Uterine cancer
Endometrial cancer is a malignant tumor that originates in the endometrium. Let’s talk about the symptoms, diagnosis and treatment of this type of cancer. Dealing with an oncologist

What is uterine cancer

Cancer of the body of the uterus is a malignant tumor originating from the epithelium (layer of cells) of the body of the uterus. Cancer of the body of the uterus affects mainly mature women between the ages of 50 and 65 and is less common in younger women.

There are two main types of endometrial cancer (aka uterine cancer).

  • hormone dependent cancer uterus is more common in women aged 45 to 50 years who had a history of polycystic ovary syndrome, infertility, obesity, hyperglycemia, diabetes mellitus, uterine bleeding. Many precancerous conditions play a significant role in the development of uterine cancer. These are scars left after birth trauma, ulcers, erosion, leukoplakia, epithelial growths (polyps, condylomas), inflammatory processes (endometritis and endocervicitis).
  • “Autonomous” cancer uterus is more often diagnosed in women over 50 years of age. Characterized by the absence of endocrine-metabolic disorders and low sensitivity to hormones.

Causes of uterine cancer

There are several theories for the development of uterine cancer:

  1. It is believed that hyperestrogenism (a significant increase in estrogen levels) and endocrine metabolic disorders can serve as a trigger for uterine cancer. Hormone-dependent cancer is more common in patients with obesity and hypertension, diabetes mellitus. Estrogen hormone replacement therapy is also one of the risk factors. Also, risk factors are a burdened heredity for ovarian, endometrial, breast, and colon cancer. Background diseases for cervical cancer are endometrial hyperplasia, uterine polyps.
  2. In the second case, it is not the role of hormones that is considered, but the fact that oncopathologies develop against the background of atrophic processes of the endometrium, immune depression, – comments oncologist Dina Sakaeva.

An increased risk of developing uterine cancer is also observed in women who have had breast cancer and in women whose direct relatives have had uterine cancer.

Symptoms of uterine cancer

If the patient has preserved menstrual function, then cancer of the body of the uterus manifests itself:

  • prolonged heavy menstruation;
  • irregular cyclic bleeding, which is why women are treated for a long time for ovarian dysfunction.

If the woman is in menopause then she has:

  • there are scant spotting or, conversely, copious discharge;
  • in addition to bleeding, the patient may have profuse watery discharge.

When the stage is advanced, neglected, the color of the discharge may be purulent or bloody and have a putrid odor.

When there are symptoms associated with pain in the abdomen, lower back, sacrum of a constant or cramping nature, this indicates that the serous membranes of the uterus are involved in the process, and there is compression of the nerve plexuses by infiltrates. If the tumor grows into the bladder, then there is blood in the urine. If in the rectum, then constipation occurs, mucus and blood appear in the feces. When the pelvic organs are affected in the fourth stage, ascites can develop, the doctor continues.

Stages of uterine cancer

As with any type of cancer, uterine cancer has four stages.

  • First. In this case, the tumor does not spread beyond the body of the uterus.
  • The second. The tumor passes to the cervix, but does not spread beyond its borders.
  • The third. Either metastases appear in the lymph nodes, or the tumor spreads well locally, for example, to the ovary or vagina.
  • The fourth. Metastases appear in distant organs.

Treatment for uterine cancer

Diagnostics

According to statistics, in most patients, uterine cancer is diagnosed in stage I of the disease (72%), stage II accounts for 12%, stage III – 13%, stage IV – 3%.

In order to diagnose cancer of the uterine body, the doctor must carefully examine your history, the results of x-ray, hysteroscopic, cytological and histological studies. Also, cancer of the body of the uterus can be detected by ultrasound examination of the pelvic organs.

The main method for diagnosing uterine cancer is a histological examination of a scraping from the uterine cavity. The study of the material is carried out in a reference foreign laboratory. Diagnosis of uterine cancer is very important for developing a plan for radiation or combined treatment.

In case of detection of atypical cells in the cytological examination of smears from the cervix, an aspiration biopsy of the endometrium is performed. Cervical curettage and endometrial aspiration biopsy are indicated for all patients with suspected uterine cancer.

With negative results of aspiration biopsy, separate diagnostic curettage of the cervix and uterus is indicated. In some cases, positron emission (PET) and computed tomography (CT) are used:

  • to diagnose a neoplasm in women with an elevated level of the CA 125 tumor marker;
  • with suspected recurrence of endometrial carcinoma;
  • with suspected involvement of the pelvic and para-aortic lymph nodes.

Modern treatments

There are several ways to cure cancer of the uterine body – radiotherapy, surgery (removal of a tumor of the uterus, the uterus itself), chemotherapy, hormone therapy for uterine tumors. The most commonly used operating method.

  • Surgery for uterine cancer. Since in most cases uterine cancer is diagnosed at stages 1-2, the tumor can be cured using some surgical methods or a combination of surgical methods and radiation therapy. Basically, during the operation, the uterus is removed, if there are metastases in the pelvic organs, then the ovaries and fallopian tubes. Usually, these organs are usually affected by any spread of the cancerous tumor.
  • Radiation therapy for uterine cancer. In advanced stages, in addition to surgical treatment, radiation therapy is used as a second stage or as monotherapy. If radiation therapy is needed, the patient is referred to a specialized clinic. In case of cancer of the body of the uterus, radiation therapy is performed with absolute contraindications to surgical treatment or in combination with it.

Prevention of uterine cancer at home

Women definitely need to monitor their weight, because the main prevention of uterine cancer is aimed at normalizing and correcting endocrine and metabolic disorders. Women should have normal weight, hormonal health, and it is also necessary to identify and treat endometrial hyperplastic processes and any “female sores” in time. Also, prevention can include hormonal contraceptives containing estrogens and progestogens, which prevent the development of endometrial hyperplasia. It is important to know that any contraceptives are prescribed only by the attending physician. You can’t go and buy them on the advice of your girlfriends. What works for them doesn’t mean it will work for you.

The sooner a woman turns to a gynecologist when alarming symptoms appear, the sooner the disease will be detected and the more successful the result of treatment will be.

Popular questions and answers

Comments Dina Sakayeva – Deputy Head Physician for Oncology, Professor of the Department of Pharmacology with a Course in Clinical Pharmacology, Doctor of Medical Sciences:

Who is at risk?

Risk factors for developing uterine cancer include smoking, hypertension, AIDS, HPV, sexually transmitted diseases, early onset of sexual activity, infertility, early childbirth, and inflammatory diseases. A particularly important factor is weight gain. If a woman is obese, then the risk of developing uterine cancer increases significantly.

How to protect yourself from uterine cancer?

In terms of preventing uterine cancer, it is necessary to control body weight, the course of diabetes, normalize menstrual function, and correctly select contraceptives. It is important to contact the gynecologist in time to identify the disease as early as possible, treat the background precancerous pathology, regularly do oncological screening, and be observed by doctors, especially those who are at risk.

Is it possible to get pregnant after curing uterine cancer?

Pregnancy is possible in women who have undergone safe treatment for the body of the uterus after hormonal therapy. But this is very rare. There are several dozen such situations throughout the country. The most important thing in rehabilitation is the joint management of patients by a gynecologist-oncologist and a gynecologist-endocrinologist.

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