Uterine Cancer: Risks and Treatment Options
As cancer is always named for the body of your body where it begins, when cancer starts in the uterus, it's called uterine cancer. The uterus is a hollow, pear-shaped organ in your pelvis, the place a baby grows when you are pregnant. The most common type of uterine cancer is endometrial cancer, named because it develops in the lining of your uterus, called the endometrium. Other types of cancer can form in the uterus, but they are much less common than endometrial cancer.
The Centers of Disease Control and Prevention reports most uterine cancers are found in women who are going through or have gone through menopause. These cancers typically develop over a period of years and may start as a less serious problem, such as endometrial hyperplasia (an overgrowth of cells in the lining of the uterus). Endometrial cancer is often detected at an early stage because it often produces abnormal vaginal bleeding, which prompts women to see their doctors and get tested.
How Uterine Cancer Grows
Cancer begins in the building blocks, or cells, that make up the tissues of your organs. Normal cells grow and divide to form new cells as you need them. Usually, when normal cells grow old or get damaged, they die, and new cells take their place. Doctors don't know what causes endometrial cancer. But they do know that sometimes, something occurs to create a genetic mutation within cells in the lining of the uterus that turns normal, healthy cells into abnormal cells. The buildup of these abnormal cells then forms a mass or a tumor, which can be benign (non-cancerous) or malignant (cancerous). Cancer cells can invade nearby tissues and can separate from the initial tumor to spread elsewhere in the body (metastasize).
In addition to age, experts have identified the indicators that increase your risk of uterine cancer, including if you have:
- Ovarian diseases, such as polycystic ovarian syndrome or complex atypical endometrial hyperplasia
- Breast or ovarian cancer
- Never been pregnant
- Or if you started menstruating before age 12, or went through menopause late.
Treatment Options for Uterine Cancer
If you are diagnosed with uterine cancer, the Centers for Disease Control and Prevention recommends that you ask to be referred to a gynecologic oncologist who has been trained to treat cancers of the reproductive system. Your oncologist will work with you to create a treatment plan, which may consist of more than one type of treatment.
There are several options for treating uterine cancer-surgery, radiation, hormone therapy, and chemotherapy, or a combination of the above. The type you receive will depend on the type of cancer you have, how far it has spread, your overall health, and your preferences. The treatment that's right for you depends mainly on the following:
- Whether the tumor has invaded the muscle layer of the uterus
- Whether the tumor has invaded tissues outside the uterus
- Whether the tumor has spread to other parts of the body
- The grade of the tumor
- Your age and general health
Surgical removal of the uterus is the main treatment for most women. During surgery, your surgeon will inspect the areas around your uterus for any signs that the cancer has spread. Lymph nodes may be taken out to help determine you're the stage of your cancer. Usually surgery for uterine cancer includes:
- Total hysterectomy (surgical removal of the uterus)
- Bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes)
- Biopsy of the omentum, a fat pad in the pelvis
- Removal of lymph nodes in the pelvis and lower abdomen
Sometimes a radical hysterectomy is done. This means removal of your:
- Cervix and surrounding tissue
- Upper vagina
Radiation therapy uses high energy rays, similar to X-rays, to kill cancer cells and stop them from spreading. In some instances, your doctor may recommend surgery and radiation to reduce your risk of cancer recurrence. If you aren't healthy enough to undergo surgery, you may opt for radiation therapy only. In women with advanced cancer, radiation therapy may help control cancer-related pain. Depending on the stage and grade of the cancer, radiation therapy may also be used at other points of treatment.
Hormone therapy involves taking medications that affect the hormone levels in your body. Hormone therapy may be an option if you have advanced cancer that has spread beyond the uterus. Some hormones can cause certain uterine cancers to grow. If tests show the cancer cells have receptors where hormones can attach, drugs can be used to reduce hormones or block them from working.
Chemotherapy uses chemicals to kill cancer cells. You may receive one chemotherapy drug, or a combination of two or more drugs. You may receive chemotherapy drugs in the form of pills or through your veins. If you have advanced cancer that has spread beyond your uterus, chemotherapy may be an option as these drugs enter your bloodstream and then travel through your body, killing cancer cells.
You may want to talk with your doctor about taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of uterine cancer.
The Mayo Clinic
The MD Anderson Cancer Center at the University of Texas
The Centers for Disease Control and Prevention
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