What is uterine cancer?

Uterine cancer begins in the womb, the hollow, pear-like organ of a woman's pelvis where the baby grows during pregnancy. Uterine cancer may form in different areas of the uterus, but the majority develops in the endometrium - the inner lining of the uterus - and is called endometrial cancer.

Endometrial cancer is the most common gynaecological cancer in the united states, accounting for 6 per cent of all cancers in women, according to the national cancer institute (NCI). Most cases of endometrial cancer are diagnosed at an early stage and treated with surgery alone.

Uterine cancer types

There are three types of uterine cancer.

Endometrial cancer: Almost all uterine cancers begin in the lining of the womb (endometrium). The two main types of endometrial cancer are:

· Endometrioid adenocarcinoma: This is the reason for most cases of endometrial cancer.

· Uterine carcinosarcoma: Cancer cells look like endometrial carcinoma and sarcoma.

Uterine sarcomas: These are less common types of uterine cancer and begin in the uterine muscle wall.

What are the symptoms of uterine cancer?

Uterine cancer may cause abnormal vaginal discharge or bleed for you. Bleeding may be abnormal due to its intensity or when it occurs, such as after menopause, between periods, or any other bleeding that is longer or heavier than usual for you. Uterine cancer may likewise cause different indications, for example, torment or weight in your pelvis.

If you have abnormal bleeding, especially if you have already gone through menopause, see a doctor immediately. Also, see a doctor if you have any other signs or symptoms for two weeks or more. These things may be caused by something other than cancer, but the only way to find out is to see your gynaecologist doctor.

What causes uterine cancer?

The exact causes of uterine cancer are unknown, but there are a number of factors that increase the risk of developing the disease. Since too much estrogen increases a woman's risk of developing uterine cancer, factors that raise a woman's estrogen level may increase her risk as well. Some of these factors include:

· Obesity

· Ovarian tumors

· Polycystic ovarian syndrome

· Estrogen therapy

· Menstruation begins early or late

· Take tamoxifen to prevent and treat breast cancer

Likewise, low estrogen reduces a woman's risk of developing uterine cancer, and factors that lower a woman's estrogen level may reduce her risk. Some of these factors include:

· Birth control use

· Pregnancy

Notwithstanding a lady's hormone levels, other dangerous elements may expand a lady's possibility of creating uterine cancer. These include:

· Diabetes

· Atypical endometrial hyperplasia

· Pelvic radiation therapy

· A family history of uterine cancer

Diagnosis of uterine cancer

Tests include diagnosing uterine cancer:

Physical examination

The doctor may examine your abdomen for any swelling. To inspect the uterus, the specialist will put two fingers inside the vagina while pushing on your midsection, or they may utilize an instrument (speculum) that isolates the dividers of the vagina (similar to the cervical screening test).

Transvaginal ultrasound

Using an ultrasound together with a device called a transducer, the doctor can see the size of the ovaries and uterus and the thickness of the endometrium. If anything unusual appears, the doctor may suggest a biopsy.

Endometrial biopsy

An endometrial biopsy is performed in a specialist's office. A long, thin tube (pipelle) is inserted into the vagina to absorb cells from the endometrium. The cells are sent to a pathologist, who examines them under a microscope. There may be some discomfort similar to menstrual cramps, so your doctor may suggest that you take a non-steroidal anti-inflammatory drug such as ibuprofen, before the procedure.

Hysteroscopy and biopsy

A hysteroscope is a telescope-like device that is inserted through the vagina into the uterus and allows a gynaecologist to see inside the uterus. During this procedure, tissue may also be removed (biopsy) and sent for further tests in the laboratory.

Blood and urine tests

Blood and urine tests can be used to assess your general health and inform treatment decisions.

Other tests

If cancer is detected in the womb, you may undergo other scans to see if cancer has spread to other parts of your body, such as an X-ray, CT scan, or MRI scan. For certain types of uterine cancer, such as sarcoma, a PET scan may be used.

