Published on Jan 30, 2021 and last reviewed on Apr 04, 2022 - 6 min read
Abstract
Uterine cancer is a type of cancer that originates in the cells that line the uterus (endometrium). Read about its signs, causes, risk factors, and treatment here.
Uterine cancer, otherwise called endometrial cancer, is a type of cancer that originates in the cells that line the uterus (endometrium). The uterus is an inverted-pear-shaped hollow female reproductive organ present in the pelvis where the fetus's development occurs. The buildup of cancer cells in uterine cancer can be benign or noncancerous, or it can be malignant or cancerous and spread to other parts of the body. The exact cause of tumor formation seen in uterine cancer is not understood. But, endometrial hyperplasia, obesity, women who have never given birth, menarche before 12 years of age, menopause after 55 years of age, etc., are some known risk factors. This cancer is often detected early as it results in abnormal vaginal bleeding. And when it is detected early, removing the uterus is the best option.
The National Cancer Institute estimates 3 in 100 women get diagnosed with uterine cancer. Almost 80 % of women who have uterine cancer survive for five years or longer after being diagnosed.
Abnormal vaginal bleeding is the most obvious and commonly seen symptom of uterine cancer. The abnormality in uterine bleeding include:
The menstruation length and flow changes. There might be prolonged periods with heavy flow.
Spotting or vaginal bleeding between menstrual periods.
Vaginal bleeding even after menopause.
The other possible symptoms of uterine cancer are:
Vaginal discharge that is watery or blood-tinged.
Pelvic pain or pain in the lower abdomen.
Painful urination.
Pain during sexual intercourse.
Always consult your doctor if you experience any of the symptoms of uterine cancer. Remember that the presence of these symptoms does not necessarily mean uterine cancer, but at the same time, it is essential to determine the underlying cause. Abnormal vaginal bleeding can also be seen before menopause, hormonal imbalance, uterine polyps, fibroids, and other noncancerous conditions. But sometimes, it is a sign of uterine cancer, vulvar cancer, and other types of gynecological cancer.
The cause of endometrial cancer is still unknown. Doctors believe that certain factors result in mutation in the DNA of the endometrial cell. This mutation results in endometrial cells to grow, multiply, and die at abnormal rates. Such abnormal cells multiply and grow exponentially in an uncontrolled way and do not die at a set time, resulting in the accumulation of cells and tumor formation. Cancer cells from uterine cancer can spread to nearby tissues and elsewhere in the body (metastasis).
The following factors increase the risk of uterine cancer:
Hormonal Imbalance - The ovaries release two female hormones, estrogen and progesterone. Any changes in the levels of either of these hormones can result in an imbalance and cause changes in the endometrium. An increase in estrogen levels makes you prone to uterine cancer. Estrogen levels are high in polycystic ovary syndrome (PCOS), diabetes, obesity, women taking Estrogen pills after menopause.
HRT After Menopause - Hormone replacement therapy (HRT) using only Estrogen pills increases the risk.
Tamoxifen - Hormone therapy using Tamoxifen to prevent or treat breast cancer increases the risk of developing uterine cancer.
Early Menarche - Menarche is the first occurrence of menstruation. Women who started menstruating before 12 years of age or menopause after 55 years of age, resulting in more years of menstruation, are at the risk of uterine cancer. The more number of periods a woman has in her childbearing years; the more effect estrogen has on the endometrium.
Older Women - As uterine cancer is commonly seen after menopause, older women are more at risk.
Overweight or Obese Women - Obesity increases the risk of uterine cancer because the excess fat in the body alters the hormonal balance.
Diabetes - A study found diabetic women to be twice as likely to develop uterine cancer.
Nulliparous Women - Women who have never been pregnant are also at a higher risk of uterine cancer than someone with at least one pregnancy.
Lynch Syndrome - It is an inherited colon cancer syndrome, which is also known as hereditary nonpolyposis colorectal cancer (HNPCC). This syndrome increases the risk of colon cancer, uterine cancer, and other cancers. It is a hereditary syndrome.
Endometrial Hyperplasia - Here, the endometrium thickens, increasing the risk of cancer growth.
Family History - The chances of uterine cancer increases if your immediate family member or members are diagnosed with it.
The gynecologist might perform the following tests to diagnose uterine cancer if the patient complains of abnormal vaginal bleeding:
Pelvic Examination - While examining the pelvis, the doctor inspects the vulva (the outer portion of the genitals) and then inserts two fingers into the vagina and presses on the abdomen to feel the uterus and ovaries. The doctor might open the vagina and cervix for examination using a device called a speculum.
Transvaginal Ultrasound - Transvaginal ultrasound uses sound waves to provide images of the uterus. The doctor can look at the endometrium's thickness and texture by inserting the probe of the ultrasound into the vagina. Any abnormality in the uterine wall can be diagnosed.
Hysteroscopy - A thin and flexible tube called a hysteroscope is inserted into the uterus through the vagina and cervix. The camera attached to the scope allows the doctor to see the endometrium and examine the uterus.
Biopsy - The doctor might remove some tissue from inside the uterus to examine the cells under the microscope to see any cancerous changes. Sometimes, if the biopsy results are inconclusive, the doctor will scrape off the uterus' lining through dilation and curettage (D&C) and then send the tissue for examination.
Once the doctor diagnoses uterine or endometrial cancer, the cancer is staged based on how much it has spread:
Stage 1 - Cancer cells have not spread beyond the uterus.
