Uterine cancer arises from the uterus. It is two main types, One arising from the inner lining of the uterus (called endometrium) is Endometrial cancer, which is the most common type constituting about 95% of uterine cancer. The second arises from the muscle layer (myometrium) and is referred to as Uterine sarcomas.
Uterine cancer Causes
Cancer of the uterus especially endometrial cancer, is caused by various factors. Hormonal imbalances are the primary factors which contribute to its development.
Excess of estrogen and lack of progesterone is linked with uterine cancer development and various situation for above hormonal imbalances include conditions like obesity, polycystic ovary syndrome (PCOS), and estrogen replacement therapy without progesterone acting as significant risk factors.
Early menstruation (before age 12) and late menopause (after age 52) also disrupt hormonal balance, increasing susceptibility.
Obesity plays a dual role, as adipose tissue produces additional estrogen, further heightening the risk.
Hereditary factors, such as Lynch syndrome and specific gene mutations, contribute significantly, affecting cell growth and division within the uterus.
Advanced age, especially post-menopause, amplifies vulnerability to uterine cancer.
Reproductive factors, Women who have never been pregnant or undergone childbirth are at elevated risk, highlighting reproductive history’s impact.
Additional risk factors include a history of endometrial hyperplasia, pelvic radiation therapy, and tamoxifen use without progesterone therapy.
Uterine cancer Symptoms
Abnormal bleeding in a post menopausal woman is one of the most common symptoms which hallmark the presence of uterine cancer. Presence of any of the symptoms should make a woman cautious and she should take prompt action and consult her gynecologist.
various symptoms include:
Abnormal vaginal bleeding: This is the most common symptom of uterine cancer. It may include bleeding between periods, heavier or longer menstrual periods than usual, or bleeding after menopause.
Pelvic pain or pressure: Persistent pelvic pain, discomfort, or pressure in the pelvic area can be a symptom of uterine cancer, especially as the tumor grows.
Vaginal discharge: Unusual vaginal discharge that may be watery, bloody, or contain pus can occur with uterine cancer.
Painful urination: Some women with uterine cancer may experience pain or discomfort during urination.
Pain during intercourse: Pain or discomfort during sexual intercourse (dyspareunia) can be a symptom of uterine cancer, especially if it is persistent or worsens over time.
Enlarged uterus or swelling in the abdomen: As the cancer progresses, it may cause the uterus or abdomen to enlarge, leading to a noticeable increase in abdominal size or bloating.
Weight loss and Fatigue: particularly are symptoms of advanced stages when the cancer may have spread.
Uterine cancer diagnosis and stages
Various diagnostic modalities used for diagnosis of uterine cancer include thorough medical examination, Imaging Imaging tests such as transvaginal ultrasound, pelvic MRI or CT scans, Biopsy with histopathological examination.
Investigation done for staging of disease include Imaging studies such as PET CT scan, CT chest, and sometimes surgical procedures such as staging laparoscopy and lymph node dissection.
Uterine cancer can be divided in various stages as follows:
Stage I – tumor is confined to the uterus
Stage II – Cancer has spread within the uterus but not beyond
Stage III – Cancer has spread beyond the uterus but limited within the pelvic cavity
Stage IV – cancer has spread to other organs
Uterine cancer Treatment
Treatment of uterine cancer depends on the stage at which cancer is diagnosed. other factors contributing to selection of therapy include health of patient, spread of cancer and individual patient preferences.
various treatment modalities for uterine cancer include:
Surgery: Surgery is often the primary treatment for uterine cancer, especially in early-stage cases. Removal of uterus can be done with advanced surgical techniques such as laparoscopy or Robotic surgery. Lymph node dissection may also be performed to assess cancer spread to nearby lymph nodes.
Radiation Therapy: Radiation therapy uses high-energy beams to target and destroy cancer cells. External beam radiation and brachytherapy (internal radiation) are common radiation techniques used in uterine cancer treatment.
Chemotherapy: It may be used in combination with surgery and/or radiation therapy, especially in advanced or recurrent uterine cancers.
Hormone Therapy: Hormone therapy is primarily used for certain types of uterine cancers, such as low-grade endometrioid carcinomas that are estrogen receptor-positive.
Targeted Therapy: Targeted therapy drugs specifically target abnormalities or proteins present in cancer cells, disrupting their growth and survival. Drugs like pembrolizumab may be used in uterine cancers with specific genetic mutations or biomarkers, especially in advanced or recurrent cases.
Uterine cancer Survival Rates
Uterine cancer is usually diagnosed in early stages due to early presentation of symptoms. Survival rates depend on the stage at which is diagnosed. stage wise survival rates are described below
Stage I Survival Rates: In stage I uterine cancer, where the cancer is confined to the uterus, the five-year survival rate is relatively high, ranging from 80% to 90%.
Stage II Survival Rates: For stage II uterine cancer, where the cancer has spread to the cervix but remains within the pelvic area, the five-year survival rate typically ranges from 60% to 70%.
Stage III Survival Rates: In stage III uterine cancer, where the cancer has spread beyond the uterus and cervix to nearby tissues or lymph nodes, the five-year survival rate ranges from 30% to 50%. Treatment often involves a combination of surgery, radiation therapy, and chemotherapy to target the cancer effectively.
Stage IV Survival Rates: Stage IV uterine cancer, indicating cancer spread to distant organs, has lower survival rates, typically ranging from 10% to 20%. Management focuses on palliative care, symptom relief, and maintaining quality of life.
It is of crucial importance to know about the symptoms, risk factors to detect the disease in early stages. Understanding about the various treatment modalities can help the patient choose the treatment in consultation with her oncologist.
