Causes and Risk Factors of Uterine Cancer
Some patients will have taken unopposed (without progestin) estrogen in the past. Their increased risk may persist for 10 years or more after stopping the drug.
Obesity, nulliparity (having borne no children), diabetes, and polycystic ovaries with prolonged anovulation (lack of menstruation), and extended use of tamoxifen for treatment of breast cancer also are risk factors.
Symptoms of Uterine Cancer
Endometrial cancer rarely occurs before menopause, when a woman is having regular menstrual periods, but it does occur around the time that regular menstruation stops. The reappearance of bleeding should not be considered simply part of the change of life. It should always be brought to a doctor's attention so he or she can rule out the possibility of cancer.
Abnormal bleeding from the uterus after menopause is the most common symptom of endometrial cancer. The bleeding may start as a watery, blood-streaked discharge that eventually contains more blood.
Abnormal menstrual bleeding in premenopausal women also should be reported to their physician. In some women, there also may be lower abdominal pain.
Diagnosis of Uterine Cancer
Endocervical and endometrial sampling is the only reliable means of diagnosis.
Vaginal ultrasonography may be used to determine the thickness of the endometrium since increased thickness may indicate cancerous change.
The Pap test, which is very accurate in detecting cervical cancer, is not a reliable means of detecting endometrial cancer. This is because abnormal cells shed by the endometrium degenerate (lose their characteristic features) before they reach the vagina.
Treatment of Uterine Cancer
Treatment of endometrial carcinoma is based primarily on the stage and grade of the cancer.
The standard therapy is an abdominal hysterectomy (surgical removal of the uterus) with removal of both fallopian tubes and ovaries, selective removal of pelvic and aortic lymph nodes and washings from the abdominal cavity to look for malignant cells.
Most gynecologic oncologists (doctors who specialize in pelvic cancers) also recommend obtaining a specimen from the cancer for analysis of its estrogen and progesterone receptor content. The receptor content has prognostic value and may be useful in the selection of hormone therapy for recurrent or metastatic cancer.
Some women also may receive radiation therapy.
Questions To Ask Your Doctor About Uterine Cancer
What type of cancer is it?
Is more testing indicated?
What are the treatment options?
Do you recommend surgery?
How successful is it?
What is the prognosis?