Abnormal growth of any type of cells comprising uterine tissue is known as uterine cancer. It is the most common type of cancer, affecting the female reproductive system and is prevalent in post-menopausal women, at 60 years of age on average.
Symptoms of uterine cancer
Uterine cancer is often diagnosed in its early stages. Some of the symptoms that may lead to diagnosis are:
- Abnormal vaginal bleeding
- Postmenopausal bleeding
- Intermenstrual bleeding
- Vaginal discharge
- Bleeding after sex
- Burning micturition
- Pain in pelvis
- Pain in the lower back
- Drastic weight loss
- Bowel changes
- Loss of appetite
Causes of uterine cancer
There is no known cause of uterine cancer but some researches suggest that high levels of estrogen in the blood lead to endometrial growth. Sometimes due to genetic abnormality, endometrial cells may arrest in the replicating phases of the growth cycle, resulting in abnormal growth of cells. This leads to the formation of a tumor. There can be several causes for high estrogen levels, some of which are as follows:
- Females on estrogen replacement therapy
- Use of drugs such as tamoxifen
- Irregular menstrual cycle
Types of uterine cancer
There are two major types of uterine cancer depending upon the location. These are:
- Endometrial cancer begins in the endometrial cells that line the womb. This is the most common type of uterine cancer and is slow in progression.
- Uterine sarcoma, also known as soft tissue sarcoma develops in the muscular wall or other tissues of the uterus. This is very rare but aggressive in nature, thus, making it harder to treat.
The exact cause of uterine cancer is still unknown but some factors put certain women more at risk to develop it than others, those are:
- Postmenopausal women
- Females on estrogen replacement therapy
- Females with a family history of uterine cancer
- Those with a history of rectal or breast cancer
- Women on certain medications such as tamoxifen
- Females with menstrual irregularities
- Those who have endometrial hyperplasia
- Early menarche
- Late menopause
- Those with metabolic syndromes
- Females who have type 2 diabetes
Uterine cancer cannot be prevented but some measures can be taken to decrease its risk:
- Regular screening after menopause
- Take progesterone in a combination with estrogen as estrogen replacement therapy
- Maintain a healthy and active lifestyle
- To avoid relapse, consider getting a hysterectomy along with bilateral salpingo-oophorectomy
Management of uterine cancer
If diagnosed at an early stage, it has a good prognosis and can be managed easily.
A single test cannot diagnose uterine cancer, a series of investigations are conducted to formulate a definitive diagnosis. These are:
- Pap smear screening test to look for any abnormal cells
- Blood tests to check the general health of the body and the functioning of different organs
- Pelvic examination to look for any visible mass or deformity
- Transvaginal ultrasound to rule out other possible causes and look for a tumor. This also detects any change in the thickness of the endometrium
- Biopsy to confirm the presence of cancer cells
- Dilation and curettage to remove the tissue from the uterus, this sample is then sent to the lab to look for signs of the disease
- MRI scan and CT scan for detailed images of the body to look for any signs of metastasis
- Chest X-Ray to check the spread of cancer to the lungs
- Lymph node dissection to look for any abnormal cells, in case of metastatic cancer
The treatment plan depends upon the type of cancer and the extent of its spread. Some of the treatment options that can be employed are as follows:
- Total hysterectomy involves removal of the uterus including the cervix
- Bilateral salpingo-oophorectomy is the removal of both ovaries and fallopian tubes
- Radical cystectomy is the removal of the uterus, cervix, and some parts of the vagina. In some cases, the ovaries, fallopian tubes, and regional lymph nodes are also removed
- Lymphadenectomy is the removal of the affected lymph nodes
Radio waves are employed to destroy the cancer cells or stop their growth. This is usually done post-surgically to avoid the relapse of cancer by destroying the remaining cancer cells.
Chemotherapy involves the use of drugs to inhibit the growth of cancerous cells. Some drugs do this by killing the cancer cells while others interfere in the growth cycle and stop the abnormal replication of cells.
When to consult a doctor?
If you begin to experience any change in your normal menstrual cycle or any abnormal sign or symptom after menopause, you should not ignore it. Signs such as intermenstrual bleeding, postmenopausal bleeding, pelvic pain, drastic weight loss, and loss of appetite should be given attention and an appointment with a physician should be booked as soon as possible.
Which type of uterine cancer is more lethal?
Uterine sarcoma is more aggressive and spreads rapidly as compared to endometrial cancer and is difficult to treat.
Where does uterine cancer spread to?
Uterine cancer mostly metastasizes to the bladder or rectum but can also inhabit the vagina, fallopian tubes, peritoneum, lungs, liver, brain, and heart.
Can a pap smear test detect uterine cancer?
No, a pap smear test is done to look for the disease before the onset of any signs and symptoms. In case of the presence of abnormal cells, other diagnostic tests are conducted such as biopsy, CT scan, and MRI.
Does a person with uterine cancer bleed all the time?
No, every individual experiences different signs and symptom. Not all women with uterine cancer, bleed.