Uterine Cancer

Overview

Uterine cancer refers to malignancies that develop in the uterus, a hollow, pear-shaped organ in a woman’s pelvis. It includes two main types: endometrial cancer (most common) and uterine sarcoma (rare). Symptoms often include unusual vaginal bleeding or discharge. Treatments typically involve surgery, but other therapies like radiation or chemotherapy may be necessary depending on the stage and type of cancer.

What Is Endometrial Cancer?

Endometrial cancer begins in the endometrium, the inner lining of the uterus. Most uterine cancers are endometrial cancer. If untreated, it can spread to nearby organs such as the bladder, rectum, or more distant organs through the lymphatic system or bloodstream.

The good news is that endometrial cancer typically grows slowly and is often detected early through regular gynecological exams.

Types of Endometrial Cancer

Endometrial cancer is further classified into two types:

Type 1 (80% of cases): Linked to excess estrogen. Develops slowly and often has a favorable prognosis. May evolve from a condition called atypical hyperplasia (abnormal cell growth in the endometrium).

Type 2: Grows and spreads more quickly. Includes aggressive subtypes like uterine papillary serous carcinoma or clear cell carcinoma.

Subtypes of Endometrial Cancer:

1. Endometrioid adenocarcinoma: The most common form, resembling normal endometrial tissue under a microscope.

2. Uterine papillary serous carcinoma: Rare and more likely to recur, even when detected early.

3. Uterine clear cell carcinoma: A rare subtype, accounting for less than 5% of cases.

4. Uterine carcinosarcoma: Aggressive and rare, also comprising less than 5% of cases.

Symptoms of Uterine Cancer

Symptoms of uterine cancer can be mistaken for other reproductive or gynecologic conditions. It is essential to consult a healthcare provider for accurate diagnosis and treatment if you experience:

- Vaginal bleeding between periods or after menopause.
- Heavy or prolonged menstrual bleeding after the age of 40.
- Pelvic pain or cramping.
- Thin, watery, or white vaginal discharge (especially postmenopausal).
- Pain during intercourse.

Risk Factors for Uterine Cancer

Several factors can increase the risk of developing uterine cancer:

- Early onset of menstruation or late menopause.
- Obesity or being overweight.
- Diabetes or hypertension.
- Having few or no pregnancies.
- History of infertility or irregular periods.
- Use of estrogen-only hormone replacement therapy.
- Family history of endometrial, breast, or colorectal cancer.
- Genetic conditions like Lynch syndrome, which significantly raise the risk.

Women who have taken birth control pills or have been pregnant may have a lower risk of uterine cancer due to the protective effects of progesterone.

Causes of Uterine Cancer

The exact cause of uterine cancer is unclear, but it begins with genetic mutations in the cells of the uterus. These mutations cause cells to grow uncontrollably, forming tumors. Risk factors such as hormonal imbalances, obesity, and genetics may contribute to these mutations.

How Is Uterine Cancer Diagnosed?

To diagnose uterine cancer, healthcare providers may:

• Review symptoms, medical history, and family history.
• Perform a physical and pelvic exam.

Diagnostic Tests

1. Blood Tests

CA-125 assay measures levels of CA-125 protein, often elevated in uterine cancer.

2. Imaging Tests

• CT scan: Provides detailed internal images.
• MRI: Uses magnets and radio waves to capture uterine structures.
• Transvaginal ultrasound: Offers clear images of the uterus via a vaginal probe.

3. Tissue Sampling

• Endometrial biopsy: A small sample of uterine lining is removed for analysis.
• Hysteroscopy: A camera-equipped scope visualizes the uterine lining.
• Dilation and curettage (D&C): Removes uterine tissue under anesthesia for further testing.

Management and Treatment

Treatment depends on the type and stage of uterine cancer and may include:

• Surgery: Most common treatment involves a hysterectomy (removal of the uterus).
• Radiation Therapy: Targets cancer cells with high-energy beams.
• Chemotherapy: Uses drugs to kill or stop cancer cells from growing.
• Hormone Therapy: Either blocks or adds hormones to slow cancer growth.
• Targeted Therapy: Focuses on specific molecules in cancer cells.
• Immunotherapy: Boosts the immune system to combat cancer.

Can You Prevent Uterine Cancer?

While uterine cancer cannot always be prevented, you can lower your risk by:

- Maintaining a healthy weight.
- Managing chronic conditions like diabetes or hypertension.
- Using progesterone-based contraceptives under medical advice.
- Regular screenings and prompt evaluation of unusual symptoms.