Uterine CANCER

Cancer is a group of many related diseases.  All cancers begin in cells, the body’s basic unit of life. There are two types of uterine cancers. Uterine cancers include endometrial cancer and uterine sarcomas, such as leiomyosarcoma.  Cancer of the uterus is cancer in the womb, the hollow, pear-shaped organ where a baby grows during a woman’s pregnancy. 

Endometrial cancer is a common cancer of the female reproductive system.  This cancer begins in the tissue lining (endometrium)  of the uterus.  Since this type of cancer is usually associated with the postmenopausal bleeding endometrial cancer is often found at an early stage.  Uterine sarcomas occur when cancer grows in the muscles or other supporting tissues in the uterus.

Epidemiology

• The most common tumor of the female reproductive system
• Usually develops after menopause, between the ages of 50 and 60.
• About 40,000 women are diagnosed with this disease each year in the United States.

Risk Factors

• Age, mostly occurs in women over the age of 50.
• Obesity – the body makes some of its estrogen in fatty tissue. Obese women with high levels of estrogen have increased the risk of developing uterine cancer. The risk of this disease is also higher in women with diabetes or high blood pressure.
• Late menopause- after age 52
• Nulliparity (never having given birth) or a history of infertility ( an inability to become pregnant)
• Women who use estrogen alone without progesterone have an increased risk of uterine cancer.
• Family history- Wite women are 70 percent more likely than African-American women to develop uterine cancer.
• Tamoxifen is a drug taken by women to treat and prevent breast cancer. Although antiestrogen effect on the breast, tamoxifen works like estrogen in some respects, such as countering osteoporosis—and promoting endometrial growth.
• Hormone replacement therapy (HRT) is used to control the symptoms of menopause, to prevent osteoporosis (thinning of the bones), and to reduce the risk of heart disease stroke.

Symptoms

• Uterine cancer usually occurs after menopause.  Abnormal vaginal bleeding is the most common symptom or discharge.
• Difficult or painful urination
• Pain during intercourse
• Pain in the pelvic area

Diagnosis

• Examination of the pelvic and transvaginal ultrasound are performed.  Transaginal ultrasound is an instrument inserted into the vagina, where high-fequency sound waves at the uterus. 
• Biopsy is performed to remove a sample of tissue from the uterine lining. This endometrial biopsy may be done in the doctor’s office. Some women may need to have a dilation and curettage (D&C).  Anesthesia is given to the patient during this procedure, where your doctor widens the cervix and gently scrapes tissue from the inside the uterus. 
• Other diagnostic test may be performed by your doctor if the cancer has spread beyond the uterus.

Treatment

Treatment options for endometrial cancer depend on chiefly on the type and   stage of your disease.

• Surgery is often done, hysterectomy (removal of the uterus) cures endometrial cancer.
• Radiation therapy (the use of x-rays or other high-energy waves to kill cancer cells and shrink tumors)
• Hormone therapy and/or chemotherapy (anticancer drugs administered intravenously or orally) after surgery, if some cancer cells remain undetected or if spread.