Uterine Cancer

Uterine Cancer, also known as endometrial Cancer, is a life-threatening disease that originates in the lining of the uterus, affecting approximately 65,000 women annually in the US. It is the most common type of gynecologic Cancer, typically affecting postmenopausal women between 60-70 years old. Caused by abnormal cell growth in the endometrium, uterine Cancer can spread to nearby organs if left untreated. Risk factors include obesity, hormone replacement therapy, family history, and genetic syndromes. With early detection and treatment, the five-year survival rate is approximately 95%, emphasizing the importance of awareness, regular screenings, and timely intervention to improve outcomes for those affected by this disease.

To explore everything about uterine Cancer and be aware of this life-threatening medical condition, read this informative article! 

What is Uterine Cancer?

Uterine Cancer, also known as endometrial Cancer, is a type of malignancy that occurs when abnormal cells grow and multiply uncontrollably in the uterus lining, called the endometrium. This Cancer originates in the uterus and can spread to nearby organs, affecting the reproductive system. Characterized by uncontrolled cell division, uterine Cancer disrupts normal uterine function, leading to symptoms such as irregular vaginal bleeding, pelvic pain, and weight loss. Uterine Cancer includes various subtypes, primarily affecting postmenopausal women, and is often linked to genetic, hormonal, and environmental factors.

What Are the Types And Stages of Uterine Cancer?

There are several types of uterine Cancer, classified based on location, cell type, and tumor characteristics. Here are the main types:

Main Types

• Endometrial Cancer (85-90% of cases)
• Originates in the endometrium (lining of the uterus)
• Subtypes: endometrioid, serous, clear cell, and mucinous

• Uterine Sarcoma (5-10% of cases)

    Originates in the uterine muscle (myometrium)

    Subtypes: leiomyosarcoma, endometrial stromal sarcoma, and undifferentiated sarcoma

• Uterine Carcinosarcoma (5% of cases)

    Mixed tumor with both epithelial and sarcomatous components

Subtypes of Endometrial Cancer

• Endometrioid Carcinoma (most common)
• Serous Carcinoma (aggressive)
• Clear Cell Carcinoma (rare and aggressive)
• Mucinous Carcinoma (rare)
• Squamous Cell Carcinoma (rare)

Rare Types

• Adenosquamous Carcinoma
• Glassy Cell Carcinoma
• Secretory Carcinoma
• Ciliated Cell Carcinoma

Staging

Uterine Cancer is staged using the International Federation of Gynecology and Obstetrics (FIGO) system:

• Stage I: Cancer confined to the uterus
• Stage II: Cancer spreads to the cervix
• Stage III: Cancer spreads to the pelvis
• Stage IV: Cancer spreads to distant organs

What Causes Uterine Cancer?

Here's an elaborate explanation of the causes of uterine Cancer:

Hormonal Factors

• Estrogen Dominance: High levels of estrogen without progesterone balance increase uterine cancer risk.
• Hormone Replacement Therapy (HRT): Prolonged use of estrogen-only HRT increases risk.
• Estrogen-Producing Tumors: Rare tumors that produce excess estrogen.

Genetic Factors

• Family History: Increased risk with a family history of uterine, ovarian, or colorectal Cancer.
• Genetic Mutations: Changes in genes such as PTEN, PIK3CA, and KRAS.
• Lynch Syndrome: Hereditary nonpolyposis colorectal cancer (HNPCC) increases uterine cancer risk.
• Other Genetic Syndromes: Cowden syndrome, Li-Fraumeni syndrome, and others.

Lifestyle Factors

• Obesity: Excess body fat increases estrogen levels.
• Physical Inactivity: A sedentary lifestyle increases cancer risk.
• Diet: High processed meat, low fruit and vegetable intake.
• Smoking: It may increase uterine cancer risk.

Medical Conditions

• Diabetes: Insulin resistance and high insulin levels.
• Hypertension: High blood pressure.
• Polycystic Ovary Syndrome (PCOS): Hormonal imbalance increases cancer risk.
• Endometrial Hyperplasia: Precancerous condition.

Environmental Factors

• Radiation Exposure: Previous radiation therapy to the pelvis.
• Certain Chemicals: Exposure to certain chemicals, such as pesticides.

Reproductive Factors

• Early Menstruation (before 12 years).
• Late Menopause (after 55 years).
• Nulliparity (never having given birth).
• Infertility.

Other Factors

• Previous uterine Procedures (e.g., D&C, endometrial ablation).
• Uterine fibroids.
• Tamoxifen use: Prolonged use for breast cancer treatment.

What Are the Symptoms of Uterine Cancer?

