Uterine Cancer: Types, Symptoms, Diagnosis, and Treatment

Uterine cancer, also known as endometrial cancer, is a type of cancer that begins in the lining of the uterus (endometrium). It is the most common cancer of the female reproductive system. This article provides a comprehensive overview of uterine cancer, including its types, symptoms, diagnosis, and treatment options.

Types of Uterine Cancer

Uterine cancer is primarily classified into two main types based on the cells where the cancer originates:

1. Endometrial Carcinoma: This is the most common type of uterine cancer, accounting for more than 90% of cases. It begins in the cells of the endometrium, the inner lining of the uterus. Endometrial carcinoma is often further categorized into different subtypes, including:
   • Endometrioid adenocarcinoma: The most common subtype, generally associated with a better prognosis.
   • Serous carcinoma: A more aggressive form that tends to spread more quickly.
   • Clear cell carcinoma: Another aggressive form that is less common.
2. Uterine Sarcoma: A rare type of uterine cancer that forms in the muscles or other tissues of the uterus. Subtypes include:
   • Leiomyosarcoma: Originates in the smooth muscle of the uterus.
   • Endometrial stromal sarcoma: Starts in the connective tissue of the endometrium.

Symptoms of Uterine Cancer

Early detection of uterine cancer can significantly improve treatment outcomes. Common symptoms include:

1. Abnormal Vaginal Bleeding: This is the most common symptom, particularly in postmenopausal women. It may include heavy periods, bleeding between periods, or any vaginal bleeding after menopause.
2. Pelvic Pain: Persistent pain or discomfort in the pelvic area.
3. Pain During Intercourse: Experiencing pain during sexual activity.
4. Unusual Vaginal Discharge: Watery or blood-tinged discharge, particularly if it has a foul odor.
5. Unexplained Weight Loss: Significant weight loss without trying.

Risk Factors for Uterine Cancer

Several factors can increase the risk of developing uterine cancer, including:

1. Age: The risk increases with age, particularly for women over 50.
2. Obesity: Excess body fat can increase estrogen levels, raising the risk of endometrial cancer.
3. Hormone Therapy: Prolonged use of estrogen without progesterone in hormone replacement therapy (HRT) can increase risk.
4. Reproductive History: Never having been pregnant can increase risk.
5. Genetic Factors: A family history of uterine or colorectal cancer, particularly with Lynch syndrome, a genetic condition that increases the risk of various cancers.
6. Menstrual History: Early onset of menstruation (before age 12) or late menopause (after age 55).

Diagnosis of Uterine Cancer

Diagnosing uterine cancer involves a combination of medical history evaluation, physical exams, and diagnostic tests. Common diagnostic methods include:

1. Pelvic Exam: A thorough examination of the uterus, ovaries, and other pelvic organs.
2. Transvaginal Ultrasound: An ultrasound probe is inserted into the vagina to create detailed images of the uterus and endometrium.
3. Endometrial Biopsy: A sample of tissue is taken from the endometrium and examined under a microscope to check for cancer cells.
4. Hysteroscopy: A thin, lighted tube is inserted into the uterus through the vagina to examine the endometrial lining and take a tissue sample if necessary.
5. Imaging Tests: MRI or CT scans may be used to determine the extent of cancer spread.

Treatment Options for Uterine Cancer

Treatment for uterine cancer depends on the type, stage, and grade of the cancer, as well as the patient’s overall health. Common treatment options include:

1. Surgery: The primary treatment for uterine cancer. A total hysterectomy (removal of the uterus) is typically performed, often along with a bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes). Lymph node removal may also be necessary to check for cancer spread.
2. Radiation Therapy: High-energy rays are used to target and kill cancer cells. This may be used before surgery to shrink the tumor or after surgery to kill any remaining cancer cells.
3. Hormone Therapy: Used primarily for endometrial carcinoma, hormone therapy involves medications that reduce estrogen levels or block its effects on the endometrium. This is particularly effective for hormone receptor-positive cancers.
4. Chemotherapy: The use of drugs to kill cancer cells, usually administered intravenously. Chemotherapy is often used for advanced or recurrent uterine cancer.
5. Targeted Therapy: Drugs or other substances that specifically target cancer cells with minimal damage to normal cells. These therapies are often used in advanced stages or when other treatments are not effective.
6. Immunotherapy: This involves using the body’s immune system to fight cancer. Certain types of immunotherapy may be effective in treating advanced uterine cancer, particularly when other treatments have failed.

Conclusion

Uterine cancer is a serious disease, but with early detection and appropriate treatment, many women can achieve positive outcomes. Regular check-ups, awareness of symptoms, and understanding risk factors are crucial for early diagnosis. Advances in treatment options continue to improve the prognosis and quality of life for women with uterine cancer. If you experience any symptoms or have risk factors associated with uterine cancer, it is important to consult with a healthcare professional for appropriate evaluation and care.