Everything You Need to Know About Uterine Cancer

Uterine cancer is one of the most common cancers occurring in females and is not talked about often enough. This form of cancer impacts many women, from all walks of life. Whether you’ve just recently been diagnosed or have family members who have been affected by it for some time now – we are here to provide all the information you need regarding this disease so that you feel empowered to take steps towards your treatment journey.

What is uterine cancer?

So what is uterine cancer? Uterine cancer refers to the cancer originating either from the middle or innermost layer of the uterus. The cancer that arises from the innermost layer is the more prevalent form, while that originating from the middle layer of the uterus is rare. The uterine cancer is specified as:
● Endometrial Cancer – Developed from the innermost layer of the uterus known as the endometrium, that is shed during menstruation cycle.
● Uterine Sarcoma – Developed from the middle muscular layer of the uterus known as myometrium that expands during pregnancy and contracts during labor.

Symptoms of Uterine Cancer

Ever wondered what are the symptoms of uterine cancer? The most common symptoms of uterine cancer are inter-menstrual bleeding and postmenopausal bleeding. Abnormal bleeding and abnormal menstruation cycle are also common symptoms along with pelvic distress. Other major symptoms include lower abdominal pain, dysuria (difficult urination), and nausea. In higher uterine cancer stages, in which the cancer has spread to other body parts, the additional symptoms include – pale appearance due to heavy blood loss, weight loss, abnormal bowel & bladder habits, and anorexia (loss of appetite).

Causes of Uterine Cancer

The biological reason for uterus cancer includes higher exposure of uterine cells to estrogen hormone. Estrogen is the hormone responsible for proliferation of uterine cells so higher exposure of this hormone is known to cause more uterine cell divisions that ultimately cause carcinoma. Besides, it is also associated with presence of obesity, type II diabetes (T2DM), early menarche (menstruation initiation), late menopause, PCOS (Polycystic Ovarian Syndrome), nulliparity (women who has never given birth or carried a child), and infertility.

Risk factors associated for uterine cancer

The risk factors for uterine cancer include those factors that can increase the chances of getting this cancer. While the risk factors might not directly cause cancer, it can surely increase the probability of it occurring. On the other hand, the absence of a risk factor does not mean one will not get uterine cancer at all. The risk factors are as follows:

● Higher age: women older than 50 years are at a higher risk of getting uterine cancer.
● Obesity and other metabolic syndromes: More than 50% of endometrial cancer is associated with obesity. This is because fatty tissues are known to convert androgens into estrogens (sex hormones), which increase the risk of cancer. Similarly, other metabolic syndromes including type 2 diabetes are associated with higher risk for uterine cancer.
● Presence of other cancers: Presence of cancers like ovarian cancer, colon cancer, breast cancer can enhance the chances of getting uterine cancer
● Familial history: Uterine cancer has been found to be associated with familial history. A genetic syndrome called hereditary non-polyposis colorectal cancer (HNPCC) or Lynch Syndrome running in family shows higher risk of uterine cancer in women of ch families.
● Certain anti-cancer therapies: Therapies involving certain medications used to treat other forms of cancers can increase the risk of uterine cancer. For example, tamoxifen, which is used to treat breast cancer, is linked with an elevated risk of developing uterine cancer. Radiation therapy used to treat cancer in the pelvic or lower abdominal region is also associated with higher risk of developing this cancer.
● Hormone Replacement Therapies (HRT): HRT done with estrogen is associated with higher risk of uterine cancer development hormone in postmenopausal women. However, it is seen that if it is given along with progesterone hormone then the risk is comparatively lower.

How is uterine cancer diagnosed?

The diagnosis of uterine cancer is done through multimodal approaches that depend upon various patient characteristics (age – premenopausal or postmenopausal; general health), symptoms experienced, and past health history. The diagnosis mainly starts with a physical & pelvic examination to check uterus, ovary, vagina, and rectum for any unusual finding. Afterward the following tests may be carried out depending upon patient requirement:

• Transvaginal ultrasound: It is usually done at first after physical examination and it gives details about endometrial thickness (normal should be ~4 mm); thickness more than normal warrants further examination through biopsy.
• Endometrial biopsy: An endometrial biopsy is performed by an excision of the small endometrial tissue followed by its examination under the microscope. The results are interpreted by histopathologists to check the presence of abnormal endometrial cells.
• Dilation and curettage (D&C) biopsy: This is another method to obtain a biopsy. It is mostly done along with hysteroscopy to visualize the internal organ.
• Computed tomography scan: it is a special X-ray technique that provides a 3-dimensional image and can easily show the presence of an extra tumour mass.
• Magnetic resonance imaging (MRI): This imaging technique utilizes magnetic fields to provide extremely detailed images that would give a doctor an insight about how a tumor is growing.
  
