Uterine Cancer Overview

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Uterine cancer is a cancer that starts in the inner lining of a woman's uterus. The uterus is also called a womb or an endometrium. Uterine cancer usually develops in women who are post menopausal. It is unknown what exactly causes uterine cancer. Some known risk factors for uterine cancer include never having been pregnant, obesity, having started menstruating before age 12, and using estrogen therapy. Women suffering from uterine cancer experience symptoms such as heavy and prolonged periods, bleeding not related to periods, and post menopausal bleeding.

Treatment comes in the form of surgery and radiation. Many women with uterine cancer will require their uterus to be removed in a procedure called a hysterectomy. Radiation treatment follows to kill all remaining cancer cells in the body. Uterine cancers that have the chance to metastasize may not be successfully treated through surgery and radiation. Over 7,000 women in the United States will die as a result of uterine cancer throughout the year. All women who have entered menopause should begin to monitor themselves more closely and schedule doctors visits regularly to prevent a uterine cancer diagnosis or poor prognosis.

Causes of Uterine Cancer

Researchers have not named a direct cause of uterine cancer but some risk factors have been declared. The female body must maintain a proper level of estrogen and progesterone hormones. If the menstrual cycle for some reason produces too much estrogen, there is a stronger change of developing uterine cancer. Estrogen therapy is sometimes taken by women who are experiencing symptoms of menopause such as hot flashes and vaginal dryness. Estrogen therapy puts more estrogen in the body, a risk factor for uterine cancer. Family history plays a role in uterine cancer. Those with uterine cancer in the family are at a higher risk of developing the disease. Also, women who have had some type of radiation therapy already performed on their pelvic region have damaged cells in that area that could lead to uterine cancer.

Uterine Cancer Prevention

Uterine cancer in most cases cannot be prevented. One thing women can do to reduce their risk of getting uterine cancer that will help their body's out in other ways as well is exercising regularly and staying in shape. This keeps a woman's estrogen and progesterone levels balanced. Birth control pills are a good way of controlling estrogen and progesterone levels and the effects can decrease a woman's chances of developing uterine cancer up to ten years after discontinuation of usage. Being pregnant is also a good way to reduce the risks of developing uterine cancer. Women should visit their gynecologists to check for any possible sign of uterine cancer so the disease can be caught in it's earliest stage and treated.

Types of Uterine Cancer

Uterine cancer is made up of different types of tumors. Two main tumors are endometrial stromal sarcoma and uterine leiomyosarcomas. Other types of uterine tumors include mixed mullerian, mullerian adenosarcoma and cancer that reached the uterus but do not originate there. These cancers usually grow in the glands of the lining in the uterus. While sharing similar symptoms, they range in size and effect on the patient. These tumors can successfully be removed but they carry a strong probability of recurring within a few years.


Endometrial Stromal Sarcoma
Make up for 1% of all female reproductive system cancers

Do not develop in uterus' glands

Breast cancer prevention drug tamoxifen known to raise estrogen levels and cause these tumors.

May set develop just before menopause.

Can be successfully treated through surgery and menopause.


Uterine Leiomyosarcoma
Develop in smooth tissue lining of uterus.

Malignant.

Effects 1 out of 100,000 women each year.

May cause vaginal bleeding and foul odor.
May require a hysterectomy.

Likely to recur in former patients.


Uterine Cancer Symptoms

Uterine cancer symptoms usually occur after menopause but it is possible to occur before it. The most common symptom experienced by women with any type of uterine cancer is vaginal bleeding. There are varying degrees of vaginal bleeding. There can be light "spots" that appear or the bleeding can be extremely heavy and problematic. Since most women with uterine cancer are post-menopausal, the vaginal bleeding can easily be differentiated from a menstrual cycle. A foul-smelling vaginal discharge may accompany the vaginal bleeding. Some women wrongfully believe that the vaginal bleeding is a normal part of menopause. This is a reason some women do not consult their doctor as soon as they should.

