Cancer Of The Uterus – The Secret Killer

Endometrial cancer, malignancy of the lining of the womb, is the third most common cause of cancer death in women. It needn’t be. More than 35,000 American women are diagnosed every year. Other uterine cancer includes cervical carcinoma, sarcoma of the myometrium (cancer of the uterine smooth muscle) and trophoblastic disease, which arises from placental stem cells.

Most endometrial cancers are carcinomas, which means that they originate from the epithelium, a thin layer of cells lining the uterus. Type I cancers occur mostly in women before or near menopause. These are minimally invasive and have a good prognosis. Type II carcinomas occur most commonly in African-American women past the age of menopause and have a poor prognosis. Endometrial sarcoma, originating from the connective tissue of the uterus, is less common.

Symptoms – The most common symptom of uterine cancer is vaginal bleeding. Prior to menopause, this can be heavier or longer periods than normal or bleeding in between periods. In women past the age of menopause, this is any bleeding at all and should not be ignored. Post-menopausal bleeding may well be an innocent fluke, but it could also be a sign of something more sinister that can easily be nipped in the bud if it is caught early. Pain during sex, difficulty emptying the bladder, lower abdominal pain or cramping may also be present. In women with irregular periods or for whom normal menses are lengthy, painful or heavy it can be difficult to differentiate between what is normal and what is worth ‘troubling’ the doctor for. If in doubt, check it out!

Diagnosis – The doctor will perform an internal examination and may take blood samples to be sent off for testing. He may perform or request a vaginal ultrasound examination. This involves the insertion of a gentle probe, about the size of a tampon, and monitoring on a screen. It may be necessary to take a biopsy, either in the doctor’s office or in a hospital.

Treatment – For cancers of the cervix, a cone biopsy may be performed or the problem may be treated with radiation. For other cancers of the uterus, a total hysterectomy and removal of both ovaries may be necessary.

Risk Factors and Causes – Nobody knows what causes the disease, but there are known risk factors. Some of these are beyond conscious control, such as elevated levels of estrogen, polycystic ovary syndrome, difficulty becoming pregnant (infertility) or no history of pregnancy, early onset of menstrual periods or late menopause (cessation of menstruation). Other possibilities are benign endometrial growths (polyps), a history of taking Tamoxifen (a cancer medication), diabetes, age over 35, anovulatory cycles or previous pelvic radiation.

Prevention – Some risk factors can be controlled, such as a diet that is high in animal fat, obesity, heavy daily alcohol consumption or hypertension (high blood pressure).

Pain and heavy periods are not necessarily normal and not ‘part of being a women’. Women should not ignore these symptoms. Most of the time there will be a simple, easily treatable explanation for them. It is unlikely but possible that they do signal uterine cancer. The sooner the problem is diagnosed and treated, the better the prognosis.

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