by What is Endometrial Cancer?
Endometrial Cancer (Uterine Cancer) begins in the uterus when the cells of the inner lining of the uterus begin to divide and grow due to abnormal changes in their DNA. Over time a tumor develops, which we call cancer. Uterine cancer and cervical cancer are two different cancers.
Read More : Cervical Cancer
What are the symptoms of Endometrial Cancer?
The main symptoms of uterine cancer are:
- Abnormal vaginal bleeding or spotting.
- Vaginal bleeding even after menopause
- Pelvic pain
- Dyspareunia
- Abnormal vaginal discharge (bloodstained, yellow)
- Weight loss
- Fatigue
- Loss of appetite
The research is still going on and the exact cause of endometrial cancer is unknown till yet. Some experts believe that high levels of estrogen may be to blame. Cervical cancer is mostly treated by surgery.
Uterine cancer status in India
Endometrial cancer is more common in Western women. However, according to a study, the rate in India is 4.3 per one lakh women.
The life expectancy of endometrial cancer in India
The above study also found that the survival rate of endometrial cancer patients in India for 5 years was 92%. Five-year rates are among women under 50 years of age (97%), non-tobacco users (94%), those with no family history of cancer (93%), and those treated by surgery. Among them (95%) women are safe from this disease.
Causes of Cancer in the Uterus
How and why does cancer occur in the uterus (uterus)?
Cancer of the uterus occurs when the cells of the endometrium become abnormal due to genetic changes. These cells grow rapidly and form tumors. Why these changes occur in DNA is still unknown. Some experts believe that high levels of estrogen may be responsible for the disease. Estrogen and progesterone are two female sex hormones produced in the ovaries. When the balance of these two hormones changes, the endometrium may also change. According to research, if estrogen levels increase but progesterone levels do not increase, the lining of the endometrium can thicken and possibly lead to cancer. (Endometrial thickness is also called endometrial hyperplasia )
Risk factors for Endometrial (uterine) Cancer
Your chances of getting uterine cancer are increased in the following situations:
Age and menopause – Most cases of endometrial cancer occur in women between the ages of 60 and 70. At this age or having gone through menopause, the following factors increase the risk of developing cancer of the uterus –
Hormone Replacement Therapy (HRT) – If hormone replacement therapy contains the hormone estrogen but not progesterone, there is an increased risk of cancer in the uterus. Hormone replacement therapy is sometimes used to treat symptoms of menopause.
Late Menopause – Even if menopause occurs at an older age, the chances of getting uterine cancer increase.
Early onset of periods – Women who have had their periods before the age of 12 are at a higher risk of uterine cancer.
Infertility or never being pregnant – Women who have never been pregnant or who have problems with infertility are also at higher risk of cancer of the uterus.
Hormonal changes – There is also a possibility of uterine cancer due to imbalance in the level of estrogen and progesterone hormones in the body. Because in this condition the wall of the uterus becomes thick and causes cancer.
Obesity – Women who are overweight are 2 to 4 times more likely to get cancer in the uterus than other women. This is because experts believe that fat tissue makes a lot of estrogen.
Sugar and High Blood Pressure – Women who have problems with sugar and high blood pressure are also more prone to endometrial cancer. Scientists believe that this is often due to obesity. However, according to the American Heart Association and the American Cancer Society, both of these conditions cause uterine cancer.
Uterine Cancer Screening
Your doctor may recommend urine and blood tests or may also ask for a health check-up.
Other tests are as follows:
Pelvic examination – In this, the doctor will check for lumps in your uterus, vagina, rectum and bladder.
Pap test – The Pap test checks for abnormal cells in your cervix and upper part of the vagina.
Transvaginal ultrasound – In this ultrasound, your uterus is examined through a picture.
Biopsy – In a biopsy, the doctor removes cancerous cells from your endometrium.
Endometrial Cancer Prevention
You have no control over some factors that can lead to uterine cancer, such as a family history of cancer. But there are some factors that you can reduce by making lifestyle changes –
- Control body weight because the body’s fat cells make estrogen.
- If you are able, breastfeed. It helps in reducing ovulation and estrogen activity. (Read more – Benefits of breastfeeding)
- Get treatment for abnormal bleeding right away.
- Exercise regularly. It helps to control your weight and reduce estrogen levels. Eat more fruits and vegetables.
Endometrial (Uterine) Cancer Treatment
Uterine cancer can be treated in four ways – surgery, radiotherapy, hormonal therapy, chemotherapy.
Surgery is the main treatment for uterine cancer. But other treatments are also used in some situations. Your age, your health, and many other factors play an important role in the treatment of cervical cancer. Your doctor will help you choose the right treatment.
Surgery
Uterine removal operation (hysterectomy) is usually done in the treatment of cancer of the uterus. As a part of additional surgeries, the fallopian tubes and ovaries are also removed. After a hysterectomy, it is not possible for a woman to become pregnant in the future. If your ovaries are removed, it will be after surgery if you have not had menopause before.
Radiation Therapy
In some cases, the doctor may recommend radiation therapy after surgery to reduce the risk of developing uterine cancer again. In some situations, radiation therapy may be done before surgery to shrink the tumor and make it easier to remove. If you are not fully fit for surgery, you can only opt for radiation therapy.
Chemotherapy
Sometimes chemotherapy is recommended after surgery to reduce the risk of developing uterine cancer again. In some cases, chemotherapy may be given before surgery to shrink the tumor and make it easier to remove. Chemotherapy may be recommended if chemotherapy is to treat advanced or recurrent endometrial cancer that has spread beyond the uterus.
Hormone Therapy
If your cancer has spread beyond the uterus, you may be given hormone therapy.
Types of Endometrial (Uterine) Cancer
There are two main types of Endometrial uterine cancer –
- Uterine sarcoma – This is a cancer of the muscular layer (myometrium) or connective tissues of the uterus.
- Endometrial carcinoma – This is a cancer that occurs in the inner lining of the uterus. Almost all cancers of the uterus are of this type. Endometrial carcinoma can be divided into different types based on the appearance of the cells under the microscope, which are as follows –
- Adenocarcinoma – Most endometrial cancers are adenocarcinomas.
- carcinosarcoma
- Squamous cell carcinoma – This occurs in many different organs, including the skin, lips, mouth, bladder, prostate, lungs, vagina, and cervix.
- undifferentiated carcinoma
- small cell carcinoma
- transitional carcinoma
Stages of Endometrial Cancer
Blood tests, chest X-rays, and computerized tomography (CT) scans are key to detecting the stages of uterine cancer. On the basis of these tests, the following are the stages of uterine cancer:
Stage 1: When the cancer is only in the uterus.
Stage 2: When cancer is in your uterus and cervix.
Stage 3: When the cancer is in the pelvic lymph nodes outside your uterus, but not in the bladder or rectum.
Stage 4: When the cancer has spread beyond your pelvic area and starts infecting your rectum, bladder and other parts of the body as well.
(Disclaimer: The information in this part of the article is for educational purposes only. All results must be clinically correlated with patient data in order to make an accurate diagnosis.)
References:
- Lentz GM, et al. Neoplastic diseases of the uterus. In: Comprehensive Gynaecology.
- American College of Obstetricians and Gynaecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 149: Endometrial Cancer.
- Niederhuber JE, et al. Abeloff’s Clinical Oncology.
