Uterine Cancer: Symptoms, Causes, Treatment

What are the symptoms of uterine cancer?

Uterine cancer, also known as endometrial cancer, often presents with various signs and symptoms, particularly in its early stages. It’s essential to recognize these symptoms and seek medical attention promptly if you experience any of them. Here are some common symptoms of uterine cancer:

  1. Abnormal Vaginal Bleeding:
  • The most common symptom of uterine cancer is abnormal vaginal bleeding, particularly in postmenopausal women. This may include:
    • Vaginal bleeding or spotting between periods.
    • Bleeding after menopause (more than a year after your last menstrual period).
    • Heavy or prolonged menstrual periods (menorrhagia).
    • Irregular menstrual cycles.
  1. Pelvic Pain or Discomfort:
  • Some women with uterine cancer may experience pelvic pain or discomfort, which can range from dull and achy to sharp and persistent. The pain may be localized to the pelvis or lower abdomen.
  1. Painful Urination:
  • Uterine cancer can sometimes cause pain or discomfort during urination, which may be accompanied by other urinary symptoms such as urgency or frequency.
  1. Painful Intercourse:
  • Pain or discomfort during sexual intercourse (dyspareunia) may occur in women with uterine cancer, particularly if the tumor is located near the cervix or affects the surrounding tissues.
  1. Unexplained Weight Loss:
  • Some women with uterine cancer may experience unexplained weight loss, often accompanied by loss of appetite and fatigue. This can occur as the cancer progresses and affects the body’s metabolism.
  1. Feeling of Fullness in the Pelvis:
  • A sensation of fullness or pressure in the pelvic area, similar to bloating, may occur in women with uterine cancer, especially if the tumor grows large enough to exert pressure on surrounding organs.
  1. Changes in Bowel Habits:
  • Uterine cancer can sometimes cause changes in bowel habits, such as constipation, diarrhea, or changes in stool caliber. These symptoms may occur if the tumor presses on the intestines or rectum.

It’s important to note that many of these symptoms can also be caused by conditions other than uterine cancer, such as hormonal imbalances, benign uterine conditions (e.g., fibroids), or infections. However, if you experience any persistent or unusual symptoms, particularly if you are at an increased risk of uterine cancer (e.g., obesity, hormonal imbalances, family history), it’s essential to consult a healthcare provider for evaluation and appropriate testing. Early detection and treatment can significantly improve the prognosis for uterine cancer.

What are the causes of uterine cancer?

Uterine cancer, particularly endometrial cancer, can be influenced by various risk factors and underlying causes. While the exact cause of uterine cancer is not always clear, several factors can increase the risk of developing this type of cancer. Here are some of the primary risk factors and causes associated with uterine cancer:

  1. Hormonal Imbalances:
  • Estrogen Exposure: Prolonged exposure to estrogen without the balancing effect of progesterone can increase the risk of endometrial cancer. This can occur in conditions like polycystic ovary syndrome (PCOS), obesity, and hormone replacement therapy (HRT) that involves estrogen without progesterone.
  • Tamoxifen: This drug, used to treat and prevent breast cancer, acts like estrogen in the uterus and can increase the risk of endometrial cancer.
  1. Age:
  • The risk of uterine cancer increases with age, particularly in women over the age of 50. Most cases occur in postmenopausal women.
  1. Obesity:
  • Excess body fat can lead to higher levels of estrogen due to the conversion of androgens to estrogen in adipose tissue. This increased estrogen level can raise the risk of endometrial cancer.
  1. Reproductive and Menstrual History:
  • Early Menarche and Late Menopause: Women who began menstruating at an early age (before age 12) and those who go through menopause at a later age have a longer lifetime exposure to estrogen.
  • Nulliparity: Women who have never been pregnant have a higher risk of endometrial cancer, possibly due to the absence of the progesterone surge that occurs during pregnancy.
  1. Genetics and Family History:
  • Lynch Syndrome: This hereditary condition, also known as hereditary nonpolyposis colorectal cancer (HNPCC), increases the risk of several types of cancer, including endometrial cancer.
  • Family History: A family history of endometrial or colorectal cancer can increase a woman’s risk.
  1. Diabetes:
  • Women with diabetes have an increased risk of developing endometrial cancer. This may be related to obesity and insulin resistance, which are common in diabetes.
  1. Diet and Exercise:
  • A diet high in fat and low in fruits and vegetables, as well as a sedentary lifestyle, can contribute to obesity and increase the risk of endometrial cancer.
  1. Prior Radiation Therapy:
  • Women who have had pelvic radiation therapy for another cancer have a higher risk of developing secondary cancers in the pelvic region, including endometrial cancer.
  1. Use of Hormone Therapy:
  • Hormone replacement therapy (HRT) that includes estrogen alone (without progesterone) can increase the risk of endometrial cancer. Combined HRT (estrogen and progesterone) reduces this risk but may have other risks associated with it.
  1. Use of Oral Contraceptives:
    • Conversely, the use of combined oral contraceptives (which contain both estrogen and progesterone) has been shown to reduce the risk of endometrial cancer, particularly when used for several years.

