Uterine Cancer (Endometrial Cancer): Symptoms, Causes, Risks, Diagnosis, Treatment, Outlook and Prevention

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A woman whos holding a tablet with a picture on the screen of Uterine-cancer((Endometrial Cancer)

1Overview

The uterus or the “womb” is a hollow organ located in women’s pelvis.
It has three parts: the cervix (forms the lower end of the uterus), the isthmus (broad section in the middle), and the fundus (dome-shaped top section of the uterus). The uterus has two (2) layers of tissue. They are the endometrium which is the inner layer of the uterus and the myometrium, the outer layer of the uterus.

Endometrial cancer or the uterine cancer is a common type of cancer in women’s reproductive system. This starts when the cells in the lining of the uterus (endometrium) overreact causing the uncontrollable growth of the cells and don’t die at the same time, thus forming a tumor. This tumor can either be malignant or cancerous that can spread to other parts of the body, or benign, which grow but will not invade nearby tissues.

This uterine cancer can easily be identified at an early stage because it will produce abnormal vaginal bleeding, which alarms women to see the gynecologist. If detected early, surgically removing the uterus often treats endometrial or uterine cancer.

The adenocarcinoma and sarcoma are the types of uterine cancer. Adenocarcinoma accounts 80% of uterine cancers and it starts from the cells in the endometrium while sarcoma develops in the tissues of the uterine glands or the myometrium.

2Symptoms

The following are the symptoms of endometrial cancer, they may vary from one person to the other:

  • Abnormal uterine bleeding (AUB) or unusual vaginal bleeding, spotting or discharge characterized by the presence of watery and blood-streaked discharge to a flow containing more blood. There is pain during sexual intercourse
  • Dysuria or difficulty urinating and pain during urination
  • Pain in pelvic area
  • Abnormal Papanicolaou smear or PAP test

3Causes

The causes of endometrial cancer are yet unknown but it is said that there is the mutation of the cells in the lining of the uterus particularly the endometrium. Ideally, the healthy cells follow a pattern of growth, cell division and program death called apoptosis.

But in this case (uterine cancer), the abnormal cells grow uncontrollably and do not die at the same time thus causing the formation of a tumor. The cancer cells can spread to nearby tissues and can detach themselves from the initial tumor to metastasize to the adjacent organs of the body.

4Risk Factors

Some people with an increased risk of endometrial cancer do not develop uterine cancer but others with no risk factors do. Knowing the following factors will help you make healthy choices and lifestyle change.

Age

Endometrial cancer happens mostly in women who have experienced menopause; those women over 50 to 60 years of age.

Obesity

Excess body fat creates an imbalance hormones.

Hormonal Imbalance

Fluctuations in the balance of estrogen and progesterone cause changes in the endometrium.

Women who started their period early

When the woman starts menstruating before age 12 or starting menopause later, increases the risk of endometrial cancer. The more monthly periods the woman had, the more exposure the endometrium has had to the hormone estrogen.

Race and ethnicity

Women who are white have a higher chance of contracting uterine cancer than other ethnicity or race.

Genetic/ hereditary

Women who have family members that have colon cancer (Lynch syndrome or the hereditary non-polyposis colorectal cancer-HNPCC) are at risk of developing the disease.

No history of pregnancy

Women who have never been pregnant have an increased chance of getting endometrial cancer than those having at least one (1) pregnancy.

Diabetes

Women with diabetes have an increased chance of acquiring the disease which is associated with obesity.

Other Cancers

There is a higher risk of uterine cancer if the women have had history of breast cancer, ovarian cancer, and colon cancer

5Diagnosis

First, the doctor gathers information about the symptoms you have experienced like how long and how often you have been experiencing them and be sure to tell all about it including its changes if there’s any.

To diagnose cancer, the doctor may order imaging tests to see whether the cancer has already spread (metastasized) to nearby tissues or organs of the body.