  

How is uterine cancer treated?

Have you ever wondered if uterus cancer is curable? With early diagnosis, taking the right steps and proper planning, it can be, but not always. Once the presence of uterine cancer and its stage is confirmed, a team of doctors would work together to make an action plan to follow. Uterine cancer is mostly treated by monotherapy, or sometimes combination therapies that include surgery, cancer medications, radiation therapy etc. The following therapies are used to treat uterine cancer:
● Therapy: These include chemotherapy, hormone therapy, immunotherapy, and molecular targeted therapies. In chemotherapy, specific medicines are given to destroy cancer cells. Hormone therapy slows down the growth of certain uterine cancer cells which have particular receptors for the hormone. Immunotherapy is given to strengthen the immune system to effectively combat growing cancer cells. On the other hand, molecularly targeted therapies target cancer-specific genes or proteins to diminish cancer growth.
● Radiation therapy: Here, high energy radiation is used to destroy cancer cells. It is the main therapy for higher uterine cancer stages. A special radiation oncologist along with other doctors makes a treatment plan for radiation doses. Both, internal beam radiation therapy and external beam radiation therapy, can be given depending upon the need of the patient.
● Surgery: Surgery is the mainstay of treatment for most uterine cancers, that includes surgical removal of the cancerous mass. The choice of surgery depends upon the stage of cancer, and a surgical doctor would remove the tumour. A simple hysterectomy is performed when cancer has not yet spread (stage II), and it involves the removal of the uterus and cervix. A radical hysterectomy is performed if the cancer has spread (stage III) to nearby organs. This surgery involves the removal of the uterus and the upper part of the vagina.
For postmenopausal women bilateral salpingo-oophorectomy is normally performed to remove the fallopian tube and ovaries. If the uterine cancer has metastasized or spread to other organs, then lymph node removal may also be performed.

Can uterine cancer be prevented?

Uterine cancer can be prevented by taking informed steps to avoid or minimize the exposure to risk factors. It involves following a healthy lifestyle with proper weight management and control of diabetes and blood pressure. Knowing your family history and proactively taking these steps would surely prevent/delay uterine cancer growth. Moreover, uterine cancer is potentially curable if diagnosed at an early stage, with the overall 5-year survival rate being around 80% for all stages of uterine cancer. This makes early testing extremely important.

Living with uterine cancer

Cancer certainly changes the life of a person at a significant level; but, coping with cancer becomes easy when you are well informed and take proper steps to treat your cancer. Every treatment has some side effects, and health care teams always prepare an action plan to minimize these effects.

In most cases, uterine cancer patients experience changes in sexual health, fertility issues, and menopause, depending upon the age of the patient. Besides this, the mere diagnosis of uterine cancer can impact a person emotionally. It is always best to have a good support system to help you through this challenging journey.

Uterine cancer treatment typically results in heavy medical-bills. Managing too many financial issues could be a reason behind anxiety and fear among uterine cancer patients. Coping with financial issues associated with uterine cancer treatment could be minimized if you would consider covering your medical-bills with the right health insurance. Opting for a health insurance plan before time would certainly help you to reduce the cost of uterine cancer treatment.

Frequently Asked Questions

Are there any warning signs of uterine cancer?
A few warning signs for uterine cancer include bleeding between menstrual periods, intense pain in the pelvic region regularly or during periods. Post menopausal bleeding is also a warning sign for elderly women.

At what age is uterine cancer commonly diagnosed?
In most cases, uterine cancer is diagnosed at an older age particularly to women who have undergone menopause. The standard age of diagnosis is after 50 years.

Does uterine cancer spread easily?
The spreading or metastasis of uterine cancer depends upon its stage at the time of diagnosis. Stage I uterine cancer typically doesn’t spread easily; but, stage II or beyond can spread quickly and easily. Make sure you always consult with a healthcare practitioner for any queries you have regarding your health. With the right steps and proper planning, you can help take good care of yourself or your loved ones.