Stage 2 - Cancer cells have spread from the uterus to the cervix.
Stage 3 - Cancer cells have reached the ovaries, vagina, fallopian tubes, or lymph nodes, but not to the rectum or bladder.
Stage 4 - Cancer has spread farther than the pelvic area to the bladder, rectum, or distant organs.
The treatment options for uterine cancer are:
1) Surgery - Hysterectomy or surgical removal of the uterus is the treatment of choice. The fallopian tubes and ovaries (salpingo-oophorectomy) are also usually removed. If the patient is not menopausal, a hysterectomy will make future pregnancies impossible, and the patient will experience menopause if the ovaries are removed.
2) Radiotherapy - This is the use of high-energy beams like X-rays or protons to kill cancer cells. Radiation can be used after surgery to prevent uterine cancer from recurring, or it can be used prior to surgery to reduce the tumor's size.
3) Medications -
Chemotherapy - Intravenous or oral drugs are used to kill cancer cells. The doctor might prescribe one drug or a combination of two or more drugs. Same as radiation, chemotherapeutic drugs can be given before or after the surgery.
Hormone-Blocking Drugs - These drugs lower the hormone levels in the body. As cancer cells grow with the help of hormones, blocking them will prevent growth, and the cells might die.
Targeted Drug Therapy - These drugs block specific weaknesses within the cancer cells, resulting in cell death. This is usually used in combination with chemotherapy.
Immunotherapy - These drugs help the immune system to fight cancer.
4) Supportive Care-
Medicines are given to relieve pain and other associated symptoms. Some patients might need mental support.
As the exact cause is unknown, uterine cancer cannot be prevented, but the risk can be reduced by:
Avoiding Estrogen pills.
Using combination birth control pills.
Maintaining a healthy weight.
To know more about uterine cancer, consult a gynecologist online.
- Abnormal vaginal discharge without blood.
- Difficulty and pain while urinating.
- Pain during sexual intercourse.
- Pain in the pelvic area with or without a mass.
- Unexplained weight loss.
Of the two types of endometrial cancer, type 1 is a slow-growing tumor and is usually detected before it spreads. On the other hand, type 2 cancers are made up of clear, serous cells, aggressive in nature, and are liable to spread to distant organs.
- Women above the age of 50 years.
- Obesity.
- Estrogen hormone replacement therapy.
- Family history.
- Diabetes.
- Tamoxifen.
- Women with breast cancer, ovarian cancer, or colon cancer.
- Previous radiation therapy.
- Diet rich in animal fat.
- Early menarche.
- Late menopause.
- Lynch syndrome.
Uterine cancer produces pelvic pain and pain during intercourse. There can also be pain while urinating, with difficulty to empty the bladder.
Uterine cancer is associated with an abnormal foul-smelling vaginal discharge that is more like pus with bloodstains.
In the initial stages, it spreads to the rectum and bladder. Later, it may spread to the ovaries, fallopian tube, and vagina.
Along with the symptoms of the third stage like abnormal vaginal bleeding or discharge, pelvic pain, abdominal pain, pain during intercourse, bloating, loss of weight, and unusual bowel or bladder habits, metastasis signs like pain in the bones and shortness of breath occur at the last stage of uterine cancer.
Uterine cancer exhibits symptoms very early, and so it can be detected in the early stages before it spreads to distant organs, so uterine cancer is curable.
Hysterectomy is the choice of treatment for the early stage of cancer. It is also suggested in people with an increased risk of developing uterine cancer. However, the most successful treatment involves hysterectomy with bilateral salpingo-oophorectomy.
Uterine cancer is not fatal if diagnosed in the early stages. However, it depends on the extent of the spread of cancer. The five-year survival rate of uterine cancer patients in stage 1 is around 90%.
Uterine cancer is the sixth most common cancer that occurs worldwide in women. In terms of general cancer, it is the fourteenth most common cancer in the world.
Vaginal bleeding in uterine cancer ranges from watery to blood-streaked flow and then turns to one which comprises more blood. Vaginal bleeding in between menstruation or after menopause should be of concern.
Last reviewed at:
04 Apr 2022 - 6 min read
RATING
Obstetrics And Gynecology
Comprehensive Medical Second Opinion.Submit your Case
D and C (Dilation and Curettage)
Article Overview: Dilation and curettage is a minor surgical procedure where the cervix is widened (dilation) and the tissue lining the uterus is scraped out (curettage). Read Article
Dilation and Curettage (D & C) Overview Dilation and curettage, or otherwise called D and C, is a minor surgical procedure where the cervix is widened (dilation) and the tissue lining the uterus is scraped or suctioned out (curettage). This procedure is usually done to treat conditions like heav... Read Article
Can Achilles' tendon weakness make a person fall often?
Query: Hi doctor, I have a question for my mother. My mother is 50 years old. She complains of episodic, sudden loss of weight bearing ability on the left Achilles tendon. This has resulted in two major falls, which resulted in trauma. These are present for past few months and have become more frequent in... Read Full »
Can uterine or cervical cancer delay my periods?
Query: Hi doctor, My period is always regular with an interval of 28 days. I never missed my period before. Now, I am late for five days. Today, I had a little light pink faint discharge when I wipe. I have taken 4 pregnancy tests and all were negative. When I referred online, it says ovarian cancer. I ha... Read Full »
Most Popular Articles
Do you have a question on Vaginal Bleeding or Transvaginal Scan?
Ask a Doctor Online