A pelvic examination and Papanicolaou test (Pap test)

The doctor examines the reproductive organs like the uterus, vagina, ovaries, and rectum to check for unusual findings. Together with this, a Pap test is also done to check for cervical cancer and to look for glandular cells that cause uterine cancer.

Biopsy (Endometrial)

This is the removal of a small tissue of the uterus. The tissue is removed with suction and this tissue sample is brought to the laboratory and analyzed by a pathologist under a microscope. The biopsy can be a base for diagnosing uterine cancer.

After the procedure, the client may have cramps and vaginal bleeding that can be lessened by taking a nonsteroidal anti-inflammatory drug (NSAID). Women who have abnormal vaginal bleeding before the test need to undergo Dilation and Curettage, even if there are no abnormal cells found.

Dilation and Curettage

It is a procedure to remove some tissue samples from the uterus for evaluation at the laboratory. This is done in combination with the viewing of the lining of the uterus (hysteroscopy) through the use of a thin, flexible, and lighted tube. Once the endometrial tissue has been removed, the pathologist analyses it for the presence of cancer cells, endometrial hyperplasia (overgrowth of tissue in the endometrium) and other conditions.

Computed tomography scan (CT or CAT scan)

This procedure makes an image of the uterus. With the aid of a computer, the images are combined producing a detailed and cross-sectional view of the uterus showing tumors with their measurements and other abnormalities if present. A contrast medium is sometimes given before the procedure either through injection in the vein or can be drunk as a liquid to provide a better outcome of the image.

Transvaginal ultrasound

This procedure uses an ultrasound wand that is inserted into the vagina going to the uterus to obtain an image.

Magnetic resonance imaging (MRI)

This can measure the tumor’s size. Contrast (a special dye) is injected to the client’s vein before the scan to have a clearer picture. MRI is used in client’s with low-grade cancer to determine how far cancer has grown and spread into the uterine wall.

If it is confirmed that there’s cancer, the doctor uses staging and grading to determine how far cancer has grown or spread. Staging also helps the doctor to choose the best treatment and predict the client’s chance of recovery.

6Treatment

There are many types of treatment that are available for uterine cancer, it depends on the stage where the cancer is or has it metastasized to other organs. Treatments are as follows:

Surgery

The removal of the uterus (hysterectomy) is an option for the patient, this can help the doctor determine the stage of cancer. They can also remove the fallopian tubes and the ovaries together with the uterus that is called hysterectomy with bilateral salpingo-oophorectomy. The removal of the neighboring lymph nodes is done when there is a spread of cancer through the body.

Radiation

Using the radiation, it can directly kill the cells on the specific area of the body. The doctor explains treatment precaution to the patient including their family.

Chemotherapy

 Whether it is a form of a fluid, a pill, or a topical solution or cream, it attacks the cancer cells the only side effect of this treatment is that the person will experience nausea and sometimes accompanied by vomiting, loss of appetite, loss of hair and loss of weight.

If the cancer is treated, follow-up check-up is strongly advised, to prevent any further recurrence of cancer.

7Outlook

Thousands of women in America are diagnosed with uterine cancer. The early diagnosis of this cancer can have a higher percentage of survival rate than people whose cancer is detected at the late stage. Treatments like chemotherapy, radiation, and surgery are being updated every year to help the patients have a better quality of life. The advancement of the technology can help determine better treatments in the future with the help of researchers and doctors.

8Prevention

Although there is no specific prevention for cancers, there are some ways that can decrease your chances for having cancer.

  • Have a healthy living, maintaining your body weight within the normal range can decrease the chances of having uterine cancer.
  • Birth control pills that have synthetic estrogen and progesterone that can regulate the menstrual cycle and can help hormonal level in check in the body.
  • Have knowledge about hormonal replacement therapy, this method has estrogen and progesterone introduced in the body to help the body with the hormone levels.
  • If the person has predisposing factors like Diabetes, they should control their sugar levels. The increased levels of sugar in the body can affect the production of hormones.
  • Have a regular check-up, especially those who have a family history of cancer and those whose age is above 40.