Of the cancers affecting the female reproductive organs, Uterine Cancer is the most common. 19 out of 20 uterine cancers affect the endometrium or the inner lining of the uterus. This is referred as Endometrial Cancer. The rest are cancers of the sarcomas i.e. the outer muscular lining of the uterus. Uterine Cancer is one of the most curable types of cancers with a survival rate of 80% or more if detected early.
The hormone Estrogen is the determinant factor for endometrial cancer. Endometrial cancer is most prevalent in women above the age of 40.The common causes can be listed as follows:
Estrogen levels: Women with high levels of the hormone estrogen are at higher risk since estrogen stimulates the growth of the endometrium. Women who had more menstrual cycles are at higher risk as estrogen is secreted in each cycle. Women who had children are at lower risk compared to those who hadn’t since pregnancies interrupt the menstrual cycle and hence estrogen levels.
Obesity: Women who are overweight are more likely to develop this cancer as the fatty tissues produce large amounts of estrogen continuously
Family history: Women with a family history of Endometrial Cancer or Breast Cancer or Colon Cancer are at higher risk.
Breast Cancer patients who take medication to avoid recurrence of it are at higher risks since the medication produces estrogen like effects. In such cases, consult with your physician who might arrange for regular monitoring to detect Uterine Cancer in the early stages.
The most common and predominant symptom of Endometrial Cancer is abnormal uterine bleeding. In premenopausal women, if bleeding occurs at unusual times it is considered abnormal. In case of postmenopausal women, if bleeding occurs then it is unusual. Most uterine cancers cause bleeding. Other symptoms include bloating of the abdomen, weight loss, pelvic pain.
Majority of Uterine cancers are diagnosed when women experience abnormal bleeding. The only reliable test is tissue sampling (biopsy) from the endometrium. The Pap smear test (refer cervical cancer section) can also be used but its results are not reliable in detecting uterine cancers. Ultrasounds can also be used but the results are less reliable compared to biopsy.
Uterus Removal: Hysterectomy or uterus removal along with removal of fallopian tubes and ovaries is integral for treatment of uterine cancer. This would lead to infertility. No additional treatment is required if the cancer is detected in the early stages and the cancer is of less aggressive type.
Chemotherapy and/or Radiation: In cases where the cancer has spread further to the walls of the uterus pelvic radiation or chemotherapy or a combination of both are required to kill the remaining cancerous cells. Pelvic Radiation can have unwanted effects such as nausea, abdominal pain and fatigue. It can also cause narrowing of the vagina which makes sex difficult and painful. Chemotherapy can also have unpleasant side effects which vary depending on the medications your doctor provides.
Medication: Synthetic progestins a type of hormone progesterone which counteracts the effects of the hormone estrogen on the endometrium are sometimes used to treat this type of cancer. This is used in advanced stages or when the cancer recurs. They have very mild side effects when compared to other cancer medications.
There are no definite ways to prevent uterine cancer but certain factors may reduce the risks of developing it. Controlling your weight by maintaining a healthy lifestyle can reduce your risk of developing it. Being engaged in physical activity or exercises may also lower the risk of endometrial cancer. Taking progesterone while taking Estrogen for menopausal symptoms can reduce your risks.