ll talk about how to protect your fertility before we start treatment.

Additional References:

Your Care with Me

If you suspect that you might have a uterine sarcoma, your first contact will typically be with your personal gynecologist, who will evaluate your health and symptoms. If specialty care is needed, your personal gynecologist will place a referral for an appointment in my department.

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.

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If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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