Uterine cancer is the growth of malignant cells in the uterus. The term uterine cancer is often used interchangeably with endometrial cancer, because uterine malignancy most often develops in the endometrium, or uterine lining. Malignant tumors may also develop in the muscular wall of the uterus (uterine sarcoma), although this is relatively rare. Endometrial cancer is the most common pelvic gynecological cancer; it most frequently affects postmenopausal women between the ages of 50 and 70. Younger women whose ovaries produce estrogen but don't ovulate and women with polycystic ovaries are also prone to develop endometrial cancer. Endometrial cancer tends to grow and spread slowly; with early detection and treatment, it is highly curable.
Symptoms of Uterine Cancer
Vaginal bleeding after menopause.
Heavy, persistent, or unusual (watery or bloodstreaked)
vaginal discharge.
Lower abdominal pain and weight loss in
advanced stages.
What Causes Uterine Cancer
The cause of uterine cancer is unknown.
Obesity, high blood pressure, diabetes mellitus, endometrial hyperplasia, endometrial polyps, polycystic ovary disease, and a late menopause with heavy bleeding are all associated with an increased risk of uterine cancer. (See these specific disorders for more information.)
Long-term use of unopposed estrogen replacement therapy (without a progestational agent) in postmenopausal women is associated with a higher incidence of endometrial cancer.
Tamoxifen, a drug used in the treatment of breast cancer, increases the risk of uterine cancer.
Endometrial cancer is more common in women who have had few or no children; it is less frequent in those who have used oral contraceptives.
Prevention of Uterine Cancer
In high-risk (non-ovulating) women, uterine cancer may be prevented with cyclical use of progestational drugs.
Regular pelvic examinations during and after menopause are advised to aid in early detection and treatment of any abnormalities.
Postmenopausal estrogen replacement in women who have not had a hysterectomy should be accompanied by a progestational agent. If not, annual endometrial biopsies should be performed.
Diagnosis of Uterine Cancer
Patient history and gynecological examination are necessary.
Diagnosis of endometrial cancer requires an endometrial biopsy or dilatation and curettage (D&C) to obtain endometrial tissue.
Pelvic ultrasound scans may be done to detect tumors.
A Pap smear (performed during a pelvic examination) reveals the presence of malignant cells from the cervix (see Cervical Cancer), but the Pap smear is not reliable for detecting endometrial cancer.
How To Treat Uterine Cancer
Primary treatment is a total hysterectomy (surgical removal of the uterus). Fallopian tubes, both ovaries, and a portion of the upper vagina, and neighboring lymph nodes may also be removed depending on the extent of the cancer.
Cancers in their earliest stage (noninvasive and with normal-appearing cells) may be treated by hysterectomy alone, without further measures.
If cancer is believed to have advanced beyond the earliest stage, radiation therapy (both external and internal radiation) may be used in addition to surgery; in internal radiation, small radioactive pellets are implanted in or near the tumor site for 48 to 72 hours at a time.
Progestational agents can be used in the treatment of endometrial cancer; chemotherapy has not proved to be effective in most cases.
When To Call A Doctor
Call a gynecologist if you develop heavy vaginal bleeding or if you experience vaginal bleeding between periods or after menopause.
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Medical Disclaimer: The information on this page is not intended to substitute for the advice of a physician.
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