The most common form of gynecologic cancer that can develop in the uterus is endometrial carcinoma, which is an adenocarcinoma that forms in the uterine lining. Several other womb cancers can develop as well, including uterine sarcoma, which forms in the myometrium and uterine glands.
A uterine cancer diagnosis can be scary, but endometrial cancer is generally highly treatable and curable when discovered early. This article covers the causes, symptoms, and treatments of endometrial and uterine cancers.
Uterine cancer occurs when abnormal cancer cells in the uterus multiply out of control. While normal, healthy cells have a predictable growth and death cycle, cancer cells do not. Uterine and endometrial cancer cells continue to grow and reproduce, eventually breaking off and spreading to other body parts, organs, and lymph nodes.
There is no known cause of uterine cancer, but several factors may increase a person’s risk of uterine cancer.
Uterine cancer symptoms are generally fairly noticeable. In menstruating people, any abnormal bleeding between periods could be a sign of uterine cancer. In menopausal people, any vaginal bleeding at all may signal the presence of uterine cancer. A doctor should investigate either of these symptoms or unexplained pelvic pain.
Who Gets It
Anyone with a uterus can develop uterine cancer. However, uterine and endometrial cancer is most common in post-menopausal people over 50. Certain drugs, medical conditions, and lifestyle choices can increase the risk of uterine cancer.
Some uterine and endometrial cancer risk factors, including obesity, diabetes, and Lynch syndrome, are related to health and genetics. Others, such as having a high-fat diet, are tied to lifestyle.
The amount of estrogen exposure a person gets in their life seems to impact the likelihood of developing uterine cancer significantly. People who began menstruating before the age of 12 or continued menstruating past the age of 50 are at a higher risk of endometrial due to a longer period of estrogen exposure.
Finally, certain medications and medical treatments used for breast cancer can increase a person’s risk of developing uterine cancers. For example, Tamoxifen, a breast cancer drug, behaves like estrogen in the body, increasing the risk of uterine cancer. Estrogen replacement therapy in menopausal women and pelvic radiation for uterine cancer treatment can also increase uterine cancer risk.
How to Prevent
What Research Says
Cancer researchers at the National Cancer Institute, the American Cancer Society, and elsewhere continue to come up with more effective endometrial cancer treatments to improve quality of life in people with them.
One clinical trial has demonstrated that a treatment protocol of carboplatin plus paclitaxel (TC) is as effective as the standard protocol of paclitaxel-doxorubicin-cisplatin (TAP), with fewer unpleasant side effects such as vomiting, diarrhea, and sensory neuropathy.
Other studies have shown that, in non-operable uterine cancers, external beam radiation therapy with or without brachytherapy can slow disease progression and control the spread of cancer. Even radiation therapy alone can improve survival rates in non-operable cancers.
While some uterine cancer risk factors can’t be modified, such as genetic risk, onset of menstruation, and polycystic ovarian syndrome, other lifestyle factors are within an individual’s control. Reducing red meat consumption and eating a low-glycemic index diet can help reduce a person’s risk of developing endometrial cancer and other cancers of the uterus.
There is no guaranteed preventative method to avoid developing uterine cancer. However, like most cancers, making healthy choices can reduce a person’s endometrial cancer risk, including:
- Weight management. Maintaining a healthy weight and avoiding obesity reduces a person’s risk of developing uterine cancer.
- Oral contraceptives. The estrogen and progesterone in oral birth control pills may reduce the risk of uterine cancer.
Diabetes management. While diabetes is a risk factor for uterine cancer, keeping diabetes under control through diet and medication can reduce this risk.
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Tests & Diagnosis
How is it given?
Doctors identify uterine cancer using several diagnostic tests and procedures. These tests include:
- Blood test. Certain indicators in drawn blood can alert doctors to cancer in the body, though further investigation is required to determine the cancer type and location.
- Pelvic exam. The doctor manually inspects the uterus and ovaries during a gynecological exam to look for abnormalities that may signal uterine or endometrial cancer.
- Ultrasound. If abnormalities are detected, the doctor usually orders an ultrasound, a procedure that uses sound waves to photograph the uterus, ovaries, and other organs.
- Biopsy. The doctor may conduct a hysteroscopy, a procedure that uses a special camera to look inside the uterus. The doctor will take an endometrial biopsy, which is sample of suspicious tissue for further laboratory testing.
- Surgery. If the doctor cannot retrieve a suitable sample during a hysteroscopy, they may recommend dilation and curettage (D&C), a surgical procedure that removes tissue from the uterine wall for sampling.