What is Uterine Cancer?
Uterine cancer is a type of cancer that affects the uterus in the
female reproductive system. Cancer most commonly develops in the
endometrium of the uterus, resulting in endometrial cancer, the
most prevalent type of uterine cancer. Much less commonly, cancer
develops in the muscles and other tissues that support the uterus.
When this occurs, it is called a uterine sarcoma. Less than 5% of
uterine cancers are sarcomas.
Causes and Risk Factors for Uterine
Cancer
Unfortunately, we cannot pinpoint what causes uterine cancer, but
we are aware of risk factors that may increase the likelihood of
it developing. Uterine cancer most often occurs in women who are
post-menopausal, regardless of what type of uterine cancer.
Younger women can develop the disease, but much less often than
women who have gone through menopause.
In cases of uterine sarcomas, we know that prior pelvic radiation
therapy treatment may increase the risk in some women. It is also
evident that uterine sarcomas occur more frequently in
African-American women than Caucasians, though the reason is
unclear.
Fortunately, we know more about endometrial cancer than we do
about uterine sarcomas. Researchers have identified several known
risk factors, including:
never being pregnant
beginning menstruation before age 12 and continuing through age 50
or more
being diabetic
obesity
use of estrogen replacement therapy (ERT)
personal or family history of breast or ovarian cancer
use of Tamoxifen, a breast cancer treatment drug
One thing to keep in mind with uterine cancer risk factors is that
some women who are at increased risk never will have uterine
cancer, while some women who do not present any risk do develop
uterine cancer.
Symptoms of Uterine Cancer
The most common symptom of uterine cancer is vaginal bleeding that
occurs after menopause. In women who have yet to go through
menopause, vaginal bleeding not related to menstruation is
experienced. Vaginal bleeding is considered abnormal when:
periods are heavy and prolonged
heavy spotting occurs between periods
more than one period in a cycle month
bleeding occurs before and/or after sex
bleeding occurs in women who are post-menopausal
Symptoms of uterine sarcoma include vaginal bleeding after
menopause, spotting between periods, and a watery, vaginal
discharge that may be blood tinged. In the early stages of uterine
sarcoma, there may not be any noticeable symptoms.
With endometrial cancer, the most common and first experienced
symptom in abnormal vaginal bleeding. Other symptoms include a
watery vaginal discharge, pain during sexual intercourse, and
pelvic pain.
Diagnosing Uterine Cancer
If uterine cancer is suspected, a thorough pelvic exam will first
be done by a gynecologist. This is an excellent time to discuss
personal and family medical history, symptoms, and to ask
questions. If you haven't had a recent Pap smear and are due for
one, the gynecologist may do one at this along with the pelvic
exam. Pap smears very rarely ever detect uterine cancer, but one
may be done to rule out other cervical conditions.
To confirm the presence or absence of cancer, an endometrial
biopsy is necessary. An endometrial biopsy can be done in the
gynecologist's office and takes only a few moments to complete.
Most women report feeling moderate pain and cramping that lasts
only through the biopsy and some mild cramping following the
biopsy.
Another method of obtaining endometrial tissue samples is through
a dilation and curettage (D&C). During a D&C, the uterus is
scraped with a instrument called a curette. You are given an
anesthetic so you will not feel anything during the procedure, but
you can expect mild cramping afterwards.
If biopsy samples reveal uterine sarcoma or endometrial cancer,
then the cancer is staged. Staging refers to how far the cancer
has spread to nearby tissue or organs.
Treating Uterine Cancer
Treatment options heavily depend on the type and stage of uterine
cancer, but surgery is the most common type of treatment for all
types. It is also when some cases of uterine cancer is staged.
Surgery to treat uterine cancer includes:
hysterectomy - surgical removal of the uterus
hysterectomy with bi-lateral salpingo oophorectomy - surgical
removal of the uterus, fallopian tubes, and ovaries
lymph node dissection - removal of pelvic lymph nodes during
hysterectomy that are later screened for cancer
Radiation therapy is also an option for treating uterine cancer.
This type of treatment uses certain types high energy beams of
radiation to shrink tumors or eliminate cancer cells. Radiation
therapy works by damaging a cancer cell's DNA, making it unable to
multiply. Although radiation therapy can damage nearby healthy
cells, cancer cells are highly sensitive to radiation and
typically die when treated. Healthy cells that are damaged during
radiation are resilient and are often able to fully recover.
Side Effects of Radiation Therapy
How to Manage Skin Side Effects Caused by Radiation Therapy
Chemotherapy may be prescribed to treat uterine cancer in some
women. Chemotherapy drugs work by eliminating rapidly multiplying
cancer cells. However, there are other healthy cells in the body
that multiply just as quickly, such as hair follicle cells.
Unfortunately, many chemotherapy drugs may not be able to discern
the two, attacking healthy cells and causing side effects, such as
hair loss.
Chemotherapy Side Effects
Hair Loss and Chemotherapy: Can It Be Prevented?
Combating Fatigue During Chemotherapy
Preventing Uterine Cancer
Because we don't know exactly what causes uterine cancer,
prevention can be difficult. We can avoid the the known the risk
factors, but many times there are risk factors we cannot avoid
like age, race, and family history.
It is difficult to prevent uterine sarcomas because the risk
factors are unavoidable. We know that prior radiation therapy may
increase the risk, but it should not be avoided for the sake of
uterine cancer prevention.
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