Risk factors for uterine cancer

A danger factor is whatever builds an individual's possibility of creating disease. Despite the fact that danger factors frequently impact the advancement of the disease, most don't legitimately cause cancer. Some people with many risk factors never develop cancer, while others have no known risk factors for developing it. Realizing your danger factors and discussing them with your doctor may assist you in making a more educated way of life and medical services decisions.

The following factors may increase a woman's risk of developing uterine cancer:

· Uterine cancer most often occurs in women over the age of 50. The average age at diagnosis is 60. Uterine cancer is not common in women younger than 45 years old.

· Adipose tissue in overweight women produces extra estrogen, a sex hormone that can increase the risk of uterine cancer. This risk increases with an increase in body mass index (BMI), which is the ratio of a person's weight to height. About 70% of uterine cancer cases are connected to stoutness.

· White women are more likely to develop endometrial cancer than women of other races/ethnicities. However, black women have a higher chance of developing advanced uterine cancer. Black women and Hispanic women are more likely to have aggressive tumors.

· Uterine cancer may run in families where colon cancer is hereditary. As explained in the introduction, women in families with Lynch syndrome, also called hereditary nonpolyposis colorectal cancer (HNPCC), are more likely to develop endometrial cancer. It is recommended that all women under the age of 60 with endometrial cancer have a lump test for Lynch syndrome, even if they do not have a family history of colon cancer or other cancers. The presence of Lynch syndrome has significant ramifications for ladies and their relatives. About 2% to 5% of ladies with endometrial cancer have Lynch syndrome. In the united states, about 1,000 to 2,500 women who develop endometrial cancer each year may have this genetic condition.

· Women may be more likely to develop uterine cancer if they have diabetes, which is often linked to obesity (see above).

Other cancers: Women with breast, colon, or ovarian cancer have an increased risk of developing uterine cancer.

Women who take tamoxifen (Nolvadex) to prevent or treat breast cancer have an increased risk of developing uterine cancer. The benefits of tamoxifen usually outweigh the risk of uterine cancer, but all women who are prescribed tamoxifen should speak with their doctor about the benefits and risks.

Radiation therapy: Women who have previously had radiation therapy for another cancer of the pelvis, which is the lower part of the abdomen between the hip bones, have an increased risk of uterine cancer.

Diet/nutrition: Women who eat foods high in animal fat may have an increased risk of developing uterine cancer.

Prolonged exposure to estrogen and/or an estrogen imbalance is associated with several of the following risk factors:

· Women who start their periods before age 12 and/or go through menopause later in life. Learn more about menopause and the risk of developing cancer

· Women who are taking hormone replacement therapy (HRT) after menopause, especially if they are taking estrogen alone. The risk is lower for women who take estrogen along with progesterone, another sex hormone.

· Women who have not become pregnant before.

Treatment for uterine cancer

The treatment your doctor recommends depends on the results of your tests, the type, and location of cancer, whether it has spread, your age, and your general health. Uterine cancer is regularly analyzed ahead of schedule before it has spread and can be dealt with carefully. For some ladies, medical procedures will be the main therapy they need. If cancer has spread outside the uterus, radiation therapy, hormone therapy, or chemotherapy may also be used.

Surgery

Uterine cancer is typically treated with an activity to eliminate the uterus and cervix (all-out hysterectomy), alongside both the fallopian tubes and the ovaries (salpingectomy and two-sided ovarian resection). The ovaries are usually removed because they produce estrogen, a hormone that may cause cancer to grow. Removing them reduces the risk of cancer returning.

The surgery is performed under general anaesthesia. The type of hysterectomy offered to you depends on a number of factors, including your age and structure, uterine size, tumor size, and the surgeon's speciality and experience. Your surgeon will talk with you about the risks and complications of your procedure.

If you are premenopausal, removing your ovaries will lead to menopause. If your ovaries look normal and you don't have any risk factors, you may be able to preserve your ovaries. Talk to your doctor about your specific condition.