Understanding these risk factors can help in the early identification and monitoring of women who may be at an increased risk of developing uterine cancer. Regular medical check-ups and discussing any concerns with a healthcare provider are crucial steps in the early detection and prevention of this disease.

What is the treatment for uterine cancer?

The treatment for uterine cancer, also known as endometrial cancer, depends on several factors, including the stage of the cancer, the woman’s overall health, her age, and her preferences. Treatment typically involves a combination of surgery, radiation therapy, chemotherapy, hormone therapy, or targeted therapy. Here are the main treatment options for uterine cancer:

  1. Surgery:
  • Hysterectomy: The primary treatment for most cases of uterine cancer involves the surgical removal of the uterus (hysterectomy). In some cases, the ovaries and fallopian tubes may also be removed (bilateral salpingo-oophorectomy).
  • Lymph Node Dissection: During surgery, nearby lymph nodes may be removed and examined to determine if the cancer has spread beyond the uterus.
  • Minimally Invasive Surgery: Techniques such as laparoscopic or robotic-assisted surgery may be used for certain cases of early-stage uterine cancer.
  1. Radiation Therapy:
  • External Beam Radiation: High-energy beams are directed at the pelvis to kill cancer cells and shrink tumors. This may be used after surgery to destroy any remaining cancer cells or as the primary treatment for some cases of uterine cancer.
  • Brachytherapy (Internal Radiation): Radioactive sources are placed directly into the vagina or uterus to deliver radiation to the tumor site. This is often used in combination with external beam radiation or as a boost after surgery.
  1. Chemotherapy:
  • Systemic Chemotherapy: Drugs are given intravenously or orally to kill cancer cells throughout the body. Chemotherapy may be used before surgery (neoadjuvant chemotherapy) to shrink tumors, after surgery to kill any remaining cancer cells, or for advanced or recurrent uterine cancer.
  • Intraperitoneal Chemotherapy: Chemotherapy drugs are delivered directly into the abdominal cavity through a catheter. This approach may be used for women with advanced uterine cancer.
  1. Hormone Therapy:
  • Progesterone Therapy: Hormone therapy with progestin (a synthetic form of progesterone) may be used to treat certain types of uterine cancer, particularly for women who cannot undergo surgery or have hormone receptor-positive tumors.
  1. Targeted Therapy:
  • Molecularly Targeted Drugs: Certain drugs target specific molecular pathways involved in cancer growth and progression. For example, drugs that target the PI3K/AKT/mTOR pathway may be used for women with advanced or recurrent uterine cancer.
  1. Clinical Trials:
  • Participation in clinical trials may be an option for women with uterine cancer, particularly those with advanced or recurrent disease. Clinical trials offer access to investigational treatments and help advance knowledge about new therapies.

Treatment for uterine cancer is often individualized based on the specific characteristics of the tumor, the woman’s overall health and preferences, and input from a multidisciplinary team of healthcare providers, including gynecologic oncologists, radiation oncologists, medical oncologists, and other specialists. The goal of treatment is to remove or destroy the cancer, prevent recurrence, and preserve quality of life. Regular follow-up care is important for monitoring for recurrence and managing any side effects of treatment.

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About the Author: John Scott

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