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Uterine Cancer: Symptoms, causes, prevention and treatment

Dr. Rashmi ByakodiSept 20, 2022

As mentioned in the South Asian Journal of Cancer, the most prevalent gynaecological malignancy in India and in the world is Uterine Cancer. However, if it is detected early, it can be successfully treated. The key to early diagnosis lies in identifying its symptoms and risks. This article will cover everything you need to know about Uterine Cancer, including its causes, diagnosis, treatment, and prevention methods.

Uterine Cancer

What is Uterine Cancer?

Uterine Cancer starts when a mutation occurs in the healthy cells of the uterus, and it grows abnormally to form a mass. This tumour could be benign or malignant. While a benign tumour grows but does not affect other parts of your body, a malignant tumour may grow more aggressively, spreading to other parts of the body. 

Types of Uterine Cancer

Here’s a section highlighting the types of Uterine Cancer.

1. Endometrial Cancer

Endometrial Cancer grows in the endometrium, the inner lining of the uterus. It is a prevalent type, and as mentioned in a 2022 NCBI study, over 90% of Uterine Cancers occur in the endometrium. Endometrial Cancer is divided into several types depending on how it looks under a microscope.

2. Uterine Sarcoma

Muscles of the uterus or other tissue supporting the uterus is where it begins. It is a very rare type of Uterine Cancer and is divided further into various kinds.

Uterine Cancer Symptoms

Occasionally, people may not show any signs or symptoms of the disease. Doctors advise keeping a close watch on unusual bleeding, leaking, or pain. Some of the common symptoms of Uterine Cancer include the following.

  • Vaginal bleeding in between menstrual cycles

  • Vaginal bleeding or spotting after menopause

  • Cramp in the pelvic area or pain in the lower abdominal area

  • A clear or slightly white vaginal discharge post menopause

  • Frequent, heavy, or prolonged bleeding even after the age of 40

  • Difficulty in urination or pain during urination

  • Unintended weight loss

Please seek medical help if you suffer from the symptoms mentioned above. Early detection and treatment can significantly improve the progress and quality of your life.

What causes Uterine Cancer?

Several unknown factors may contribute to this condition. Some women develop the disease without being at high risk. According to the American Cancer Society, factors that may increase your risk of developing Uterine Cancer include the following. 

  • Age: Women after age 50 are more vulnerable to Uterine Cancer. The average age for most women diagnosed is 60 years, but that does not mean women under 50 are not at risk.

  • Obesity: Fatty tissues in overweight people produce extra oestrogen, which may increase the risk. Around 70% of cases of Uterine Cancer are related to obesity.

  • Diet: A diet high in animal fat may increase the risk because a high-fat diet contains high calories, which leads to obesity. This may become a factor for Uterine Cancer.

  • Genetics: There is a high risk of developing Uterine Cancer in families with hereditary Colon Cancer. People with close relatives having Lynch Syndrome, also known as Hereditary Non-polyposis Colorectal Cancer (HNPCC), may have an increased risk for the same.

  • Diabetes: As type 2 diabetes causes obesity, people with the disease may have an increased chance of Uterine Cancer.

  • Ovarian disease: Women with ovarian tumours produce high oestrogen and low progesterone. This hormonal change can also increase the risk.

  • Hormone replacement therapy: Some women take estrogen therapy to get relief from menopause symptoms. Taking oestrogen alone without progesterone is believed to increase the risk.

Uterine Cancer stages

When a woman is diagnosed with Uterine Cancer, the doctors try to figure out whether it has developed and, if so, how far it has spread. This is known as staging. The stage of cancer determines the level at which it has grown in the body. According to the National Cancer Institute, the cancer stages are divided into I to IV based on their spread.

Stage I

In this stage, cancer grows inside the uterus only. Stage I is further divided into the following.

  • Stage IA: The malignancy is within the endometrium (the inner lining of the uterus) only or may be less than halfway through the myometrium (muscle layer of the uterus).

  • Stage IB: Cancer has already spread halfway or more into the myometrium.

