What is uterine cancer? Causes, symptoms, treatment of uterine cancer

The uterus is an empty organ in the female located in the pelvis, commonly called the uterus, which supports the development of the fetus until birth. The uterus is shaped like an upside-down pear, the top is the bottom, the middle is the corpse and the bottom is the cervix, the inner layer of the uterus is the endometrium and the outer layer is the muscle.

Uterine cancer, also known as endometrial cancer, is a type of gynecological cancer that begins in any cell of the uterus including uterine tissue.

What is uterine cancer?

1. Uterine cancer (endometrial cancer) is a common cancer affecting the female reproductive system. It is more common in women who have gone through menopause.
2. The cells in the uterus sometimes change and no longer grow or function normally. These changes can lead to non-cancerous or benign conditions such as endometriosis. They can also lead to non-cancerous tumors like uterine fibroids.
3. Changing the cells in the uterus can also cause precancerous conditions. This means that the abnormal cells are not cancerous but they can become cancerous if left untreated. The most common precancerous condition of the uterus is atypical endometrial hyperplasia.

Almost all uterine cancers begin in the endometrium and are called endometrial carcinoma. Cancer can also begin in the muscle layer or support connective tissue of the uterus called uterine sarcomas.

Types of uterine cancer

There are two main types of uterine cancer:

Endometrial cancer: Almost all uterine cancers begin in the lining of the uterus (endometrium). The two main types of endometrial cancer are:

• Endometrial cancer: This accounts for the majority of endometrial cancer.
• Uterus carcinosarcoma: Cancer cells that look like endometrial cancer and sarcoma.

Uterine sarcomas: These are less common uterine cancers and begin in the wall of the uterus. There are three types of uterine sarcoma:

• endometrial sarcoma,
• sarcoma Mullerian Viking carcinosarcoma

These are rare and can spread rapidly to other parts of the body.

What is the cause of uterine cancer?

Doctors do not know what causes these cancers, but they have identified risk factors.

For endometrial cancer they include:

1. Fat
2. Metabolic syndrome: a group of conditions including high blood pressure, high blood sugar and excess fat around the waist.
3. Never had a baby
4. Start menstruating from a young age
5. At menopause at a later age
6. Use tamoxifen for breast cancer
7. Use estrogen without progesterone

For uterine sarcoma they include:

1. Radiation therapy to the pelvis
2. Use tamoxifen for breast cancer
3. Exposure to X-rays

The symptoms of cervical cancer

Signs and symptoms of endometrial cancer include:

1. Abnormal vaginal bleeding not related to menstruation
2. Vaginal bleeding after menopause
3. Painful urination
4. Pain during intercourse
5. Pain in the pelvis
6. Lose weight without trying

Signs and symptoms of uterine sarcoma include:

1. Abnormal vaginal bleeding not related to menstruation
2. Vaginal bleeding after menopause
3. A mass in the vagina
4. Pain or a feeling of fullness
5. Frequent urination

The most common symptom of uterine cancer is abnormal vaginal bleeding, especially if it occurs after menopause. Some women with watery discharge may have an unpleasant odor. Abnormal bleeding or discharge may occur for other reasons but it is best to check with your doctor.

Diagnosis of uterine cancer

Early and accurate diagnosis of uterine cancer can increase the chance of successful treatment. MD Anderson uses the most advanced techniques and technologies to diagnose uterine cancer and find the exact level of the disease. This helps your doctor choose the type of treatment best for you.

Tests used to diagnose uterine cancer include:

1. physical exam: to check your abdomen for any swelling
2. endoscopic ultrasound : to see the size of the ovaries, the uterus and the thickness of the endometrium
3. biopsy: remove some tissue so that it can be viewed under a microscope. This can be done in a number of ways including dilatation and curettage (D&C).
4. x-rays and other scans: such as computerized tomography (CT) or magnetic resonance imaging (MRI)
5. Blood test: to check your general health and to help make decisions about your treatment.

Doctors and specialists may conduct similar tests for endometrial cancer or uterine sarcoma. A Pap test is used to screen for cervical cancer, often without these cancers.

Staged cancer

If you are diagnosed with uterine cancer, your doctor will determine the stage of the disease.

