"It is possible to reduce the risk by avoiding hormone replacement therapy with estrogen alone, maintaining a healthy weight, daily physical exercise and a thorough control by your gynecologist in case of family history, risk factors, taking tamoxifen or any genital bleeding".
DR. JOSÉ ÁNGEL MÍNGUEZ MILIO
SPECIALIST. GYNAECOLOGY AND OBSTETRICS DEPARTMENT
Cancer of the uterus is a type of tumor that is most often located within the uterus and therefore can have a good chance of being cured.
Although different types of tumors can appear in the uterus, the most frequent is endometrial adenocarcinoma (mucous membrane that covers the uterus inside).
The most frequent age of appearance is post-menopause, being rare in women under 40. It usually produces symptoms in the initial stages, which facilitates early diagnosis.
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What are the symptoms of uterine cancer?
The most frequent symptom, in almost 90% of cases, is vaginal bleeding, which appears on dates that do not correspond to menstruation, essentially in the postmenopausal period.
- Abnormal vaginal discharge, especially brownish in color.
- Pain or bleeding with sexual intercourse.
- Pelvic pain.
The most common symptoms are:
- Vaginal bleeding.
- Brownish vaginal discharge.
- Pelvic pain.
Do you have any of these symptoms?
You may have uterine cancer
What are the causes?
The exact causes of uterine cancer are unknown. The risk increases if there are chronically elevated estrogen levels and the woman is past menopause.
Predisposing factors are considered to be obesity, a history of infertility or lack of pregnancy, late menopause (over 52 years of age), polycystic ovarian syndrome, estrogen-producing ovarian tumors or the use of estrogen-containing hormones (e.g. hormone replacement therapy without added progesterone).
Some endometrial cancers may have a genetic component. If there is a family history of uterine cancer, it is advisable to consult with a specialist in Clinical Genetics to perform the necessary tests to determine if there is a hereditary component.
What are the risk factors for uterine cancer?
- Late menopause (over 52 years old).
- Nulliparity (not having had children).
- Diabetes, hypertension, fat consumption, estrogen-only hormone replacement therapy, chronic anovulation (polycystic ovary or other causes).
- Taking tamoxifen frequently administered as part of breast cancer treatment.
- Hereditary conditions: carriers of the gene for hereditary nonpolyposis-linked colorectal cancer (Lynch type II).
- Personal history of breast or ovarian cancer.
- Endometrial hyperplasia.
- Some estrogen-producing ovarian tumors.
How is uterine cancer diagnosed?
In the diagnosis of uterine cancer, a complete clinical history and a detailed gynecological examination are performed first.
A blood test with determination of tumor markers will be requested.
A transvaginal ultrasound is often performed first to see the characteristics and thickness of the endometrium.
If the endometrium is very thickened or suspicious, it is necessary to rule out the presence of cancer and, to do so, it is necessary to perform a biopsy, which is sometimes done by hysteroscopy.
When it is confirmed that endometrial cancer is present, it is necessary to perform complementary tests to determine the extent of the cancer: CAT scan, magnetic resonance imaging (MRI), PET-CT, etc.
In this way it is possible to know whether the tumor has spread or not, which is related to the most appropriate type of treatment in each case.
How is uterine cancer treated?
The usual treatment for uterine cancer is surgical. Depending on the size, location and stage of the tumor, the specialist will recommend one or another type of surgery, being necessary, in some cases, to completely remove the uterus by means of a hysterectomy and the adnexa (tubes and ovaries). Also, depending on certain prognostic factors (depth of invasion of the uterine wall and degree of differentiation) it is also necessary to remove the pelvic nodes and, in some cases, the aortic nodes.
In some cases in which there are adverse prognostic factors (lymph nodes with tumor, some histological types, etc.) that increase the risk of local and/or distant recurrence, it is recommended to administer radiotherapy and/or chemotherapy after surgery.
In advanced cases due to extension of the disease in the abdomen, chemotherapy should be administered after surgery that resembles that of ovarian cancer. Hormone therapy is frequently used in this type of tumor when it is disseminated.
The specialist will also consider the administration of radiotherapy after surgery to reduce the local and regional incidence of the tumor.
In patients of reproductive age and with the desire to have children, when the tumor is located in the uterine cavity and there is no suspicion that it infiltrates the uterine wall or is disseminated, treatment with hormone therapy can be given.
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