Uterine (Endometrial) Cancer

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Uterine cancer, also known as endometrial cancer, starts in the lining of the uterus (the endometrium). It is the most common cancer of the female reproductive system.

Types:

  1. Endometrioid Adenocarcinoma: The most common type, originating from the endometrial glands.
  2. Serous Carcinoma: A more aggressive type often diagnosed at a later stage.
  3. Clear Cell Carcinoma: Another aggressive form, usually associated with poor outcomes.
  4. Uterine Sarcomas: These arise from the muscle or connective tissue of the uterus and are less common.

Risk Factors:

  • Age: Most cases occur in postmenopausal women, typically over 50.
  • Obesity: Excess body fat increases estrogen levels, which can lead to an increased risk.
  • Hormonal Imbalance: Conditions that increase estrogen without progesterone (like polycystic ovary syndrome) can heighten risk.
  • Family History: A family history of uterine, breast, or colorectal cancers may increase risk.
  • Diabetes and Hypertension: These conditions are associated with higher risk.

Symptoms:

Symptoms may include:

  • Abnormal vaginal bleeding (especially post-menopause)
  • Heavy or irregular periods
  • Pelvic pain
  • Unexplained weight loss
  • Discharge from the vagina (not related to menstruation)

Diagnosis:

  • Pelvic Exam: A doctor checks for abnormalities.
  • Ultrasound: Transvaginal ultrasound can help evaluate the endometrium.
  • Endometrial Biopsy: A sample of the endometrial tissue is taken for examination.
  • Hysteroscopy: A procedure to view the inside of the uterus and potentially take a biopsy.

Treatment:

  1. Surgery: The primary treatment is often a hysterectomy, which involves removing the uterus and possibly the cervix and ovaries.
  2. Radiation Therapy: Used post-surgery or for advanced cases to kill remaining cancer cells.
  3. Chemotherapy: May be used for more advanced or recurrent cancer.
  4. Hormonal Therapy: In cases that are hormone receptor-positive, hormone therapy can help slow growth.

Prognosis:

The prognosis is generally good when detected early. The five-year survival rate for localized endometrial cancer is quite high, but it decreases for advanced stages.

Prevention:

  • Maintain a Healthy Weight: Reducing obesity can lower risk.
  • Manage Hormonal Health: Discuss hormonal treatments with a doctor if you have conditions that affect estrogen levels.
  • Regular Check-ups: Annual gynecological exams can help with early detection of abnormalities.