A cancerous tumour that grows in the lining of the uterus
- Most common between the ages of 55 and 65
- Being overweight and not having had children are risk factors
- Genetics is not a significant factor
Cancer of the uterus is one of the most common cancers of the female reproductive organs in the UK, with about 6,900 new cases diagnosed in 2005. Most uterine cancers develop in the endometrium (the lining of the uterus). More rarely, cancer occurs in the muscular wall of the uterus.
What are the causes?
The causes of cancer of the uterus are unclear. The disorder is more common in women aged 55–65 and in those who have or have previously had abnormally high levels of the female sex hormone oestrogen. Raised oestrogen levels may be caused by being overweight and by certain disorders, such as polycystic ovary syndrome. The disorder is also more likely in women who have had a late menopause (after the age of 52) or who have not had children.
What are the symptoms?
The symptoms of cancer of the uterus vary depending on whether it develops before or after the menopause. These symptoms may include:
In premenopausal women, heavier than normal periods (see Menorrhagia) or bleeding between periods or after sexual intercourse.
In postmenopausal women, vaginal bleeding that may vary from spotting to heavier bleeding.
Left untreated, cancer of the uterus may spread to the fallopian tubes and the ovaries and to other organs, including the lungs and sometimes the liver.
How is it diagnosed?
If your doctor suspects cancer from your symptoms, he or she will perform a pelvic examination. During the examination, a small sample of tissue may be taken from the endometrium to check for the presence of cancerous cells (see Endometrial sampling). Your doctor will also arrange for ultrasound scanning to assess the thickness of the lining of the uterus. A thicker than normal lining may indicate cancer of the uterus.
If these tests are not conclusive, a hysteroscopy may be needed to remove a larger amount of tissue from the uterus. Samples of the endometrial tissue are then microscopically examined for cancerous cells. During the hysteroscopy, your doctor is also able to directly view the endometrium to check for any obvious abnormalities.
If cancer of the uterus is diagnosed, tests will be carried out to see if the cancer has spread. For example, you may have a chest X-ray or MRI of the pelvis and abdomen. You may also have blood tests to assess the function of the liver.
What is the treatment?
The treatment for cancer of the uterus depends on the stage at which the cancer is diagnosed and whether or not it has spread elsewhere in the body.
In most women, the tumour can be treated by a hysterectomy, in which the uterus, ovaries, and fallopian tubes are removed. In addition, samples from nearby pelvic lymph nodes are usually taken and examined under a microscope to see if the disease has spread and to check whether further treatment is required. Surgery is often followed by radiotherapy to destroy any cancer cells that remain.
If cancerous cells are found in the lymph nodes, you will be treated with chemotherapy and the female hormone progesterone (see Sex hormones and related drugs), which slows down the growth of cancer cells. After treatment, you will have regular follow-ups to check for signs of cancerous changes in the pelvis.
The outlook for cancer of the uterus depends on whether the tumour is treated at an early stage before the condition has spread to other parts of the body. About 4 in 5 women who are treated when the cancer is at an early stage survive for 5 years or longer.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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