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Uterine cancer, also known as endometrial cancer, is the second most common type of cancer affecting the female reproductive organs. While it can be a frightening diagnosis, with early detection and proper treatment, the prognosis for uterine cancer is often favourable This blog aims to empower women with knowledge about uterine cancer, its symptoms, diagnosis, and treatment options.
Synopsis
Risk Factors
Uterine cancer develops in the lining of the uterus (endometrium). While the exact cause of uterine cancer is unknown, certain risk factors can increase your chances of developing it. Here's a breakdown of the key risk factors:
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Obesity: Fat tissue produces estrogen, and excess body weight can lead to prolonged exposure to estrogen, increasing cancer risk.
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Polycystic Ovary Syndrome (PCOS): This hormonal imbalance can cause irregular ovulation and lead to unopposed estrogen stimulation of the endometrium.
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Never Been Pregnant: Women who have never been pregnant haven't experienced the hormonal changes associated with pregnancy, which can offer some protective effects against endometrial cancer.
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Lynch syndrome: This is caused by mutations in certain genes that are responsible for repairing errors in DNA. These errors can lead to uncontrolled cell growth and eventually cancer. The mutated genes are passed down from a parent to their children. While Lynch syndrome is most well-known for increasing the risk of colon cancer, it also raises the chances of developing other cancers, including Endometrial cancer (cancer of the lining of the uterus), Stomach cancer, Small intestine cancer and Ovarian cancer.
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Tamoxifen: This medication blocks the effects of estrogen, which can fuel some types of uterine cancer if taken for a prolonged duration.
Symptoms
Here's a list of the telltale symptoms to watch out for:
Abnormal Vaginal Bleeding: This is the most common symptom of uterine cancer, particularly any bleeding after menopause.
Be aware of:
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Bleeding between periods, even if your periods are still regular.
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Heavier than usual periods.
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Spotting or bleeding after menopause (any vaginal bleeding after menopause is considered abnormal and requires a checkup).
Other Potential Symptoms
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Pelvic pain: This can manifest as a dull ache or cramping in the lower abdomen or pelvic area.
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Vaginal discharge: A watery or blood-tinged discharge that's unusual or persistent can be a cause for concern.
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Pain during sex: Discomfort or pain during sexual intercourse can sometimes be a symptom of uterine cancer.
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Unexplained weight loss: While this can have various causes, unexplained weight loss can be a symptom of some cancers, including uterine cancer
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Abdominal distension and bloating: When uterine cancer spreads outside the uterus, can lead to a feeling of fullness and abdominal bloating.
Consult our gynaecology hospital in Delhi if you are experiencing symptoms of uterine cancer.
Diagnosis
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Hysteroscopy: Hysteroscopy is a minimally invasive procedure that allows a doctor to examine the inside of the uterus (womb) and cervix. It's a valuable tool used for both diagnostic and surgical purposes in women's health.
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Endometrial Biopsy: An endometrial biopsy is a medical procedure that involves taking a small tissue sample from the lining of the uterus (endometrium) for examination under a microscope. This examination helps diagnose various uterine conditions.
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Pipeline Biopsy: A pipeline biopsy is a specific type of endometrial biopsy done as an OPD procedure, which is used to collect tissue samples from the lining of the uterus. It's also sometimes referred to as an endometrial pipeline biopsy or pipeline biopsy.
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D&C: D&C, which stands for Dilation and Curettage, isn't a diagnosis itself, but rather a surgical procedure used for both diagnostic and therapeutic purposes in the uterus. It is done under anaesthesia as a daycare procedure.
Treatment
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Surgical staging: The mainstay surgery for uterine cancer, particularly in earlier stages, is an extrafascial abdominal hysterectomy with bilateral salpingo-oophorectomy (EAH-BSO). It involves removing the entire uterus, including the cervix. Bilateral Salpingo-oophorectomy refers to the removal of both fallopian tubes and ovaries. Along with that, sentinel lymph node mapping and excision as per indication
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Cytoreductive surgery: Even in advanced uterine cancers, upfront surgery is the standard path, provided complete cytoreduction is attainable. Adjuvant chemotherapy with or without radiotherapy is usually indicated thereafter.
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Minimally Invasive Surgery: Since patients with uterine cancer tend to be obese, minimal access surgery offers the advantage of ease of procedure, small incision, relief from post-operative morbidity, less chances of wound breakdown, and early discharge. Can be done via Laparoscopic or robotic route.
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Laparoscopic surgery: Several small incisions are made in the abdomen, and slender instruments with cameras are inserted to visualize and operate on the uterus and other structures.
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Robotic-assisted laparoscopy: Similar to laparoscopy but utilizes robotic arms for more precise, tremor-filtered movements with a greater range of motion, potentially offering advantages for complex procedures.
Consult our gynaecologist in Delhi if you need Robotic Surgery for Uterine Cancer.
Adjuvant Therapy (Additional Treatment After Surgery)
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Radiation Therapy: External beam radiation or brachytherapy (internal radiation) can be used to destroy any remaining cancer cells after surgery, especially if there's a higher risk of recurrence.
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Chemotherapy: Medications are used to kill cancer cells throughout the body. It might be used in combination with radiation therapy or for advanced-stage cancers, particularly useful for serous carcinomas and lymph node-positive tumours.
Metastatic Cancers
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Chemotherapy: Systemic therapy as the sole treatment with platinum-based chemotherapeutic agents is the backbone of treatment
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Immunotherapy: Molecular marker testing in endometrial cancers has brought about a paradigm shift in the management, particularly for MMR mutated cancers. Monoclonal antibodies (Pembrolizumab, Durvalumab) and TKI (Lenvatinib) have shown promising results in the light of recent evidence, and are widely available drugs at affordable prices.
Conclusion
Early detection is the most powerful tool in the fight against uterine cancer. By understanding the risk factors, symptoms, and treatment options, you can take charge of your health and empower yourself to face any challenges that may arise. Book a consultation with our Gynae Oncologist for diagnosis or personalised treatment. We also invite you to explore our blog page to read the latest healthcare blogs shared by our doctors.
The objective of our blog page is to disseminate medically accurate information and help people make well-informed and timely decisions.
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