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Uterine cancer: Treatment, symptoms, advice and help

About uterine cancer

The word refers to cancer of the womb. It commonly refers to the cancer of the inner most lining (endometrium) of the uterus called as carcinoma. The cancer of the middle and outer part is referred to as sarcoma.

Uterine cancer: Incidence, age and sex

The highest incidence is found in North America, with age-standardized incidence rates of around 18 per 100,000 in US Whites and around 15 in Canadians. At this time, endometrial cancer is the fourth most common cancer in women in the United States and is the most common gynecological cancer. However, one fourth of the cases may occur in women who are premenopausal and about 5% occur in women under the age of 40.

Signs and symptoms of uterine cancer: Diagnosis

Abnormal uterine bleeding especially inter menstrual or post menopausal bleeding are important symptoms. Such woman must be evaluated promptly by gynaecologists. A careful physical examination and internal check up is performed. Pelvic scan with a probe inserted in the vagina helps in further evaluation of the inner layer of the womb.

The diagnostic procedure for evaluating the endometrium must be performed with a biopsy or a fractional curettage. An endoscope (hysteroscopy) put in the womb through the cervix helps in actually visualizing the inner layer and taking biopsy from the abnormal area. Staging of the disease to see how advanced it is requires some more investigations including blood tests, X- ray of the lungs and an MRI scan of the pelvis and upper abdomen.

Causes and prevention of uterine cancer

The carcinoma is a result of prolonged uninhibited action of the female hormone called oestrogen on the inner lining called the endometrium.

The main risk factor for endometrial adenocarcinoma is long-term unopposed estrogen exposure of either endogenous or exogenous origin. Nulliparity, early menarche and late menopause appear to be associated with high endogenous levels of unopposed estrogen.

Obesity, hypertension, and diabetes (metabolic syndrome or corpus triad are important medical risk factors. An ovulation due to polycystic ovaries results in unopposed exposure to estrogen. Oestrogen-secreting tumours, such as granulosa cell tumours, are associated with endometrial cancer up to 25% of the time. Other risk factors include a history of pelvic irradiation, a history of breast or ovarian cancer, and use of tamoxifen.

White women have a higher incidence but also have a higher survival rate than black women. Endometrial cancer is the most commonly inherited gynaecological cancer. The clearest hereditary link to this disease is seen in what is known as the Lynch syndrome.

Uterine cancer: Complications

If not treated promptly the disease will progress to advance stage which can cause death due to bleeding, cachexia and eventually death.

Uterine cancer: Treatment

The primary management for endometrial cancer is surgery. Surgical staging.

Procedures including careful exploration of the abdomen and pelvis, removal of the uterus, cervix, and adnexal structures and lymphadenectomy, are performed. Tumour grade and depth of invasion and assessment of the estrogen and progesterone receptor levels are done on the removed uterus.

Post-operative radiation therapy is carried out in patients with advanced early or late disease. Progestin have been used for many years in the management of recurrent endometrial carcinoma, with approximately one third of patients having a favourable response.