Uterine Cancer – Types, Causes, Symptoms and Treatment

Uterine cancer is one of the most common gynaecological cancers affecting women worldwide.  When abnormal cells grow uncontrollably in the uterus, they can form a tumour and, in some cases, spread to other parts of the body. Understanding the types, causes, symptoms, and available treatments for uterine cancer is crucial for early detection and effective management.

Types

Uterine cancer is mainly classified into two types, each originating in a different part of the uterus.

1. Endometrial Cancer

95% of all uterine cancer cases are Endometrial cancer. It begins in the uterus’s inner lining, known as the endometrium. This type of cancer typically affects postmenopausal women but can also occur in younger women. Endometrial cancer is often detected early because it causes noticeable symptoms like unusual vaginal bleeding.

2. Uterine Sarcoma

A more aggressive and rare form of uterine cancer is Uterine sarcoma. It begins in the myometrium, the muscle wall of the uterus, or other supporting tissues. It accounts for a much smaller number of uterine cancer cases and typically grows and spreads more rapidly than endometrial cancer. Due to how rare it is and its aggressive nature, uterine sarcoma often requires a different treatment approach.

Causes and Risk Factors

While the cause of uterine cancer isn’t completely known, some factors are known to elevate a woman’s risk. Some of the known risk factors include:

1. As people age, their chances of acquiring uterine cancer increase. The majority of cases are diagnosed in women 50 years or older, with an average diagnosis age of 65.
2. An imbalance in the hormones progesterone and estrogen increases the risk of endometrial cancer. High estrogen levels without appropriate progesterone may stimulate the uterine lining, resulting in unusual cell proliferation.
3. Obesity and extra body fat can boost estrogen levels, increasing the risk of endometrial cancer. Obese women are two to four times more likely than healthy-weight women to get uterine cancer.
4. Women with a family history of ovarian, colon, or uterine cancer may have a higher risk. Inherited genetic illnesses, such as Lynch syndrome, have also been linked to an increased risk of uterine cancer.
5. Starting periods early (before 12) and reaching menopause late (after 55) expose women to more estrogen, which may increase their risk. In addition, women who have never been pregnant are more vulnerable than those who have children.
6. Following menopause, women who get estrogen-only hormone replacement therapy without progesterone are more likely to develop endometrial cancer.
7. Diabetes, hypertension, and polycystic ovarian Syndrome (PCOS) have all been linked to an increased risk of uterine cancer.

Symptoms of Uterine Cancer

Endometrial cancer is often detected early because it causes very noticeable symptoms. However, it’s important to recognise the warning signs and consult a doctor if they occur.

Common symptoms include:

• Abnormal vaginal bleeding: Bleeding between periods, heavy menstrual periods, or bleeding after menopause.
• Unusual vaginal discharge: Watery or blood-tinged discharge not related to menstruation.
• Pelvic pain or pressure: Persistent discomfort in the pelvic area.
• Pain during intercourse.
• Unintended weight loss and persistent fatigue are typically seen in advanced stages.

While other, less serious conditions can cause these symptoms, it’s crucial to have them checked by a healthcare professional to rule out cancer or detect it early.

Diagnosis

If uterine cancer is suspected, your doctor may order tests and procedures to confirm it and assess its severity. Common diagnostic methods include:

• Pelvic examination: To examine the uterus for any irregularities.
• Transvaginal ultrasound: Employs sound waves to visualise the uterus and assess endometrial thickness.
• Endometrial biopsy: A tiny piece of endometrial tissue is removed and checked for cancer cells.
• Hysteroscopy: A thin, lighted instrument is used to look inside the uterus and take tissue from the endometrium.
• Dilation and curettage (D&C): A surgical procedure to scrape tissue from the uterus for examination.
• Imaging tests, Such as MRI or CT scans, may be used to check if cancer has spread.
  

Treatment Options

Uterine cancer treatment varies based on the cancer’s type, stage, grade, and the patient’s health and preferences. Common treatment options include:

1. Surgery

Hysterectomy, or removal of the uterus, is the primary treatment, especially in early-stage endometrial cancer. The removal of the ovaries, fallopian tubes, and nearby lymph nodes may be necessary if the cancer has spread.

2. Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. It can be used before surgery to shrink tumours or eliminate any remaining cancer cells. In some cases, it may be the primary treatment if surgery isn’t an option.

3. Hormone Therapy

Hormone therapy targets cancers influenced by hormones. It involves taking medications that lower estrogen levels or block its effects on uterine cancer cells. It’s often recommended for advanced or recurrent cases.

4. Chemotherapy

Chemotherapy targets cancer cells with drugs and is typically applied to uterine sarcomas or later-stage/recurrent cancers. It may be administered alone or alongside other treatments like radiation.

5. Targeted Therapy and Immunotherapy

In recent years, newer treatments like targeted therapies and immunotherapy have shown promise, especially for advanced or treatment-resistant uterine cancers. These treatments work by targeting specific molecules involved in cancer growth or helping the immune system recognise and attack cancer cells.

Prevention and Outlook

Although uterine cancer cannot always be prevented, healthy lifestyle choices and routine check-ups can lower the risk.

• Maintain a healthy weight.
• Stay physically active.
• Manage conditions like diabetes and high blood pressure.
• Consult your doctor to understand both the risks and benefits of hormone therapy.
• Be aware of family medical history and consider genetic counselling if needed.
• Seek prompt medical attention for unusual vaginal bleeding.
  

The prognosis for uterine cancer is generally good, especially when detected early. Endometrial cancer caught in its early stages has a five-year survival rate of over 90%. Regular gynaecological examinations and awareness of the symptoms are vital in improving outcomes.

Conclusion

Uterine cancer is a serious condition, but it is often treatable if detected early. Knowing the types, risks, symptoms, and treatments of uterine cancer helps women protect their reproductive health. If you experience any unusual symptoms or have concerns about your risk, consult your healthcare provider for appropriate evaluation and advice.