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UTERINE CANCER

Cancer of the uterus most often affects the lining of the uterus (endometrium). If it is found and treated early, the cure rate is very good. It can be better than 90% when the disease is in an early stage. The more advanced the disease is, the lower the cure rate. This is why finding it early is best.

What Is Cancer?

Normally, healthy cells that make up the body's tissues grow, divide, and replace themselves on a regular basis. This keeps the body in good repair. Sometimes, however, certain cells develop abnormally and begin to grow out of control. Too much tissue is made, and growths or tumors begin to form. Tumors can be benign (not cancer) or malignant (cancer).

Malignant tumors can invade and destroy nearby healthy tissues and organs. Cancer cells can also spread (or metastasize) to other parts of the body and form new tumors.

It is important for your doctor to find out as early as possible if a tumor is benign or malignant. As soon as a malignant tumor is found, your doctor can begin treatment to control the disease. Cancer is much easier to treat and cure if it has not spread to other parts of the body.

Most types of uterine cancer are adenocarcinomas. Adenocarcinomas involve cells in the lining of the uterus.

Sarcomas are another type of uterine cancer. They arise from muscle and other tissue. However, sarcomas are rare.

 Who Is at Risk?

Cancer of the uterus is rare in women under 40 years of age. It most often occurs in women between the ages of 60-75 years.

Women are at a higher risk of uterine cancer if they:

  • Are obese
  • Do not ovulate regularly and often miss periods
  • Have late menopause (the time when menstrual periods end, which is most often around age 50)
  • Have polycystic ovary syndrome (in which the ovaries contain many abnormal cysts)
  • Have endometrial hyperplasia (abnormal thickening of the endometrium)
  • Have had cancer of the ovary, breast, or colon
  • Have a close family member with uterine cancer

Some women take estrogen after menopause to replace the hormone that is no longer produced by the ovaries. These women may be at risk for cancer of the uterus. If estrogen is combined with another hormone - progesterone - the risk of uterine cancer may be reduced.

The most common type of birth control pills is the combination (estrogen plus progesterone) pill. Women who have used these pills have a lower risk of uterine cancer. This lower risk lasts for at least 10 years after a woman stops taking the pill.

Even if a woman has some or all of the risk factors described here, she may never have uterine cancer. But women at risk should be aware of the symptoms of uterine cancer. They should discuss their concerns with their doctor and have routine checkups that include pelvic exams.

Symptoms

At present, there is no simple way to detect uterine cancer at an early stage in women with no symptoms. The key to finding the disease early is being alert to its symptoms.

The main symptoms of uterine cancer are abnormal bleeding, spotting, or discharge from your vagina. It may be steady or off and on. A watery discharge that has an odor may occur before abnormal bleeding begins. The discharge may be the first sign of a problem. The cause of any abnormal bleeding or discharge needs to be looked into by your doctor.

Except when combination hormone therapy is being taken, any bleeding or spotting after menopause is not normal. Ask your doctor about any bleeding or spotting you have after menopause.

Diagnosis

Most of the methods used to diagnose cancer of the uterus can be done in the doctor's office. Methods that may be used include ultrasound or endometrial biopsy. Sometimes hysteroscopy may be done in the doctor's office with local anesthesia. The patient may have dilation and curettage (D&C) done in the hospital.

Although the Pap test should be part of a regular checkup, it is not a good test for uterine cancer. It can detect cancer or precancer of the cervix, but it is less likely to detect uterine cancer.

Treatment

If cancer of the uterus is found, surgery will be done to decide the stage of the disease and how it should be treated. Staging helps your doctor decide what treatment has the best chance for success.

About 75% of the women with uterine cancer have stage I disease. Of these women, 85-90% will have no sign of cancer 5 years or more after treatment. The chance for a cure decreases as the cancer becomes more advanced.

To treat uterine cancer, most patients have both hysterectomy and salpingo-oophorectomy. Tissue from lymph nodes in the pelvic region may be tested to find out if the cancer has spread. Some cases of uterine cancer may also require radiation therapy after surgery.

If tests show that the cancer has spread or come back after surgery or radiation, your doctor may advise more drug therapy. Chemotherapy or progestin (a hormone) therapy may be used to treat uterine cancer that has spread to other organs.

Prevention

There are things you can do to lower your risk of uterine cancer and improve the chance of finding it early:

  • Report any abnormal vaginal bleeding promptly to your doctor. Most bleeding is not caused by cancer. Only your doctor can perform the tests needed to find the cause of the problem.
  • Get a yearly pelvic exam.
  • Eat foods that are low in fat and cholesterol and high in fiber. This includes fruits, vegetables, and whole-grain breads and cereals.

Finally. . .

If you think you have a problem, see your doctor at once. When uterine cancer is found early, the outlook is great. This disease is much harder to cure if treatment is delayed.

If you have cancer of the uterus, you may have many fears and concerns. Talk to your doctor about them. Your doctor and the other people involved with your care will do all that they can to help you get well. You and the members of your health care team can work to reduce the chances of further problems and find ways to keep you healthy.

From: acog.org

 

 





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