Uterine cancer constitutes the most widespread cancer of the female reproductive tract and represents 13 percent of all cancers experienced by women. We can distinguish two main kinds of uterine cancer.
* Endometrial cancer — It’s the most frequent kind of uterine cancer. It appears in the inner lining of the uterus, known as the endometrium. Specialists still do not fully understand the exact cause of this disease. The majority of endometrial cancers are those of glandular cells, or adenocarcinomas. Women aged from 50 to 65 are the most vulnerable. Women are at greater risk of developing endometrial cancer when they have high levels of the hormone estrogen that are not counterbalanced by the hormone progesterone. Due to the fact that progesterone levels decline after menopause, postmenopausal women are very likely to develop this cancer. Other women that are at risk of having high levels of estrogen without enough progesterone are those suffering from obesity, who have a history of infertility, and who take long-term estrogen replacement therapy (for instance, due to the treatment of osteoporosis). Women who are also likely to develop endometrial cancer are those with high blood pressure and diabetes, and women taking regularly tamoxifen (Nolvadex) as a method of treatment of breast cancer.
* Uterine sarcoma — The uterine wall is composed of connective tissues, such as muscle, fat and fibrous tissue. If this type of tissue is affected by cancer we can talk of sarcoma. Uterine sarcoma happens rather seldom, and it represents only 2 per cent to 4 per cent of all cancers of the uterus. Although the cause of this disease is not known to specialists, it occurs most frequently in middle-aged and elderly women. Women who have undergone pelvic radiation in treatment of other cancers may be at greater risk of developing this cancer. African-American women seem to be at a great risk for one kind of uterine sarcoma, leiomyosarcoma. The scientists still do not know the exact cause of this disease.
Symptoms
The most important symptom of all uterine cancers is unusual bleeding from the vagina. It constitutes the crucial complaint of an estimated 90 per cent of women diagnosed with endometrial cancer and 85 per cent of postmenopausal women diagnosed with uterine sarcoma. For women in younger age, abnormal bleeding can include heavier menstruation than normally, spotting (bleeding between periods) and bleeding after sexual intercourse. For women in older age, any bleeding that occurs half a year after menopause starts may be a concern. Abnormal bleeding at the time menopause begins also ought to be reported to your healthcare provider.
Merely around 10 per cent of women suffering from uterine sarcoma feel pain before being diagnosed. Some of them also are able to feel a mass.
Diagnosis
If you observe signs and symptoms of uterine cancer, you should be examined by a gynecologist immediately. This specialist will investigate your medical history and will examine you, with special concentration on the pelvic area. The Pap test, an inspection of sample cells from the cervix and upper vagina, is frequently performed at this time. Nevertheless, normally it is possible to recognize uterine cancer only if it has spread outside the uterus.
Your healthcare provider may take a sample of endometrial tissue to be tested. An endometrial biopsy may be done in the physician’s office. In the course of this procedure, the healthcare provider suctions a small amount of tissue through a very thin tube inserted through the cervix into the uterus. It is possible that you will feel some cramps in the course of this procedure. A pathologist will examine the sample for cancerous cells.
If a biopsy does not provide any clear diagnosis, the physician may do an outpatient procedure known as dilation and curettage (D & C). During this procedure, the cervix is dilated (widened) and tissue is scraped from inside the uterus. The patient is always given general anesthesia or conscious sedation for this procedure. It’s frequent to experience bleeding for a few days after this procedure. Nevertheless, very few women complain of grave discomfort. In the course of the D & C , the physician may also use an instrument known as a hysteroscope to scrutinize the interior of the uterus.
Radiographic (X-ray) examinations may also be used to search for cancer inside the uterus. During a procedure known as a transvaginal sonogram, a probe is put into the vagina. The probe emits sound waves that bounce off uterine tissue, and creates images that make it possible for the doctor to locate cancerous cells. In the course of a specific kind of transvaginal sonogram, known as an ultrahysterosonogram, saline is inserted into the uterus through a catheter (tube) to help outline existing problems.
If cancer is acknowledged, your healthcare provider probably will ask you to visit a gynecologic oncologist, a doctor specializing in cancers of the female reproductive system. The subsequently step is to find out if, and how far, it has spread outside the uterus. Blood tests are normally ordered together with standard imaging tests, including a computed tomography (CT) scan and a chest X-ray.
Expected Duration
The size and extent of the cancer determines its stage. Higher rates of survival are connected with earlier stages. The following applies to uterine cancer:
* Stage I — The cancer is restricted to the uterus.
* Stage II — The cancer has spread from the uterus to the cervix.
* Stage III — The cancer has spread beyond the uterus, and is still limited to the area of pelvis.
* Stage IV — The cancer has spread to the inner surface of the urinary bladder or rectum. This stage can also suggest that the cancer has moved into the lymph nodes in the groin, or into organs located far from the uterus, such as the lungs.
Prevention
Due to the fact that specialists don’t fully understand the causes of uterine cancer, there are no clear strategies of preventing it. Some healthcare providers advocate a healthy diet and physical activity to help control weight and blood pressure.
If you undergo estrogen replacement therapy, talk to your healthcare provider about taking estrogen together with progesterone, and the necessity of regular examinations.
Treatment
Kinds of uterine cancer treatment include: surgery, radiation therapy, chemotherapy and hormone therapy.
* Surgery — If you have developed uterine cancer, most probably you will have to undergo some form of surgery. The procedure that s used depends mostly on the stage, kind and grade of the cancer. Your overall state of health may also constitute a factor. The most frequent surgery involves removal of the entire uterus and the ovaries. Complications occur very seldom, however both of these procedures result in infertility.
* Radiation therapy — Radiation therapy is also dependent on the stage, kind and grade of cancer. If you require treatment over a greater area due to the fact that the cancer has spread, you will be exposed to radiation from an outside source that is called external beam radiation. In other cases, a form of internal radiation known as brachytherapy will probably be used. During this procedure, a pellet of radioactive material is placed near the tumor. There can occur some side effects with both kinds of radiation, such as tiredness, skin irritation and diarrhea, however most soon go away after treatment has been completed.
* Chemotherapy — Chemotherapy is the use of medications in order to kill cancerous cells, is normally only used with uterine cancer when it has spread beyond the uterus.
* Hormone therapy — The aim of this type of therapy is to block cancer cells from getting the hormones they need to grow. With uterine cancer, it involves progesterone pills and in some cases of advanced or recurring disease, tamoxifen (Nolvadex).
When To Contact A Specialist
Contact a physician without any hesitation if you observe unusual vaginal bleeding. You also ought to notify your physician whenever pain occurs during urination, sexual contact, or in the pelvic area in general, even though uterine cancer is normally not the cause of these symptoms.
Prognosis
If the cancer is recognized and treated very early, the outlook is much better. Generally, 80 per cent of women suffering from uterine cancer survive five years or more. Nevertheless, it is essential to know that, even in the best of cases, there is a likelihood of the cancer returning. Follow-up care is necessary.
