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Uterine Cancer Overview
Uterine cancer is also called endometrial cancer and begins in the endometrium or lining of the uterus. It is the most common type of uterine cancer although there are other rarer types such as sarcomas of the uterine muscle. It is related to having an increased level of estrogen in the body, which stimulates the uterine lining to grow. It causes buildup of the lining and eventually cancer cells grow out of the thickened lining. Studies in animals have shown that increased oestrogen means an increased degree of uterine cancer. Most cases occur between the ages of 60-70 but can occur before the age of 40 in a few situations.
There are several factors that increase the risk of uterine cancer. If you have diabetes or are on oestrogen replacement therapy without progesterone therapy concurrently, you have a greater risk of getting endometrial cancer. If you have had benign polyps of the endometrium, this puts you at a greater risk of later cancer. If you are infertile, you can get endometrial cancer. If you have infrequent periods, you are at greater risk of getting cancer of the uterus. Women on Tamoxifen for breast cancer are at greater risk. Women who have never had children or are obese have a greater risk for uterine cancer. Women who have menstruation before aged twelve or menopause after age 50 have a greater risk for endometrial cancer and women who have polycystic ovarian syndrome or PCOS have a greater risk. Endometrial cancer is also associated with having colon or breast cancer in the past, gallbladder disease, high blood pressure or high blood pressure.
Symptoms of endometrial cancer include having abnormal periods or abnormal vaginal bleeding after menopause. Bleeding between periods can play a role in the disease. Vaginal bleeding after menopause is a great symptom of the disease. Women who have long or heavy vaginal bleeding after the age of forty and who have abdominal cramping or pelvic cramping have an increased risk for having uterine cancer. There can be a thin white or clear vaginal discharge after menopause as a sign of uterine cancer.
Doctors can test for the presence of uterine cancer in several ways. The uterus can be of an unusual size or shape when palpating the uterus. An endometrial biopsy or aspiration can be done to show cancerous cells under the microscope. A full dilation and curettage can get a larger area of endometrial tissue for analysis in the laboratory. Sometimes a Pap test can show changes suspicious for an endometrial cancer but it is not a good test for the diagnosis of the disease.
Once doctors find endometrial cancer, they must stage the cancer to help in prognosis and treatment of the disease. Stage I disease is only within the endometrium and uterus. Stage II disease is in the uterus and in the cervix. Cancer has spread to outside of the uterus in stage III cancer and in stage IV cancer, the tumor has spread to other body areas outside the pelvis.
The treatment of uterine cancer involves doing surgery to remove the uterus, tubes and ovaries. Radiation therapy is done to remove any specific areas of cancer not removed during surgery. Some types of uterine cancer respond to chemotherapy as well. When surgery is done, it is done using an open abdominal surgery in order to get a better look at the entire uterus and surrounding tissue, in case metastases are found. Chemotherapy is used in stage III and stage IV disease and gets to the entire body to remove residual endometrial tissue.
Prognosis of endometrial cancer is good if it is diagnosed in the early stages. Up to 92 percent of women survive for a year. If cancer has not spread at all, up to 95 percent of women survive past the five year mark. If the cancer is stage IV, however, the five year survival rate is only about 23 percent.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here