Uterine Cancer

This is cancer of the uterus or the uterine linings – the endometrium.

What to look for…

Uterine cancer causes no symptoms at onset. They will usually become noticeable as the malignancy begins to grow. But there are some women with uterine cancer who experience no symptoms until the disease spreads to other organs. 

The most likely symptoms are: 

• abnormal vaginal bleeding – heavier than normal periods or bleeding in between periods. (if you have had menopause, any bleeding will be abnormal, unless you are on HRT).
• vaginal discharge.
• an enlarged uterus.
• unexpected weight loss;
• weakness and pain in the lower abdomen, back, or legs. (This occurs once the cancer has spread to other organs).

The uterine lining (the endometrium) in women thickens every month as it prepares to receive a fertilised egg. If no egg is fertilised, the extra tissue and blood are expelled through menstruation. There are a number of conditions that can affect the uterus. These conditions may or may not be cancerous. 

Benign problems include fibroid tumours on the uterine wall and women who have them are not at more of a risk for uterine cancer. Endometriosis is the most serious benign uterine condition, and in some women it evolves into uterine cancer.  

The most common place in the uterus for cancers to develop are in the endometrium. This is called endometrial cancer or carcinoma. It is most dangerous if left untreated when it can penetrate the uterine wall and invade the bladder, vagina, fallopian tubes, ovaries or rectum or other organs. Fortunately, endometrial cancer grows slowly and usually is detected before spreading very far. 

Causes 

Women whose risk of getting uterine cancer is high include postmenopausal women who began menstruating early and went through menopause late, are obese, diabetic, or have high blood pressure, have few or no children, are infertile, have irregular menstrual periods, or endometrial hyperplasia. 

Susceptibility to endometrial cancer is also linked to how much the endometrium has been exposed to oestrogen without progesterone. Oestrogen stimulates cell division, while progesterone suppresses it. With a high level of cell division, the chance of cancer increases. Women on HRT should be monitored regularly for uterine cancers.

Pap smears should be regularly performed as these may detect some uterine cancers before symptoms develop. Otherwise, uterine cancer is usually diagnosed by the appearance of symptoms. 

Traditional Treatments 

Conventional medicine is usually successful in curing most women of uterine cancer. The type of treatment will vary depending on the stage of the cancer. 

Surgery is standard treatment for uterine cancer that has not begun to metastasise, or spread. The usual treatment for early endometrial cancer is total hysterectomy, which means the uterus, cervix, ovaries, and fallopian tubes are all removed. If the disease has begun to spread beyond the uterus, the patient is given radiation therapy after surgery, in the hope of wiping out the remaining cancer cells. 

Patients with widespread (metastatic) uterine cancer are usually given hormone therapy to slow the cancer’s growth. Chemotherapy or radiation might also be given to reduce the size and number of metastatic tumours. Such treatment is rarely curative but can prolong life and relieve symptoms. If it destroys tumours in the other organs, and the cancer is confined to the uterus or close surrounding areas, surgery may then be undertaken. 

Patients in remission need checkups every few months for several years. If cancer recurs, it quite often happens within three years.

Caught early, recurrent cancer may be cured with aggressive radiation therapy or further surgery. (See cancer) 

Complementary Therapies 

There are many support groups to join if you are needing extra help in dealing with this disease. Counselling also may be very helpful for you at this time. 

Prevention 

Have a Pap smear and pelvic exam annually. If you are of child bearing age, discuss the pros and cons of taking birth-control pills with your doctor. 

It is also advisable to exercise regularly and eat sensibly to become as healthy as you can. (See Cancer entry for more information on this illness).

It is reported that certain vitamins and minerals such as antioxidants may have anticancer properties.

When to seek further professional advice 

• you experience abnormal vaginal bleeding or discharge. Abnormal bleeding is not a symptom of menopause. It should be brought to your doctor’s attention immediately.