Introduction of Uterus Cancer:
Cancers of the uterus (womb) usually begin in the cells that make up the lining of the uterus (called the endometrium). Cancers of the uterus are often called endometrial cancer because this term helps to distinguish them from other cancers that can affect the female reproductive system, such as cervical cancer or uterus cancer.
Uterus cancer refers to several types of malignancies that arise from the endometrium, or lining, of the uterus. Endometrial cancers are the most common gynecologic cancers in the United States, with over 35,000 women diagnosed each year. The most common subtype,endometrioid adenocarcinoma, typically occurs within a few decades of menopause, is associated with excessive estrogen exposure, often develops in the setting of endometrial hyperplasia, and presents most often with vaginal bleeding. Endometrial carcinoma is the third most common cause of gynecologic cancer death (behind ovarian and cervical cancer). A total abdominal hysterectomy (surgical removal of the uterus) with bilateral salpingo-oophorectomy is the most common therapeutic approach.
Uterus Cancer may sometimes be referred to as endometrial cancer. However, different cancers may develop not only from the endometrium itself but also from other tissues of the uterus, including cervical cancer, sarcoma of the myometrium, and trophoblastic disease.
What Causes Uterus Cancer?
As with any cancer, the exact reason why one woman gets uterine and another does not is unknown. However, there are well-recognized risk factors which increase a woman’s chance of developing it. These have much in common with breast cancer risks, since both cells in the uterus and breast respond to hormone stimulation:
- Obesity is linked to a 10 times greater risk of getting uterine cancer. Thus, other conditions associated with being too fat, such as diabetes and high-blood pressure are also linked to uterine cancer. The reason why obese woman get more uterine cancer is thought due to hormone changes caused by fat cells.
- Older Age (after menopause) is a factor for developing uterine cancer. The average age of a uterus cancer patient is 60 years old. Only about 10% of patients are less than 40 years old.
- Childless women are more likely to get uterine (and breast) cancer, since they have more “unopposed estrogen stimulation of the uterus.” This means that a woman’s uterine lining has a period of “rest” during pregnancy, estrogen levels are low and progesterone levels are high.
- Birth Control Pills containing only estrogen stimulate the uterine lining and thus increase the risk of cancer.
- Heredity– Women whose mothers or maternal aunts have uterine or breast cancer are at increased risk.
- Hyperplasia (thickening) of the uterine lining, especially when the cells look abnormal, can raise the chance of getting uterine cancer to 20%.
- Radiation Exposure is a rare, but possible cause of uterine cancers, especially those arising from the muscular wall of the uterus (“sarcomas”).
Uterus Cancer Treatment:
Surgery is the most common approach to treating uterine cancer. Additional therapy to destroy uterine cancer cells may include radiation, cancer-killing drugs (chemotherapy) and hormone therapy.
- Surgery– During exploratory surgery, doctors who specialize in tissue study (pathologists) examines the cancer tissue so your surgeon can determine how much tissue to remove. In most cases, your surgeon will recommend a hysterectomy (removal of your uterus) or a complete hysterectomy (removal of your uterus, fallopian tubes and ovaries). To find out whether your cancer has spread, your surgeon also removes tissue from the lymph nodes near the uterus and other abdominal sites.
- Radiation therapy– Radiation (high-level X-rays) kills microscopic cancer cells that may remain after surgery. If you have an aggressive form of uterine cancer or are at high risk for recurrence, you may need radiation after surgery. Occasionally, your doctor may recommend radiation instead of surgery if the tumor can’t be removed safely.
You may receive external beam radiation or brachytherapy. If you receive external radiation, your doctor may recommendintensity modulated radiation therapy (IMRT) to decrease damage to nearby healthy tissue.
- Hormone therapy– Your doctor may recommend progestin (synthetic progesterone) to help stop the cancer from spreading. You may take progestin with other medications.
- Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Symptoms of Uterus Cancer:
Uterus cancer symptoms are often vague. Women and their doctors often blame the symptoms on other, more common conditions. By the time the cancer is diagnosed, the tumor has often spread beyond the ovaries.
