Uterine (endometrial) cancer is the uncontrollable growth of abnormal cells in the uterus lining (endometrium). This type of cancer is often referred to as "cancer of the uterus." The disease usually develops in women fifty years and older. When found in its early stage, cancer can be contained within the uterus without metastasizing (spreading) to other areas of the body.
Without intervention, abnormal uterine cell growth can eventually form a malignant or benign (non-cancerous) mass. There are certain risk factors for the development of hyperplasia (endometrial tissue growth) including obesity, Females who have never given birth, menopausal women fifty five years and older, females undergoing estrogen therapy, family history (genetic predisposition) of uterine cancer, females who began menstruating before age twelve, females with inherited colorectal cancer diagnoses and those who have had radiation to the pelvis or are taking tamoxifen.
- Endometrial Cancer Causes and Risk Factors
- Common Uterine Cancer Symptoms
- Diagnosing Uterine Cancer
- Treating Uterine Cancer
Endometrial Cancer Causes and Risk Factors
Doctors, scientists, and researchers have yet to determine the exact cause of endometrial uterine cancer. However, some think that it is the result of a genetic mutation within endometrium cells. There are specific risk factors that could exacerbate the development of endometrial cancer. These include:
- Hormonal Change – Type I endometrial uterine cancer is caused by high levels of estrogen hormone in relationship to progesterone hormone levels in the body. The hormonal imbalance results in the gradually thickening of the lining of the uterus that if allowed to build up can begin forming cancerous cells. Many conditions and diseases are known to increase the levels of estrogen without affecting progesterone levels that could increase the potential risk of developing uterine cancer. Some conditions include irregular ovulation patterns including those occurring in diabetic or obese females and those with polycystic ovary syndrome.
- Extended Menstruation – Females who begin menstruating before age twelve or continue to menstruate long after common menopausal years have a potential risk of developing uterine cancer. Simply put, the more periods a woman has experience, the more exposure the uterus' endometrium has had to deal with estrogen.
- Never Being Pregnant – Females who have never become pregnant have an increased potential risk of developing uterine cancer compared to females who have been pregnant at least once.
- Aging – As women become older, the potential risk of developing uterine cancer increases. In fact, the highest numbers of endometrial cancer cases involve women who have already passed their menopausal years.
- Obesity – Being significantly overweight increases the potential risk of developing uterine cancer. This is thought to happen because excess amounts of body fat can cause hormonal imbalances especially between estrogen and progesterone.
- Breast Cancer Hormone Therapy – Individuals undergoing breast cancer hormonal therapy and taking the medication tamoxifen have an elevated potential risk of developing uterine cancer. However, the benefits of taking the medication might significantly outweigh the minimal risks involved in developing endometrial cancer. Only having a discussion with your doctor can determine if the therapy is right that is for you.
- Inherited Colon Cancer Syndrome – Females with hereditary non-polyposis colorectal cancer have an elevated level of risk of developing colon cancer and other serious cancers including uterine cancer. This syndrome is a result of a gene mutation inherited from parents. Females who have had other family members diagnosed with the condition are at greatest risk of developing uterine cancer compared to women with a family history of the genetic mutation.
Common Uterine Cancer Symptoms
Typically, the patient usually knows that there is something wrong long before the doctor performing a physical examination discusses the most common uterine cancer symptoms that include:
- Unusual vaginal discharge or bleeding that is unassociated with menstruation (having a period)
- Difficulty when urinating
- Pain in the pelvic area
- Pain associated with sexual intercourse
- Unexpected weight loss
The most common uterine cancer symptoms can occur during and after menopause. Most of the symptoms appear in the later stage of the disease. This means any delay in seeking medical attention could allow the cancer cells to progress to a life-threatening condition.
Diagnosing Uterine Cancer
To successfully and accurately diagnose endometrial (uterine) cancer, the doctor will perform a variety of procedures and tests. These include:
- A Comprehensive Pelvic Examination – The doctor will perform a pelvic examination to carefully inspect the vulva (the outer portion of the genitals) with two fingers inside the vagina while simultaneously pressing down on the abdomen with the other hand to feel the ovaries and uterus. A speculum inserted into the vagina can allow the doctor to view abnormalities of the cervix and vagina.
- Transvaginal Ultrasound – The doctor can use sound waves to evaluate the texture and thickness of the endometrial layers of the uterus to rule out any other disease or condition. Using a transvaginal transducer, the doctor will insert the wand-like device into the vagina that will create video imaging of the uterus to allow viewing of any abnormality.
- Hysteroscopy Procedure – The doctor will use a scope to examine the interior lining of the uterus using a hysteroscope. The flexible, lighted thin to is inserted into the vagina and cervix to allow the doctor to view and examine the endometrium lining of the uterus.
- Tissue Sample Biopsy – The doctor will collect an endometrial biopsy from the inside of the uterus to rule out conditions or diseases through a laboratory analysis.
- Surgically Remove Tissue – If the results of the biopsy are inconclusive, the doctor may choose to perform surgery to remove endometrial tissue to undergo an analysis. Typically, this requires a D & C (dilation and curettage) procedure where the doctor scrapes away tissue from the uterus lining to be examined using a microscope to identify cancer cells.
If the test results are conclusive that endometrial (uterine) cancer has been diagnosed, the doctor typically refers the patient to a gynecological oncologist who specializes in treating cancerous cells in female reproductive systems.
Treating Uterine Cancer
Before the doctor can accurately and successfully treat uterine cancer, the condition must be staged, meaning the doctor will determine the progression of cancer. Typically, the patient will undergo chest x-rays, PET (positron emission tomography) scans, CT (computerized tomography) scans, and blood tests. The diagnosing physician will categorize uterine cancer as one of four different stages including:
- Stage I – This cancer is detected in the uterus only
- Stage II – These cancerous tissues are present in both the cervix and the uterus
- Stage III – This cancer has metastasized (spread) to areas outside of the uterus but has yet to reach the bladder or rectum. The cancer is detected in the pelvic area lymph nodes.
- Stage IV – at this level, the cancerous mass has spread (metastasized) beyond the pelvic region and now affects the rectum, bladder, and more distant areas in the body.
Typically, the doctor will remain manned one of five treatments for the disease based on its stage. This includes
- Surgical Options – The doctor may recommend surgical removal of the uterus, fallopian tubes, and ovaries.
- Radiation – Using powerful beams of protons or x-rays, the radiation therapy can destroy cancer cells.
- Hormone Therapy – The doctor may prescribe medications known to increase the levels of progesterone in the body or reduced levels of estrogen.
- Chemotherapy – Chemicals are known to destroy cancer cells through chemotherapy.
- Palliative (Supportive) Care – If the condition has progressed to the stage where effective treatment is no longer available, doctors will often recommend specialized medical care to provide relief from symptoms and pain.