How the surgery is done?

Laparotomy

The surgery is performed through the abdomen. Usually, a cut is made from the pubic area to the navel. Some of the time a cut is made along the pubic line. Once the abdomen is opened, the surgeon flushes the area with fluids. Then the uterus, fallopian tubes, and ovaries are removed. If cancer has spread to the cervix, the surgeon may also remove a small portion of the upper part of the vagina and the ligaments supporting the cervix.

Laparoscopic hysterectomy

This is sometimes called keyhole surgery. The surgeon makes 3-4 small cuts in the abdomen and uses a thin telescope (laparoscope) to see inside the abdomen. The uterus and different organs are generally eliminated through the vagina. A robotic hysterectomy is a specialized form of laparoscopic hysterectomy in which surgical instruments are controlled with robotic arms guided by the surgeon seated next to the operating table.

Lymph nodes in your pelvis may likewise be eliminated, contingent upon the size and kind of disease. This procedure is called a lymph node resection or lymph node biopsy. In some cases, biopsies or extra tissue may be taken, depending on the type of tumor you have. The gynaecologist will discuss this with you before the operation.

All tissues and fluid removed are examined for cancer cells by a pathologist. The results will help confirm the type of uterine cancer you have if it has spread (metastasized), and its stage.

Most women with uterine cancer will undergo this procedure. However, your case may be different. Talk to your doctor. Pre-operative fallopian tubes of the uterus ovary cervix (cervix) After the operation, the dotted chart shows the organs removed during surgery. Ovarian vagina (birth canal)

After the operation

When you wake up after the operation, you will be in the recovery room near the operating room. Once you are fully conscious, you will be taken to the ward, where you will stay for one to four days until you can return home. The length of your stay will depend on the type of surgery (laparoscopy or laparotomy) you had.

You'll get an injection into a vein in your arm to give you medications and fluids. There may also be a tube in your abdomen to drain the operation site and a tube in your bladder (catheter) to collect urine. It is usually removed the next day after the operation.

As with all major operations, you will feel some discomfort or pain. On the first or second day, you may be given a pain reliever through a drip or by injection of a local anaesthetic into the abdomen (TAP block) or the spine (epidural). Tell your doctor or nurse if you are in pain so that they can adjust your medications to make you as comfortable as possible. Don't wait until the pain is severe.

You can also expect some light vaginal bleeding after surgery, which should stop within two weeks. Once you get home, your doctor will talk to you about how to keep the wound clean to prevent infection.

You will have to wear compression stockings for two weeks to help the blood in your legs circulate. You will likewise be given a day by day infusion of blood more slender to decrease the danger of blood clusters. Depending on your risk of developing a clot, you may be taught to give this injection to yourself, so that you can continue to do so for a few weeks at home.

Your doctor will get all the test results about a week after the operation. The necessity for additional treatment depends on the type, stage, and grade of the disease, and the amount of any cancer remaining. On the off chance that the cancer is at the beginning phase, you may not require extra treatment.

Prevention of uterine cancer

Different factors contribute to different types of cancer. Researchers are continuing to investigate factors that increase the risk of developing this type of cancer, including ways to prevent it. Although there's no proven way to completely prevent uterine cancer, you may be able to reduce your risk of developing it. Talk to your health care team for more information about your cancer risk.

Research has shown that some factors can reduce the risk of developing uterine cancer:

· Take birth control pills. The birth control pill contains a mixture of estrogen and progesterone that is taken periodically to produce a monthly period, which reduces the risk of endometriosis, especially when taken for a long period of time.

· Use of an intrauterine device that secretes progestin (IUD), which is a form of birth control.

· Consider the risk of developing uterine cancer before starting HRT, especially estrogen replacement therapy alone. Using a combination of estrogen and progesterone in HRT may help reduce the risk.

· Maintain a healthy weight.

· If you have diabetes, good disease management, such as regular monitoring of blood glucose levels, can reduce the risk.