Jan 12, 2018 in Medicine

Uterine Cancer

Introduction

Uterine cancer, sometimes referred to as endometrial cancer, is the most prevalent form of gynecologic cancer in the US. Uterine cancer is caused by the abnormal cells growing the internal uterus lining (endometrium). B%u0151sze (100) points out that uterine cancer occurs usually after menopause, although there are some instances where uterine cancer has been diagnosed prior to menopause. In the United States, at least 35,000 women are diagnosed with uterine cancer annually. According to MedicineNet, uterine cancer is more common among women who are aged over 50 years. When diagnosed early, uterine cancer is curable when found during its earliest phase before spreading to other parts of the uterus. This paper provides an overview of uterine cancer with a special focus on its causes and risk factors, signs and symptoms, diagnosis, and treatment options.

Causes and Risk Factors of Uterine Cancer

Several studies have pointed out a number of risk factors that increase the chances of a woman to develop uterine cancer. Diaz-Montes (156) defines a risk factor as “something that increases the likelihood of getting a given disease”. In this regard, Diaz-Montes (157) identifies 7 risk factors of developing uterine cancer, which include the endometrium overgrowing abnormally, obesity, menstrual and reproductive history, estrogen intake history, tamoxifen intake history, radiation therapy, and family health history. With respect to the endometrium overgrowing abnormally (a condition referred to as endometrial hyperplasia), Diaz-Montes (158) points out that any unusual increase in the cell numbers found in the uterus lining is a potential risk factor for the development of uterine cancer. Diaz-Montes (158) notes that hyperplasia is not considered a form of cancer; however, there are instances wherein hyperplasia develops into cancer. Some of the most common signs associated with endometrial hyperplasia include bleeding following menopause, bleeding in between menstrual periods, and heavy bleeding during menstrual period. Diaz-Montes (160) points that hyperplasia is most prevalent among women aged at least 40 years.

Regarding obesity, Cote, Suster, and Weiss (56) point out that, obese women are at risk of suffering from uterine cancer. With respect to the menstrual and reproductive history, women who have never given birth, had their menopause after 55 years, and had their first menstruation before 12 years, are at a greater risk of getting uterine cancer. In addition, Cote, Suster, and Weiss (57) show that women who prevented or treated breast cancer using tamoxifen are at a greater risk of getting uterine cancer. Similarly, Hiroyuki, Masato, and Nishida (100) found out that the use of radiation therapy in the pelvis increases the likelihood of getting the uterine cancer. Regarding the family health history, Kuntz (44) points out that women having a sister, mother, or daughter suffering from uterine cancer are at a greater risk of getting the disease.

Other risk factors associated with uterine cancer include age and ethnicity, wherein women over 50 years and Caucasian women are at a greater risk of getting uterine cancer (Littleton et al. 58). Littleton and Engebretson (158) also outlined other risk factors, which include high estrogen hormone levels, hypertension, diabetes, high animal fat intake, ovarian cancer, lack of physical exercise, breast cancer, and consuming alcohol in high amounts on a daily basis.

Signs and Symptoms of Uterine Cancer

Littleton and Engebretson (175) affirm that the most prevalent symptom associated with uterine cancer is abnormal vaginal bleeding, which is likely to commence as a blood-streaked and watery flow, with the blood content increasing gradually. Littleton and Engebretson (177) point out that after reaching menopause, any instance of vaginal bleeding should be considered abnormal. Other common symptoms of uterine cancer highlighted by MedicineNet include abnormal vaginal discharge or spotting, experiencing pain during sexual intercourse, experiencing difficulty or pain when emptying the urinary bladder, and frequent pains experienced in the pelvic area. According to MedicineNet, these signs and symptoms do not necessary mean that a person is developing uterine cancer because there are other health problems typified by similar symptoms. In such instances, it is imperative to consult a cancer specialist for early diagnosis and treatment. Other signs and symptoms associated with the disease include bleeding in between menstrual periods, especially for women yet to reach their menopause and aged above 40 years. Anemia is also another potential sign, especially if the woman disregarded the recurrent and extended abnormal menstrual bleeding (Skeel 258).

Diagnosis of Uterine Cancer

Jiménez-Ayala and Jiménez-Ayala (155) suggest three clinical tests that can be used in the diagnosis of uterine cancer, which include pelvic examination, ultrasound, and biopsy. A pelvic exam can be used to check the vagina uterus and other tissues to detect any lumps and any changes in the size and shape of the lumps. Jiménez-Ayala and Jiménez-Ayala (163) point out that the results of a pelvic exam are often normal, particularly when undertaken during the early phases of uterine cancer; this is because alterations in the consistency, shape and size of the uterus, supporting structures, and surrounding tissues are likely to be detected at advanced stages of the disease. Ultrasound can be used to visualize the uterus and the surrounding tissues to detect the presence of a uterine tumor. The transvaginal ultrasound device creates an enhanced view of the vagina, which can be integral in assessing the endometrial thickness among women exhibiting vaginal bleeding after menopause.  Endometrial biopsy, which entails extracting a tissue sample from the uterus lining, can be used to diagnose the presence of cancer cells in the uterus. Muggia and Oliva (78) assert that endometrial biopsy is the only confirmatory test that can be used to detect the presence of cancer cells in the uterus.

During the diagnosis of uterine cancer, it is imperative for the doctor to ascertain the stage of the cancer in order to determine the most appropriate treatment for the disease. B%u0151sze (125) points out that the phase of uterine cancer depends on whether it has spread to the surrounding tissues and other body parts. For instance, when cancer cells multiply beyond its original place to other parts, the newly formed tumor is the same as the original tumor regardless of the distant body tissue. An example is when uterine cancer cells spread to the cervix; it should be treated as uterine cancer and not cervical cancer. Some tests that doctors can use to determine the stage of uterine cancer include lab tests such as a Pap smear test, chest X-rays, CT scans, and MRI. The following table 1 shows the stages of uterine cancer (B%u0151sze 123).

Stage 0

The uterine cancer cells are only at the inner surface of the uterus lining

Stage I

The cancer tumor has attacked the myometrium

Stage II

The cancer tumor has spread to the cervix

Stage III

The uterine cancer cells have multiplied beyond the uterus and has attacked the surrounding tissues such as the lymph node and vagina

Stage IV

The cancer cells have spread to the intestine or bladder and other body parts such as bones, lungs and liver

Treatment of Uterine Cancer

Littleton and Engebretson (145) assert that the treatment options for women having uterine cancer include hormone therapy, chemotherapy, radiation therapy, and surgery. According to MedicineNet, the right treatment is determined by a number of factors such as the extent to which the tumor has attacked the surrounding tissues, whether the cancer cells have spread to the uterus’ muscle layer, age, and the tumor’s grade.

Conclusion

Uterine cancer is the most prevalent form of gynecologic cancer in the US, affecting about 35,000 women annually. Uterine cancer is caused by the abnormal cells growing the internal uterus lining (endometrium). The risk factors of developing uterine cancer include the endometrium overgrowing abnormally, obesity, menstrual and reproductive history, estrogen intake history, tamoxifen intake history, radiation therapy, and family health history. The symptoms of the disease include abnormal vaginal discharge or spotting, experiencing pain during sexual intercourse, experiencing difficulty or pain when emptying the urinary bladder, and frequent pains experienced in the pelvic area. The clinical tests that can be used in the diagnosis of uterine cancer include pelvic examination, ultrasound, and biopsy. Regarding the treatment options, uterine cancer can be treated using hormone therapy, chemotherapy, radiation therapy, and surgery. 

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