Stage II

In this stage, cancer spreads from the body of the uterus to the auxiliary connective tissues of the cervix, which is called the cervical stroma. But cancer has not spread outside the uterus or to the lymph nodes.

Stage III

In this stage, the carcinoma has already aggravated outside the uterus and cervix. But it has not crossed beyond the pelvis. Stage III is further divided as follows. 

  • Stage IIIA: Cancer has grown to the outer surface of the uterus and/or to the ovaries, fallopian tubes, and uterine ligaments.

  • Stage IIIB: Cancer has reached the vagina and the connective and fatty tissues around the uterus (parametrium).

  • Stage IIIC: Cancer has spread to the pelvic lymph nodes and/or around the aorta, which is the largest artery in the body.

Stage IV

In this stage, cancer has aggravated beyond the pelvis. Stage IV is divided as follows. 

  • Stage IVA: Cancer spreads to the urinary bladder and inner lining of the intestinal wall (lower part of the large intestine). It may or may not have affected the nearby lymph nodes.

  • Stage IVB: Cancer has spread beyond the pelvis to the lymph nodes in the groin, the omentum (a double-layered fatty tissue that supports and covers the intestine and organs in the lower abdomen), the upper abdomen, and distant organs from the uterus, such as liver, bones or lungs.

Treatment of Uterine Cancer

Treatment mainly depends on how far the cancer has progressed.

1. Surgery

Usually, surgery is the primary treatment for Uterine Cancer. The surgery is called hysterectomy, in which the uterus and the cervix are removed. The hysterectomy procedure is of four types.

  • Total abdominal hysterectomy

  • Vaginal hysterectomy

  • Radical hysterectomy

  • Minimally invasive hysterectomy

Apart from the above, during the hysterectomy procedure, sometimes the uterus, along with the ovaries and fallopian tubes, are removed. It is done to make sure that all cancerous cells are removed and to prevent the recurrence of cancer. Also, as mentioned in the American Cancer Society, a lymphadenectomy procedure is done to remove the malignant lymph nodes and other associated lymph nodes that have a high risk of cancer.

2. Radiation Therapy

This method makes use of x-rays and protons (energy beams) to destroy cancer cells. It may also be recommended by doctors to lessen the risk of postoperative cancer recurrence. 

3. Chemotherapy

In chemotherapy, powerful drugs are administered to kill the cancerous cells. It may be one drug or a combination of two or more drugs. It is given in the form of oral pills or through the veins (intravenously). The medication kills the cancerous cells as it circulates throughout the body through the bloodstream. Chemotherapy is often recommended post-surgery to reduce the risk of recurrence of cancer.

4. Hormone therapy

In this type of therapy, medications are given to lower the hormone levels in the body. As a result, the cancer cells that grow with the help of hormones may die. It can be preferred in the case of advanced Uterine Cancer that has metastasized beyond the uterus.

5. Immunotherapy

Immunotherapy helps the immune system fight cancer. It works by interfering with the process in which cancer cells produce proteins that blind the immune system. It is considered in advanced Uterine Cancer cases.

Frequently Asked Questions (FAQs)

Here’s a list of common questions and their answers related to Uterine Cancer.

Can Uterine Cancer be prevented?

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Though Uterine Cancer cannot be prevented, some steps can be taken to lower the risk, which may include the following.

  • Maintain a healthy diet

  • Keep a check on weight

  • Control diabetes

  • Discuss with your doctor about using contraceptives

Shall I go through a screening test for Uterine Cancer?

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There is no such screening tool. Doctors generally do not recommend regular testing for people without symptoms. If you think that you are at high risk, then talk to your doctor to have your regular check-ups done for Uterine Cancer.

What is the survival rate of Uterine Cancer?

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81% of people diagnosed with Uterine Cancer have a survival rate of 5 years. If the cancer is localised and has not spread, then the survival rate may go up to 95%. Treatment helps to improve the condition with the survival rates as well.

Is Uterine Cancer curable?

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Fortunately, Uterine Cancer is curable if the disease is detected at an early stage because most people notice unusual bleeding and consult their doctors. If the cancer is caught at this point, the uterus can be removed, and the patient can be cured.

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