Staging is a way of classifying cancer according to the degree of disease in the body and where it has spread when diagnosed. This helps the doctor plan the best way to treat cancer.

When the stage classification is determined it remains the same even if effective treatment or cancer has spread.

Stages of uterine cancer

Stage I: Cancer only in the uterus

• IA: Cancer only in endometrium or endocrine
• IB: The tumor has spread to less than half of the uterine muscle layer volume.
• IC: The tumor has spread to more than half of the endometrium.

Stage II: The tumor has spread outside the uterus but is still inside the pelvis.

• IIA: Cancer has spread to tissues attached to the uterus, such as the ovaries or ligaments.
• IIB: Cancer has spread to other pelvic tissues.

Stage III: The tumor has spread to other tissues in the abdomen.

• IIIA: Cancer has spread to a location.
• IIIB: Cancer has spread to many places.
• IIIC: The cancer has spread to nearby lymph nodes. The tumor ranges from intrauterine only until metastases to the abdominal position.

Stage IV

• IVA: Cancer has spread to the bladder or rectum.
• IVB: Cancer has spread to distant parts of the body.

Treatments for uterine cancer

If you are diagnosed with uterine cancer, your doctor will discuss the best options to treat it. This depends on a number of factors, including the type and stage of cancer and your general health.

One or more of the following treatments may be recommended to treat uterine cancer or to relieve symptoms.

Surgery

Surgery to remove cancer is the most common treatment. Our doctors use minimal and accurate invasive robot surgical techniques. This allows pain relief, smaller incisions and faster recovery.

Options include:

• Total hysterectomy: removal of the uterus and cervix.
• Bilateral resection salpingo-oophorectomy: removal of ovaries and fallopian tubes on both sides.
• Radical hysterectomy: removal of the uterus, cervix, part of the vagina and possibly the ovaries, fallopian tubes and nearby lymph nodes.
• A dissection of lymph nodes: removal of lymph nodes so they can be checked for cancer cells.

Radiotherapy

Radiotherapy may be used to treat uterine cancer after hysterectomy or as the primary treatment when surgery is not possible.

Depending on the stage and grade of the cancer, radiotherapy may also be used at other treatment sites.

The most advanced radiation treatments for uterine cancer, including:

• Brachytherou: Small radioactive particles placed in the body close to the tumor
• External beam radiation: uses a machine outside the body to target cancer.

Valence

• The drug is used to destroy or stop the growth of cancer cells almost anywhere in the body. Medicines either kill the cells or prevent them from dividing.
• Chemotherapy is usually given in a series of slow intravenous drip fluids.

Hormone therapy

Hormone therapy removes, blocks, or stimulates hormones to prevent certain cancer cells from growing.

• With endometrial cancer, drugs that increase the amount of progesterone in your body can help stop the growth of cancer cells.
• Drugs that lower the amount of estrogen in your body can help kill endometrial cancer cells that rely on estrogen to grow.

These drugs can be taken in the form of pills, liquids or injections.

Targeted therapy

Drugs used in pill or intravenous formulations can target specific molecules in cancer cells with minimal damage to normal cells.

For endometrial cancer targeted therapy can:

• Use antibodies from an immune system cell.
• Using antibodies that can carry toxins or radioactive material to cancer cells.
• Use inhibitors that block a certain protein to keep cancer cells from growing.

Targeted therapy is used less often in uterine sarcoma.

Prospects for patients with uterine cancer

The prospect of uterine cancer is not high with higher, more widespread tumors and older patients.

The 5-year average survival rate is:

• Phase I or II: 70 – 95%
• Phase III or IV: 10 – 60%

Overall, the rate of survival of uterine cancer patients after 5 years after treatment was 63%.

Source of Cervical Cancer Reference:

• Source mayoclinic.org article Endometrial Cancer : https://www.mayoclinic.org/diseases-conditions/endometrial-cancer/symptoms-causes/syc-20352461 , updated July 25, 2019.
• Source en.wikipedia.org Uterine Cancer article : https://en.wikipedia.org/wiki/Uterine_cancer , updated September 16, 2019 .
• A reputable source index-china.com summarizes the article What is uterine cancer? : https://index-china.com/uterine-cancer/, updated 14/3/2019.