Uterine Cancer (Endometrial Cancer): Symptoms, Causes, Treatment

What are the symptoms of uterine cancer?

Symptoms of uterine cancer can vary, but common signs include:

• Abnormal Vaginal Bleeding: This includes bleeding between periods, heavy or prolonged menstrual bleeding, or postmenopausal bleeding.
• Pelvic Pain: Persistent pain or cramping in the pelvic region.
• Abnormal Vaginal Discharge: Unusual discharge that may be watery or tinged with blood.
• Pain During Intercourse: Discomfort or pain during sexual activity.
• Unexplained Weight Loss: Sudden and unexplained loss of weight.
• Enlarged Uterus or Pelvic Mass: A noticeable mass or swelling in the pelvic area.

These symptoms can also be caused by conditions other than uterine cancer, so it’s important to consult a healthcare provider for an accurate diagnosis if any of these symptoms occur.

What are the causes of uterine cancer?

Uterine cancer, particularly endometrial cancer, has several known risk factors, although the exact cause is not always clear. Key risk factors include:

• Hormonal Imbalances: Elevated levels of estrogen relative to progesterone, often seen in conditions like obesity or hormone replacement therapy, can increase risk.
• Obesity: Excess body fat can lead to higher estrogen levels, which may contribute to the development of uterine cancer.
• Age: The risk increases with age, particularly after menopause.
• Family History: A family history of uterine cancer, ovarian cancer, or colorectal cancer can increase risk, often linked to genetic conditions like Lynch syndrome (hereditary nonpolyposis colorectal cancer).
• Personal History: Previous cancer diagnoses, especially breast cancer or ovarian cancer, can be a risk factor.
• Reproductive History: Early onset of menstruation, late menopause, or having no children can increase risk due to prolonged exposure to estrogen.
• Medical Conditions: Conditions like polycystic ovary syndrome (PCOS) and diabetes can be associated with higher risk.
• Tamoxifen Use: Women taking tamoxifen for breast cancer treatment may have a slightly increased risk of uterine cancer.

While these factors can increase the likelihood of developing uterine cancer, they do not guarantee it, and having one or more risk factors does not mean a person will definitely develop the disease.

What is the treatment for uterine cancer?

The treatment for uterine cancer, particularly endometrial cancer, depends on the stage of the cancer, the patient’s overall health, and other factors. Common treatment options include:

• Surgery:
• The most common treatment is a hysterectomy, which involves the removal of the uterus. This can include:
  • Total Hysterectomy: Removal of the uterus and cervix.
  • Radical Hysterectomy: Removal of the uterus, cervix, surrounding tissue, and part of the vagina, often for more advanced cases.
• Bilateral Salpingo-Oophorectomy: Removal of both ovaries and fallopian tubes, often performed alongside a hysterectomy.
• Lymph Node Dissection: Removal of nearby lymph nodes to check for cancer spread.
• Radiation Therapy:
• Often used after surgery to kill any remaining cancer cells, especially if there’s a high risk of recurrence.
• Can be used as the primary treatment for those who cannot undergo surgery.
• Chemotherapy:
• Typically used if the cancer has spread beyond the uterus or in advanced stages.
• Common drugs include carboplatin and paclitaxel.
• Hormone Therapy:
• Used for cancers that are hormone receptor-positive, especially in advanced or recurrent cases.
• Involves medications like progestins, tamoxifen, or aromatase inhibitors.
• Targeted Therapy:
• In some cases, drugs that specifically target certain aspects of cancer cells may be used.
• Immunotherapy:
• Used for advanced or recurrent uterine cancer, particularly in cases involving specific genetic changes like microsatellite instability-high (MSI-H) or mismatch repair deficiency (dMMR).
• Palliative Care:
• For advanced stages, palliative care focuses on relieving symptoms and improving quality of life.

Treatment plans are often tailored to the individual, and a combination of treatments may be recommended based on the specifics of the case. Early detection generally results in more treatment options and better outcomes.

What is the survival rate for uterine cancer?

The survival rate for uterine cancer, specifically endometrial cancer (the most common type of uterine cancer), varies based on the stage at diagnosis:

• Stage I (Localized): When uterine cancer is confined to the uterus, the 5-year relative survival rate is around 95%. This is because it is often detected early.
• Stage II (Regional): If the cancer has spread to nearby tissues or lymph nodes, the 5-year relative survival rate is about 69%.
• Stage III-IV (Distant): When the cancer has spread to distant parts of the body, the 5-year relative survival rate drops to around 17%.

These rates are general estimates and can vary depending on factors such as the specific type of uterine cancer, the patient’s overall health, and the treatment approach used. Early detection and treatment typically lead to better outcomes.