Uterine (Endometrial) Cancer - Symptoms, Diagnosis & Treatment
How Does Uterine Cancer Occur?
The uterus, the main reproductive organ of a woman, is where the fetus completes its development. In medical language, it is called the uterus. It is located between the intestine and bladder. It is approximately 7.5 cm in size and 3 cm in thickness. The inner surface of the uterus, which consists of three layers, is covered with cells called endometrium, which thicken over time and shed during menstruation. As it goes outward, first comes the muscle layer (myometrium), then the Perimetrium layer, which surrounds the outside of the uterus.
On the other hand, Uterine cancer occurs when the cells on the endometrium layer undergo changes due to external factors and grow uncontrollably. Abnormally proliferating cells form a mass, or tumor, over time. Because the endometrium layer is a tissue sensitive to hormones released from the ovaries or taken from outside, if possible hormonal disorders are not diagnosed and treated. Cancer may develop in the intrauterine layer due to cellular changes over time.
What are the stages of uterine cancer?
Uterine cancer is divided into stages according to the spread of the tumor.
The tumor is located only locally in the uterus. It has not yet spread.
The tumor has advanced to the supporting connective tissues of the cervix as well as the uterus. However, it did not reach the lymph nodes.
The tumor has also spread outside the uterus; It has reached the fallopian tubes and ovaries. There is also spread to the lymph nodes.
The tumor has reached outside the uterine region; It has metastasized to distant organs such as the bowel, bladder, bones, and lungs.
What are the causes of uterine cancer?
The causes of uterine cancer are not fully known. However, some risk factors predispose to the development of cancer.
- Hormonal Disorders: Endometrium can be affected by changes in estrogen and progesterone levels, which may predispose to uterine cancer.
- Age: According to statistics, 75 percent of women who develop uterine cancer are over 50.
- Irregular period: People who experience menstrual irregularities and menstrual delays at a younger age are also at increased risk of uterine cancer because of increased exposure to estrogen. However, since obesity and Polycystic Ovary Syndrome are among the causes of irregular menstruation, the risk of uterine cancer can be reduced by treating these diseases.
- Late Menopause: Those who have had late menopause are at risk. In the treatment of menopause during this period, only the administration of estrogen hormone increases the risk of uterine cancer, and the risk of cancer is eliminated when the hormone progesterone is also given, as the hormone balance will be provided. On the other hand, starting menstruation before 12; Those who enter menopause after 55 are in the risk group.
- Those who have not given birth to children: Although it is not clear, some studies show that pregnancy reduces the risk of uterine cancer. Although the estrogen hormone, which poses a risk for uterine cancer, is secreted intensively during pregnancy, progesterone production has the feature of preventing the harmful effects of this hormone.
- Obesity: The risk of uterine cancer in obese patients with dense adipose tissue is 3 times higher than in thin women. Because adipose tissue also secretes estrogen, increasing the level of estrogen in the body.
- Family Story: People with a first-degree relative with cancer have an increased risk of uterine cancer.
- Diabetes and Hypertension: Women with type 2 diabetes and hypertension have a higher risk of developing uterine cancer.
- Those with Ovarian Tumors: Since this situation increases the rate of estrogen secretion, it also poses a risk for uterine cancer. Vaginal bleeding due to these tumors can sometimes be a symptom of uterine cancer.
Symptoms of Uterine Cancer
Since it occurs in the post-menopausal period, the chance of an early diagnosis of uterine cancer is very high. Therefore, it is recommended that those who have complaints of the following symptoms consult a specialist doctor.
- Vaginal bleeding
- Abnormal discharge that is not bloody
- Bleeding between periods in menstruating women
- Bleeding after menopause
- Prolongation of the period
- Pelvic pain
- Pain during sexual intercourse
- Weight loss
How is uterine cancer diagnosed?
First, a physical and pelvic examination of the patient is performed. Then some tests are needed. Some of these are those:
- Vaginal Ultrasound: Ultrasound can be used to determine the wall thickness of the uterus or possible abnormalities. The inside of the uterus is visualized with the help of a special, smooth, and round instrument placed at the entrance of the uterus.
- Hysteroscopy: A long, thin, and flexible tube is inserted into the uterus. Thanks to the fiber optic camera on the tube, the inside of the uterus and the endometrium layer can be examined in detail. If necessary, a tissue sample (biopsy) can also be taken.
- Endometrial Biopsy: It is the process of taking a tissue sample from the uterus to make a definitive diagnosis. This procedure is called a biopsy. The sample taken is examined in the pathology laboratory, and the diagnosis of uterine cancer is made.
- Dilatation and Curettage: It is performed when a biopsy is not sufficient to make a definitive diagnosis of cancer. This more complex procedure is performed in the operating room. Expanding the cervix, the tissue inside is scraped with special tools, and a sample is taken.
- CT & MR: CT and MR imaging techniques are among the methods preferred in diagnosing. Contrast material is used to visualize the uterus more clearly. Thanks to this substance, detailed images of the size and location of the tumor can be obtained.
How Is Uterine Cancer Treated?
When uterine cancer is detected early, the 5-year survival rate of patients in the first stage is over 90%. After the definitive diagnosis, the patient is referred to a specialist gynecologist oncologist. Appropriate treatment is determined by considering variables such as the stage and type of cancer, the patient's health status, and the expectation of a child. The primary treatment method is surgery, but chemotherapy and radiotherapy can also be applied.
- Surgical treatment: It is the most commonly used treatment method. The uterus, ovaries, and tubes are removed; Cleaning lymph nodes and sampling from surrounding tissues are also performed. Additional treatments can be applied when surgical treatment is not sufficient.
- Chemotherapy: If it is seen that the uterine cancer is at an advanced stage and has spread to other organs after the surgery, chemotherapy is applied to kill the cancerous cells. After the treatment, the patients were followed up at regular intervals, subject to specific tests.
- Radiotherapy: If there is a risk of cancer recurrence after surgical intervention, radiation therapy is performed after removing the uterus.
- Hormone Therapy: If cancer has spread, high doses of progesterone hormone can be given to reduce the spread and stop the growth of the tumor.
Questions to Ask Your Doctor
If you are diagnosed with uterine cancer, here are some questions to ask your doctor before treatment:
- How advanced is cancer?
- What treatment options are best for me?
- How many different treatments do I need?
- What is the purpose of treatment? (Eliminate cancer or stop its progression?)
- What kind of process awaits me after the treatment?
- Is there a chance of recurrence after cancer has completely disappeared?
- Am I in the risk group for other cancers?
Is It Possible to Prevent Uterine Cancer?
There is no method to prevent uterine cancer definitively. However, it is possible to minimize the risk with some precautions to be taken.
To prevent uterine cancer:
- Eat healthily.
- Try to maintain your ideal weight.
- Exercise regularly.
- See a gynecologist regularly every year. In addition, if you are receiving hormone therapy for breast cancer, it is helpful to have regular doctor check-ups for uterine cancer.
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