You should see your doctor if you have the following symptoms on a daily basis for more than a few weeks:
- Bloating
- Difficulty eating or feeling full quickly
- Pelvic or abdominal pain
Other symptoms are also seen with ovarian cancer. However, these symptoms are also common in women who do not have cancer:
- Abnormal menstrual cycles
- Digestive
symptoms:
- Constipation
- Increased gas
- Indigestion
- Lack of appetite
- Nausea and vomiting
- Sense of pelvic heaviness
- Swollen abdomen or belly
- Unexplained back pain that worsens over time
- Vaginal bleeding
- Vague lower abdominal discomfort
- Weight gain or loss
Types of Uterus Cancer:
There are two main types of Uterus (endometrial) cancer:
- Type 1 endometrial cancer is a slow-growing cancer, thought to be linked to the female hormone oestrogen.
- Type 2 endometrial cancer is a more aggressive, faster-growing form of cancer that does not appear to have any connection to oestrogen.
Type 1 endometrial cancer is the most common type, accounting for an estimated 80% of cases. Type 2 accounts for around 10% of cases.
As well as types 1 and 2 endometrial cancers, there are several rarer types of cancers of the uterus.
Uterus Cancer Surgery:
Surgery to remove the uterus (hysterectomy) is the most common treatment for uterus cancer. The surgeon will also remove the fallopian tubes, ovaries, and often the pelvic lymph nodes, which are examined to find out the extent of the cancer and to help plan your treatment. If examination of tissue determines that more aggressive cancer still may be in the lymph system, a lymphadenectomy may be done to remove and examine additional lymph nodes. Surgery has the highest cure rate of all treatments for endometrial cancer.
Surgery Choice:
- Hysterectomy with removal of the fallopian tubes and ovaries (bilateral salpingo-oophorectomy)
- Lymphadenectomy (removal of lymph nodes)
Estrogen replacement therapy (ERT) is often prescribed to relieve these problems. However, ERT is not commonly used for women who have had endometrial cancer. Because estrogen has been linked to the development of uterine cancer, many doctors are concerned that ERT may cause uterine cancer to recur. Other doctors point out that there is no scientific evidence that ERT increases the risk of recurrence. A large research study is being conducted to determine whether women who have had early stage endometrial cancer can safely take estrogen.
Follow up Care:
You’ll need regular checkups (such as every 3 to 6 months) after treatment for uterine cancer. Checkups help ensure that any changes in your health are noted and treated if needed.
You should contact your doctor if you have any of the following health problems between checkups:
- Bleeding from your vagina, bladder, or rectum
- Bloated abdomen or swollen legs
- Pain in the abdomen or pelvis
- Shortness of breath or cough
- Loss of appetite or weight for no known reason
Uterine cancer may come back after treatment. Your doctor will check for return of cancer. Checkups may include a pelvic exam, lab tests (such as for CA-125), a chest x-ray, a CT scan, or an MRI.
Prevention of Uterus Cancer:
You may be able to reduce your risk of developing uterus cancer through certain lifestyle changes such as stopping smoking and eating a healthy, balanced diet.
Getting enough vitamin D may reduce your risk of developing a number of cancers, including uterus cancer – although more research needs to be done to be certain. Vitamin D is also well known to be important for bone health.
Vitamin D is produced naturally by your body when your skin is exposed to sunlight and can also be obtained from some foods, such as oily fish. You may get enough vitamin D during summer by spending frequent short spells in the sun without wearing sunscreen (the exact time you need is different for everyone, but is typically only a few minutes in the middle of the day). However, do not let your skin redden. If you don’t get much sun exposure and particularly during winter months, taking up to 25 micrograms of vitamin D a day (two high-strength 12.5 microgram capsules) can help to make sure you get enough.
Cost of Uterus cancer treatment Surgery
In comparison to conventional surgery, Uterus cancer treatment surgery offers patients many benefits in terms of results and low costs. Cost savings include:
- Lower treatment cost – uterus cancer treatment is 30 to 70 percent less expensive than hospitalization for patients and surgical resection
- Fewer charges because most patients are released within 24 hours
- Faster recovery eliminates the hidden costs of long convalescence
