Uterine Cancer

Uterine cancer (also called endometrial cancer) refers to cancer that begins in the uterus, the hollow, pear-shaped organ where fetal development occurs during pregnancy. Uterine cancer primarily affects postmenopausal women, although it can occur before menopause. The most common type of uterine cancer is endometrial cancer, which begins in the lining (endometrium) of the uterus. Another, less common form is uterine sarcoma, which develops in the muscle or other tissues of the uterus.

Types of Uterine Cancer

  1. Endometrial Cancer:
    • The most common type, accounting for more than 90% of uterine cancers.
    • Begins in the cells of the endometrium, the lining of the uterus.
    • Subtypes include:
      • Endometrioid adenocarcinoma: The most common form, often detected early.
      • Serous carcinoma and clear cell carcinoma: More aggressive and less common forms.
  2. Uterine Sarcoma:
    • A rare type of uterine cancer that forms in the muscles (myometrium) or other supporting tissues of the uterus.
    • Includes subtypes such as leiomyosarcoma and endometrial stromal sarcoma.

Risk Factors for Uterine Cancer

Several factors increase the risk of developing uterine cancer, particularly endometrial cancer:

  1. Age:
    • Most cases occur in postmenopausal women, typically in their 50s and 60s.
  2. Hormone Imbalance:
    • Higher levels of estrogen without sufficient progesterone (known as unopposed estrogen) can increase the risk.
    • Conditions like polycystic ovary syndrome (PCOS), obesity, and estrogen-only hormone replacement therapy (HRT) increase estrogen levels.
  3. Obesity:
    • Excess body fat increases estrogen levels, leading to a higher risk of endometrial cancer.
  4. Family History and Genetics:
    • A family history of uterine, ovarian, or colon cancer may increase the risk.
    • Lynch syndrome, a genetic condition that raises the risk of several cancers, is a known risk factor for uterine cancer.
  5. Early Menstruation or Late Menopause:
    • Women who start menstruating before age 12 or enter menopause after age 55 have a higher risk due to prolonged exposure to estrogen.
  6. Tamoxifen Use:
    • This drug, used to treat breast cancer, has been linked to an increased risk of endometrial cancer, although the benefits for breast cancer patients often outweigh the risks.
  7. Radiation Therapy:
    • Previous radiation therapy to the pelvis can increase the risk of developing uterine sarcoma.
  8. Diabetes:
    • Diabetes is associated with an increased risk of uterine cancer, likely due to its link with obesity and hormonal imbalances.

Symptoms of Uterine Cancer

The most common symptom of uterine cancer is abnormal vaginal bleeding, especially in postmenopausal women. Other symptoms may include:

  • Unusual vaginal discharge that may be watery or blood-tinged.
  • Pelvic pain or discomfort.
  • Pain during intercourse.
  • Frequent urination or difficulty urinating.
  • Unexplained weight loss (in advanced cases).

Diagnosis of Uterine Cancer

Several diagnostic methods are used to detect and assess uterine cancer:

  1. Pelvic Exam:
    • A doctor may perform a pelvic exam to feel for abnormalities in the uterus or surrounding areas.
  2. Ultrasound:
    • Transvaginal ultrasound uses sound waves to create images of the uterus, helping doctors detect abnormal thickening of the endometrium.
  3. Endometrial Biopsy:
    • A small sample of the endometrial tissue is removed and examined under a microscope to check for cancerous cells.
  4. Hysteroscopy:
    • A thin, lighted scope is inserted through the vagina into the uterus to visually inspect the endometrium and take a biopsy if needed.
  5. Dilation and Curettage (D&C):
    • A procedure where tissue from the lining of the uterus is scraped and analyzed for cancer.
  6. Imaging Tests:
    • CT scans, MRIs, and PET scans may be used to determine if cancer has spread to other parts of the body.

Staging of Uterine Cancer

Uterine cancer is staged based on how far it has spread:

  • Stage I: Cancer is confined to the uterus.
  • Stage II: Cancer has spread to the cervix but not beyond the uterus.
  • Stage III: Cancer has spread to nearby tissues such as the pelvic area, ovaries, or lymph nodes.
  • Stage IV: Cancer has spread to distant organs, such as the bladder, rectum, or other parts of the body.

Conclusion

Uterine cancer, particularly endometrial cancer, is highly treatable when detected early. Surgery is often curative in early stages, while more advanced cases may require a combination of treatments. Regular monitoring for abnormal symptoms, maintaining a healthy weight, and managing hormone levels can significantly reduce the risk of uterine cancer. Early detection and treatment remain key to improving outcomes and survival rates.