Some women may experience pain while urinating or during sexual intercourse. Many uterine cancer symptoms may not be present until later stages of uterine cancer. Less common symptoms include fever, fatigue and weight loss. Women experiencing any symptoms that could possibly be uterine cancer should seek a medical professional immediately.

Uterine Cancer Screening

Women should receive uterine cancer screenings despite a lack of symptoms just to be safe. Screenings are a good precautionary measure. Pap tests are often given as a form of uterine cancer screening but they should not be heavily relied upon. Pap tests usually will not show any abnormal signs of uterine cancer until the cancer has advanced to the mouth of the cervix, close to entering the vagina. During a pap test, cells are collected and examined. If the cells show uterine cancer cells the cancer is likely already in an advanced state. In rare cases where the results of a pap test lead to a biopsy, uterine cancer could possibly be caught in an early stage. Many women are not concerned with receiving a uterine cancer screening because the disease is quite rare.

Uterine Cancer Diagnosis

It is important to diagnose uterine cancer as early as possible. Early detection allows for the simplest treatment options and the best prognosis. All women who begin menopause should have uterine screenings and either a biopsy, image test or blood test just to be sure they are in good health. There are tests that allow doctors to examine tissues, blood and inside patient's bodies.


Examining Tissue


Endometrial Biopsy- A vacuum-like tube is inserted in a patient's vagina and sucks pieces of endometrium out. These pieces of tissue can be examined during a biopsy.

Hysteroscopy- A hysteroscopy is characterized by a small telescope that is inserted through the cervix. The uterus is filled with salt water which lets the doctor more easily see and remove anything out of the ordinary such as signs of cancer signs or a polyp. Some medicine to numb the area is required before the procedure.

Dilation and Curettage- Dilation and curettage is a procedure in which the cervix is dilated and a special tool is used to scrape tissue from inside the uterus. It is performed if other biopsy tests failed to gather enough tissue to make a sure diagnosis.


Imaging tests

Ultrasounds- Ultrasounds checking for uterine cancer are characterized by the insertion of a special probe in the vagina. The probe lets off sound waves. The sound waves bounce off the tissue inside the uterus and may create an image of a tumor. The image created could also indicate if the cancer has grown into the outer muscle layer of the uterus.

Cystoscopy and Proctocsopy- A lit up tube enters either the bladder or rectum and the doctor can remove pieces of tissue to be examined and checked for cancer cells.

CT Scans- CT scans are rarely used to diagnose uterine cancer but they are sufficient for checking to see if the cancer has spread to other organs.

Chest X-ray- Chest x-rays check if the cancer has metastasized and spread to the lungs.

Blood Tests
Complete Blood Test- Blood tests can check for a reduced number of red blood cells. Women who have lost blood from the uterus (vaginal bleeding is a symptom of uterine cancer) may have a low number of red blood cells. This is known as anemia.

CA 125 Blood Test- CA 125 is a substance that many endometrium and ovarian cancers release into the blood stream. CA 125 in the blood can be monitored to diagnose if a patient has uterine cancer, test how the patient is responding to treatment and determine if the cancer is reemerging.

Uterine Cancer Staging

Uterine cancer staging is used to determine how advanced the cancer has become. Survival rates decrease and treatment becomes more complicated as uterine cancer levels advance. The staging system is based on the model set in place by the American Joint Committee on Cancer, named the TNM system. The letters stand for tumor (T), lymph nodes (N) and metastasis (M). Each letter is given a grade next to it. A combination of grades for each letter make up specific stages. Uterine cancer has five main stages (0-4), some of them with multiple sub-stages for other possibilities. The current stage the cancer is in will give doctors a good idea of how to treat the patient as well as determine a prognosis.

Uterine Cancer Prognosis

A uterine cancer prognosis depends on what type of tumor a patient has along with their past medical history and what stage the cancer is in. Prognoses are often based on a patient's chances of surviving five years past the original uterine cancer diagnosis.

Five-year survival rates are used to determine the likelihood a patient will survive based on the stage of the malignant tumor in their body.

 

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