Uterine Cancer (Endometrial Cancer)

Uterine cancer, or endometrial cancer, is a silent yet formidable foe that affects the female reproductive system. While it may not receive the same public attention as some other cancers, its impact can be profound, and understanding its nature is crucial for early detection and management.

What is Uterine Cancer?

The uterine tumour is a type of cancer that originates in the uterus, the hollow, pear-shaped organ in a woman's pelvis where a foetus develops during pregnancy. The most common variety of uterine cancer is endometrial cancer (cancer of the uterine lining), which develops in the endometrium (inner lining of the uterus). While it is primarily a disease of older women, it can also affect younger individuals, making it a concern for all women. Early detection significantly improves prognosis and survival rates.

What are the Symptoms of Uterine Cancer?

The early symptoms of endometrial cancer can be subtle and often go unnoticed, which is why it is sometimes referred to as the "silent killer." However, some common symptoms are:

• Unusual vaginal bleeding or spotting, particularly after menopause
• Heavy menstrual bleeding or bleeding between periods
• Pelvic pain or pressure 
• Discomfort or pain during sexual intercourse
• Abnormal vaginal discharge, which may be watery, pink, or white and is not related to menstruation bleeding
• Difficulty urinating or a feeling of fullness in the pelvis
• Unexplained weight loss
• Fatigue 

Unfortunately, these symptoms can be easily overlooked or attributed to other medical conditions, delaying the endometrial cancer diagnosis.

What Causes Uterine Cancer?

The exact reason for uterus cancer is not entirely known, but several risk factors have been recognised. These include:

• Obesity: Excess body weight, particularly in the abdominal area, is a significant risk factor for uterine cancer.
• Hormone imbalances: Conditions that involve an excess of estrogen, such as polycystic ovary syndrome (PCOS) or estrogen therapy, can increase the chance of uterine cancer.
• Age: The possibility of uterine cancer increases as one gets older, most commonly occurring in females over the age of 50.
• Family history: Women with a close relative (mother, sister, or daughter) who has had uterine cancer have a higher possibility of developing this disease.
• People with type 2 diabetes have a higher chance of developing uterine cancer.

Complications of Uterine Cancer (Endometrial Cancer)

Uterine cancer, if left untreated or undetected, can result in various complications that can significantly impact a woman's health and well-being. These complications may include:

• Spread to localised organs such as the ovaries, fallopian tubes, or bladder, making the disease more difficult to treat.
• Bowel and bladder dysfunction (in case of advanced uterine cancer) leading to difficulties with urination and bowel movements.
• Pain and discomfort, which can severely impact a woman's quality of life.
• Metastasis - spread to faraway organs, like the liver and lungs, which can be potentially life-threatening.

Diagnosis of Uterine Cancer

Uterine cancer often manifests with subtle symptoms, making it difficult to detect in its early stages. When a woman experiences persistent or unusual vaginal bleeding, it is crucial to seek medical assistance promptly. A doctor will typically perform a pelvic examination and may conduct additional evaluations for uterine cancer detection, such as an ultrasound, biopsy, or endometrial sampling, to confirm the diagnosis. These diagnostic methods can provide valuable information about the cancer's size, location, and stage, which is essential for determining the appropriate treatment plan.

Treatment for Uterine Cancer

The treatment and management of the cancer depend on the stage and type of endometrial cancer and the patient's overall wellness and personal preferences. 

In the initial stages, surgery is often the primary treatment to remove the cancerous tissue and prevent the spread of the disease. Surgery may involve a hysterectomy, which is the surgical removal of the whole uterus and, in some cases, one or both fallopian tubes and ovaries as well.

For more advanced or aggressive forms of uterine cancer, a combination of treatments may be necessary. Radiotherapy, which uses high-energy waves to destroy cancer cells, may be used before or after surgery to enhance the effectiveness of the treatment. Chemotherapy, which includes the use of powerful drugs to kill rapidly dividing cancer cells, may also be prescribed to target remaining cancer cells or to prevent the disease from spreading.

In recent years, advancements in targeted therapies have provided new hope for patients with uterine cancer. These innovative treatments target specific molecular pathways involved in the growth and spread of cancer cells. They can be used with traditional therapies or as a standalone option for patients who may not be eligible for surgery or other conventional treatments.

Prevention of Uterine Cancer

Steps that women can take to reduce their risk of uterine cancer, include:

• Maintaining a healthy weight and regular exercising 
• Limiting hormone therapy, especially estrogen-only hormone therapy
• Minimising the exposure to known risk factors such as smoking and excessive alcohol intake
• Regular pelvic examinations and screening tests, such as the Pap test and endometrial biopsy, can also help detect the cancer in its early stages when it is most treatable.

When to See a Doctor?

Women should proactively monitor their gynaecological health and seek medical attention if they experience unusual or persistent symptoms. It is significant for those with known risk factors for uterine cancer, such as a family history of the disease or a history of endometrial hyperplasia, a precancerous condition that can lead to uterine cancer.

If a woman notices any changes in her menstrual cycle, experiences unexpected vaginal bleeding, or feels pelvic discomfort or pain. In that case, scheduling an appointment with a doctor as soon as possible is crucial. 

FAQs

1. What are the different warning signs of uterine cancer?

The most common warning sign of uterine or endometrial cancer is unusual vaginal bleeding or spotting, which may occur between menstrual cycles or after menopause. Other symptoms may include pelvic pressure or pain, difficulty urinating, and unexplained weight loss.

2. Is uterine cancer curable?

Uterine cancer is generally a highly treatable form of cancer, especially when detected and treated in the early stages. With prompt and appropriate treatment, many women with uterine cancer can achieve long-term remission or even a complete cure.

3. Is uterine cancer very painful?

Uterine cancer may not cause significant pain in its early stages, as the disease can often progress without producing noticeable symptoms. However, as the cancer advances, it may cause pelvic pain, cramping or discomfort. The level of pain can vary and depend on the stage and location of the tumour.

4. Does uterine cancer spread quickly?

The rate at which uterine cancer spreads can differ and depend on the type and stage of the disease. In general, uterine cancer is considered a relatively slow-growing cancer, and it may take several years for the disease to spread to other organs or tissues. However, in some cases, particularly with more aggressive subtypes, the cancer can spread more rapidly.

5. At what age is endometrial cancer most common?

Endometrial cancer is the most common variety of uterine cancer and is typically diagnosed in women between the ages of 50 and 70. The risk of developing endometrial cancer rises with age, with the majority of cases occurring in postmenopausal women.

6. What should I ask my healthcare provider?

When discussing uterine cancer with your doctor, consider asking the following questions:

• What type of uterine cancer do I have, and what stage is it?
• What are the best treatment options for my specific case?
• What are the potential side effects and risks associated with the recommended treatments?
• How often will I need to undergo follow-up appointments and screenings?
• Are there any lifestyle alterations or preventive measures I can take to reduce my risk of recurrence?
• Can you provide me with educational resources or support services to help me better understand and manage my condition?

Dr. Yugandar Reddy

MBBS, MS (General Surgery), DNB (Surgical Oncology)
Gurunanak CARE Hospitals, Musheerabad, Hyderabad, CARE Hospitals, HITEC City, Hyderabad, CARE Hospitals, Banjara Hills, Hyderabad

To Book an Appointment, call:

+91 406 810 6585

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