Symptoms of uterine Cancer vary in intensity according to the stage. Here are the common symptoms of uterine Cancer:

Early Symptoms

• Abnormal Vaginal Bleeding:

    Heavy or prolonged menstrual bleeding

    Bleeding between periods

    Postmenopausal bleeding

    Spotting or staining

• Pelvic Pain or Pressure:

    Pain or discomfort in the lower abdomen

    The feeling of fullness or pressure in the pelvis

• Unusual Vaginal Discharge:

    Watery or bloody discharge

    Foul-smelling discharge

Advanced Symptoms

• Weight Loss:

    Unexplained weight loss

    Loss of appetite

• Fatigue:

    Feeling weak or tired

    Decreased energy

• Abdominal Swelling:

    Enlarged abdomen

    Bloating

• Urinary Symptoms:

    Frequent urination

    Painful urination

    Difficulty starting or stopping urination

• Bowel Symptoms:

    Constipation

    Diarrhea

    Blood in stool

Other Symptoms

• Back Pain
• Leg Pain
• Difficulty Walking
• Abdominal Mass (tumor)
• Loss of Bladder or Bowel Control

How is Uterine Cancer Diagnosed?

Here's a comprehensive overview of the diagnosis process for uterine Cancer:

Diagnostic Steps

• Medical History: Review of patient's medical history, symptoms, and risk factors.
• Physical Exam: Pelvic exam to check for any abnormalities.

• Imaging Tests:

    Ultrasound (transvaginal or abdominal)

    MRI (magnetic resonance imaging)

    CT scan (computed tomography)

    PET scan (positron emission tomography)

• Endometrial Biopsy: Sampling of endometrial tissue for histological examination.
• Dilation and Curettage (D&C): Surgical procedure to remove tissue from the uterus.
• Hysteroscopy: Visual examination of the uterus using a scope.

• Blood Tests:

    CA-125 (cancer antigen 125)

    Other tumor markers (e.g., CA 19-9, CEA)

Diagnostic Procedures

• Endometrial Sampling:

    Office biopsy

    D&C

    Hysteroscopic biopsy

• Imaging-Guided Biopsy:

    Ultrasound-guided biopsy

    MRI-guided biopsy

• Surgical Staging:

    Laparotomy (open surgery)

    Laparoscopy (minimally invasive surgery)

What Are the Treatment Options For Uterine Cancer?

Here's a guide to uterine cancer treatment:

Surgical Treatment

• Hysterectomy (removal of the uterus): Open or laparoscopic surgery.
• Salpingo-oophorectomy (removal of ovaries and fallopian tubes).
• Lymphadenectomy (removal of lymph nodes).
• Debulking surgery (removal of tumor tissue).

Radiation Therapy

• External Beam Radiation Therapy (EBRT): Targets tumors from outside the body.
• Brachytherapy: Internal radiation, delivering high doses directly to tumors.
• Intensity-Modulated Radiation Therapy (IMRT): Precise radiation delivery.

Chemotherapy

• Systemic Chemotherapy: Oral or intravenous medication.
• Intra-Arterial Chemotherapy: Directly delivers chemotherapy to tumors.
• Intraperitoneal Chemotherapy: Delivers chemotherapy to the abdominal cavity.

Hormone Therapy

• Progesterone Therapy: Slows tumor growth.
• Aromatase Inhibitors: Blocks estrogen production.
• Gonadotropin-Releasing Hormone (GnRH) Agonists: Reduces estrogen levels.

Targeted Therapy

• Trastuzumab (Herceptin): Targets HER2-positive tumors.
• Bevacizumab (Avastin): Inhibits angiogenesis (blood vessel growth).
• Pembrolizumab (Keytruda): Targets PD-L1-positive tumors.

Minimally Invasive Treatments

• Laparoscopic Surgery.
• Robotic Surgery.
• Stereotactic Body Radiation Therapy (SBRT).

Can You Prevent Uterine Cancer?

You can lower your risk of uterine Cancer by the following preventive tips: 

• Maintain healthy weight
• Exercise regularly
• Eat a balanced diet (fruits, vegetables, whole grains)
• Limit processed meat and sugar
• Quit smoking
• Manage diabetes and blood pressure
• Consider progesterone therapy (for hormone imbalance)
• Limit estrogen-only hormone replacement therapy
• Get Annual pelvic exams, regular Pap tests, endometrial biopsy (if abnormal bleeding), transvaginal ultrasound (TVUS)
• Limit radiation exposure
• Manage stress
• Get enough sleep

Conclusion 

Uterine Cancer is a significant women's health concern, with hormonal imbalances, genetic predispositions, and lifestyle factors contributing to its development. Early detection through routine screenings and pelvic exams significantly improves treatment outcomes. Advances in surgical, radiation, and medical oncology offer hope for improved survival rates and quality of life. Awareness, prevention, and research are crucial in combating this disease. By prioritizing women's health and supporting innovative treatments, we can reduce the burden of uterine Cancer and improve outcomes for affected women.