In more than 90 percent of women, unexpected abnormal vaginal bleeding is the most common early sign of uterine cancer. However, the early signs and symptoms of uterine cancer may vary from person to person. Irregular bleeding might be
- Vaginal bleeding after the menopause.
- Bleeding between periods.
- Bleeding that is unusually heavy.
- Vaginal discharge from blood-stained to a light or dark brown.
Uterine cancer usually occurs after menopause, typically between the ages of 60 and 70 years. Additionally, it may occur around the time when menopause begins. Bleeding may start as watery, blood-streaked flow that gradually contains more blood. Women should not assume that abnormal vaginal bleeding is part of menopause. You should see your doctor if you have any of the following symptoms along with abnormal bleeding:
- Thin white or clear vaginal discharge with foul smell after menopause
- Extremely long, heavy, or frequent episodes of vaginal bleeding after the age of 40 years, which is unresponsive to medical management
- Difficult or painful urination
- Pain during intercourse
- Pain or pressure in the pelvic area; sometimes, a lump in the pelvic area or lower belly may also be palpated
- Unintentional weight loss
- A feeling of fullness or pressure in the abdomen
- Changes in bowel or bladder habits
What is uterine cancer?
Uterine cancer, also known as endometrial cancer, is characterized by irregular growth of the cells in the uterus. The uterus, or womb, is the place where a baby grows when a woman is pregnant. Uterine cancer is the most common cancer of a woman’s reproductive system. It begins when the normal cells in the uterus begin to change, grow uncontrollably and form a mass of cells called a tumor. If this tumor is found to be malignant, it is then considered uterine cancer. Two different types of uterine cancer are described below:
- Endometrial cancer: This occurs in the lining of your uterus, which is called the endometrium. It is the most common type of uterine cancer and accounts for more than 95% of diagnosed cases. It primarily affects postmenopausal women and is rare in women younger than 45 years of age. More than 80 percent of uterine cancers are adenocarcinomas that start in the endometrium (lining of the uterus).
- Sarcoma: It forms in the supporting muscle tissues of the uterus. It accounts for about 2 to 4 percent of uterine cancers and usually considered rare.
The exact cause of uterine cancer is unknown, but there are several factors that can increase the risk of developing uterine cancer. Risk factors include
- Advancing age
- History of endometrial hyperplasia
- Estrogen therapy
- History of an inherited form of colon cancer (called hereditary nonpolyposis colon cancer or Lynch syndrome)
- History of breast or ovarian cancer
- History of taking tamoxifen for breast cancer treatment or prevention
- Race (African American women are affected with uterine sarcoma at a rate twice that of Caucasian or Asian women)
- History of radiation therapy to the pelvic area
- High-fat diet
- History of polycystic ovary syndrome (PCOS)
- Reproductive and menstrual history (The risk increases if you never had children, had your first period before the age of 12 years and/or went through menopause after the age of 55 years.)
Treatment for uterine cancer will depend on the type of cancer, current cancer stage and general health. Treatment options for uterine cancer can include
- Surgery: Surgery is often recommended for aggressive cases of endometrial cancer or to prevent it from spreading further. A hysterectomy is usually suggested with salpingo-oophorectomy as a precautionary step. At the same time, the lymph nodes will be removed for testing, which is essential to determine the stages of cancer.
- Radiation: If cancer is not aggressive or is still in the initial stages, radiation therapy is often used to kill the cancer cells. Radiation can be used to shrink a tumor, making it easier to remove it. It can also be used to reduce the risk of cancer recurrence after surgery. It is also recommended for women who are not eligible for surgery.
- Hormone therapy: It is often suggested for advanced cases of endometrial cancer that has spread beyond the uterus. It targets certain hormones in the body that aid or prevent uterine cancer growth.
- Chemotherapy: It involves the use of a chemical drug that is designed to kill the cancer cells; it can be used to treat cancer. It can be taken through intravenous drips or orally. It is often recommended for individuals who have recurrent endometrial cancer that has spread beyond the uterus.
Endometrial cancer is the 10th most common cancer in the United States. The number of women diagnosed with uterine cancer has increased in recent years and includes younger women. This increase is likely because of the increasing rates of obesity and diabetes. The sooner endometrial cancer is found, the better is the outcome. However, according to the National Cancer Institute, the five-year survival rate of all people with endometrial cancer is 81.3 percent.
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