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Uterine Cancer
Also called Endometrial Cancer
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Uterine cancer is a type of cancer occurring only in women and with a good cure rate if found early. It is a relatively common type of cancer that begins in the endometrial cells or lining of the uterus. Less commonly, the muscle of the uterus can become cancerous but this is called a "sarcoma". It is found usually at an early stage because it often results in abnormal vaginal bleeding, particularly after menopause or between periods.
Most of the cases of uterine cancer happen in women who are postmenopausal. Signs and symptoms of this type of cancer include post-menopausal bleeding, bleeding between menstrual periods, abnormal vaginal discharge, pain in the pelvis, pain with intercourse and a weight loss that is unintended. It is a type of cancer that responds to a predominance of estrogen and the risk is greater in those who have had early onset of menses and a late onset of menopause, never being pregnant and having irregular ovulation.
Women who are obese have a greater risk of having endometrial cancer because fatty tissue makes its own estrogen. A high fat diet is believed to contribute to endometrial or uterine cancer. It also contributes to being obese. Being diabetic is a risk factor for uterine cancer and being on estrogen-only post menopausal therapy can mean you have an excess of estrogen and uterine cancer. Tumors of the ovary can produce excess estrogen and can contribute to uterine cancer. The older a woman is, the higher the risk of cancer. Women over 55 will be at a higher risk than younger women. If you have had ovarian or breast cancer in the past, you are at higher risk for endometrial cancer. Women on Tamoxifen have a higher risk of endometrial cancer because it acts on the endometrium and mimics estrogen. Black women are at a higher risk for dying from uterine cancer but white women get the disease more than blacks.
There is a hereditary disease called hereditary nonpolyposis colorectal cancer that affects both the colon and the endometrium. You can get colorectal cancer and endometrial cancer at different times of one's life. It is due to a DNA mutation that gives a lifetime risk of having endometrial cancer of between 40 and 60 minutes.
Tests for uterine cancer include transvaginal ultrasound that can look at the lining of the uterus. An endometrial biopsy can take samples of cells inside the uterus and can look at them for cancer. A D and C or dilatation and curettage takes the uterus and completely scrapes away the uterine lining. It will determine the character of all the cells of the uterus and can identify uterine cancer. Sometimes a PAP test will define uterine cancer.
Doctors do pelvic surgery in order to stage uterine cancer. In this surgery, Stage I is found when the uterus alone is involved. Stage II involves cancer of the cervix and uterus but hasn't spread beyond the range of the rest of the pelvic structures. Stage III involves cancer of the rectum and bladder as well as the uterus. The lymph nodes may be cancerous as well. Stage IV cancer means that the cancer has affected distant parts of your body, including the rectum and bladder.
The treatment for endometrial cancer is primarily surgery. The uterus and the surrounding structures, including the ovaries and the fallopian tubes are removed during the surgery along with lymph nodes and other areas involved with tumor. If you have higher stage cancer or aggressively growing tumor, radiation can be used to kill off tumor cells. Radiation can be done externally or in the form of brachytherapy, where seeds of radioactivity are imbedded near the cancerous areas.
Synthetic progesterone or progestin can stop a uterine cancer from growing. It is given in high doses and is good treatment for those who want to have children and don't want to have a hysterectomy yet. Chemotherapy is used to kill cancer cells in higher stages of uterine cancer. It is usually reserved for stage III and stage IV cancers of the uterus.