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oncology1

Uterine Cancer

Uterine cancer or womb cancer is any type of cancer that emerges from the tissue of the uterus. It can refer to several types of cancer, with cervical cancer (arising from the lower portion of the uterus) being the most common type worldwide and the second most common cancer in women in developing countries.

Signs & Symptoms:

  • Unusual vaginal bleeding, spotting, or discharge. For premenopausal women, menorrhagia, or abnormal uterine bleeding (AUB)
  • Difficulty or pain when urinating
  • Pain during sexual intercourse
  • Pain in the pelvic area

Risk Factors:

  • Female gender
  • Age
  • Genetics
  • Other cancers
  • Tamoxifen
  • Radiation therapy
  • Diet
  • Estrogen

Common Types:

  • Endometrial cancer:
  • Cervical cancer
  • Uterine sarcomas
  • Gestational trophoblastic disease

Diagnosis:

  • Pelvic examination
  • Transvaginal ultrasound
  • Computed tomography (CT or CAT) scan
  • Magnetic resonance imaging (MRI)
  • Endometrial biopsy
  • Dilatation and Curetage  (D&C)

Stages:

  • Stage 0: 
    The tumor is called carcinoma in situ, which means it is very early stage cancer. It is found only in one layer of cells and has not spread
  • Stage 1: 
    The cancer is found only in the uterus or womb, and it has not spread to other parts of the body
  • Stage 2: 
    The tumor has spread from the uterus to the cervical stroma but not to other parts of the body
  • Stage 3:
    The cancer has spread beyond the uterus, but it is still only in the pelvic area
  • Stage 4A: 
    The cancer has spread to the mucosa of the rectum or bladder
  • Stage 4B: 
    The cancer has spread to lymph nodes in the groin area, and/or it has spread to distant organs, such as the bones or lungs

Prevention:

  • Taking birth control pills, especially over a long period of time
  • Considering the risk of uterine cancer before starting HRT, especially estrogen replacement therapy alone
  • Maintaining a healthy weight
  • If diabetic, maintaining good disease control such as regularly monitoring blood glucose levels

Management:

  • Surgery
    Hysterectomy is done to remove the cervix and uterus, with or without removing nearby lymph nodes. A radical hysterectomy also removes some tissues around the cervix and upper vagina. A bilateral salpingo-oophorectomy is done to remove both ovaries and fallopian tubes. It is usually done at the same time as the hysterectomy. Pelvic exenteration is sometimes done when cancer has come back (recurred) after treatment, but has not spread outside the pelvis (is localized). The reproductive organs (cervix, uterus, ovaries and fallopian tubes) are removed along with the lymph nodes in the pelvis. The rectum or bladder or both may be removed. For advanced uterine cancer, surgery is done to remove as much of the tumor as possible (debulk).
  • Radiation therapy
    • External beam radiation therapy
    • Brachytherapy
    • A combination of both external beam radiation therapy and brachytherapy
  • Hormonal therapy
    • After surgery, for some types of uterine cancer
    • For advanced or recurrent uterine cancer
    • To relieve symptoms of advanced disease
  • Chemotherapy

Chemotherapy is administration of chemotherapeutic medication, either alone or in combination with surgery and/or radiation therapy. The patient may require multiple cycles of chemotherapy at regular intervals. Chemotherapy may be administered after surgery, for advanced or recurrent uterine cancers or to relieve symptoms of advanced disease

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