Malignant neoplasms of the uterus – causes, symptoms, treatment. Can they be prevented?

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The most common malignant tumor that originates in the lining of the womb (endometrium) is cancer. This neoplastic lesion most often develops in women over 50 (75%). The main symptoms of this ailment include heavy menstrual bleeding or bleeding after the menopause.

What is endometrial cancer?

Endometrial cancer is the most common cancer in women and develops in the lining of the womb (endometrium). This type of cancer most often develops in women in their 50s. Fortunately, changes are detected relatively quickly, and the implemented treatment is so effective that the risk of death is significantly reduced. Endometrial cancer usually occurs after the menopause! Only about 25 percent. cases occur before the menopause. Lack of children, diabetes and anovulatory cycles increase the risk of the disease.

Endometrial cancer – types

Two types of endometrial cancer have been distinguished, which differ in age, aggressiveness and molecular causes. Is it:

1. type I cancer – the most common cancer, especially in the menopausal period. It occurs due to estrogen-stimulated endometrial hyperplasia. The prognosis is good;
2. type II cancer – is a rarer type of endometrial cancer that occurs in women in their XNUMXs and XNUMXs. Unlike type I, its development has nothing to do with hormone stimulation. It is a serous cancer that unfortunately has a worse prognosis.

The causes of malignant neoplasm of the endometrium

Endometrial cancer is usually preceded by an abnormal growth of the endometrium. Before the appearance of cancer, the most common are:

1. irregular menstruation
2. fertility disorders,
3. delay in menopause (menopause).

Straight endometrium it usually occurs in women with: hypertension, obesity, diabetes and ovulation disorders. It is also worth mentioning that recently, more and more emphasis in the prevention of endometrial cancer has been put on informing about its family history.

Symptoms of endometrial cancer

The main symptoms of cancer endometrium are:

1. disturbing, massive uterine bleeding in menstruating women,
2. the appearance of bleeding (often after a long period) after stopping menstruation,
3. the appearance of copious water-bloody discharge (advanced form of cancer),
4. pain in the lower abdomen,
5. pain in the sacral area,
6. a feeling of fullness in the pelvis (advanced form of cancer).

Almost 90 percent pre-menopausal women see a doctor with symptoms of disturbing vaginal discharge and bleeding. Endometrial cancer can sometimes be accompanied by inflammation and symptoms of cancer in the ovaries.

Diagnosis of endometritis

Attention! Any abnormal bleeding during the menopause, and especially after the menopause, should be reported to the gynecologist. Unfortunately, it is often necessary to perform diagnostic and therapeutic curettage of the cervical and uterine cavity. The aim of the procedure is to collect tissue material for histopathological evaluation. This assessment is to exclude or confirm the presence of a neoplastic process within the cervical canal or in the uterine cavity, as well as the risk of this process if abnormal mucosal hyperplasia is confirmed by histological examination. It happens that the final diagnosis cannot be made definitively on the basis of a one-off examination.

It has become more and more popular in recent years hysteroscopic examinationwhich involves the endoscopy of the uterine cavity using an optical device. This examination allows for a visual assessment of its walls (e.g. the possibility of revealing submucosal fibroids or developmental defects) and the assessment of the endometrium with the simultaneous possibility of extracting the material for histopathological examination.

It should be noted that an important role in the diagnosis of endometrial cancer risk is also played by a thorough analysis of the endometrium using ultrasound.

Malignant neoplasm of the uterus – treatment

Treatment of endometrial cancer depends mainly on:

1. the age of the woman,
2. the desire to have children in the future,
3. the result of the histopathological examination.

It can be carried out by hormonal or surgical treatment.

The primary treatment for clinically developed endometrial cancer is surgery. The length of the surgery depends on the advancement of the lesion. The operation may consist of a simple hysterectomy with ovaries or an extended, radical hysterectomy with removal of the pelvic lymph nodes and sometimes also the peraortic lymph nodes. Usually, the surgery is supplemented with hormone therapy afterwards. However, in the case of metastases to the lymph nodes or when the neoplastic lesions infiltrate half the thickness of the uterine muscle, surgery is performed and radiotherapy is additionally implemented.

The type of treatment depends on the stage of the disease:

1. Stage I and II – treated with the hysterectomy together with the appendages and the removal of adjacent lymph nodes. If the infiltration is deep, additional radiotherapy is also implemented. In the second stage, a hysterectomy is performed together with the appendages and the iliac and obturator lymph nodes, and adjuvant radiotherapy is introduced;
2. Stage III and IV of the tumor – different methods are used here, depending on the stage of the tumor (usually combined treatment). In the case of stage IIIB and IV metastases, hormone therapy (progestogens) is implemented.

Can a malignant neoplasm of the uterus be prevented?

The most important in prevention are regular visits to the gynecologist and transvaginal ultrasound. With routine monitoring, it is possible to detect endometrial cancer at an early stage or worrying endometrial hyperplasia. It is worth remembering that cancer is influenced, among others, by obesity, the lack of children, family predisposition or long-term estrogen intake. It is worth taking care of a proper diet and physical activity.