What is a uterus cancer?
There are two parts of the womb (uterus) that are prone to cancer the neck (cervix), which can develop cervical cancer, and the lining of the body of the womb, called the endometrium, which can develop endometrial cancer.
This section will concentrate on endometrial cancer; a separate section deals with cancer of the cervix.
Cancer of the lining of the womb (endometrial cancer) has quite different features from cervical cancer and is much less common. It is essentially a disease of older women and occurs most often between the ages of 50 and 70, and it is commoner in women who have not had children.
Symptoms of uterus cancer
The usual symptom of endometrial cancer is vaginal bleeding after the menopause i.e. after the woman’s periods have stopped happening. This may start, as light bleeding accompanied by a watery discharge but usually becomes heavier with time.
Those women who develop endometrial cancer before the menopause may notice bleeding between periods or especially heavy periods.
Causes of uterus cancer
The exact cause of uterine cancer is not known. Known risk factors for endometrial cancer are:
- Never having been pregnant
- Late menopause
- Close family history of cancer of the breast, ovary or colon.
- Taking estrogen (a female hormone) without another protective female hormone called progesterone. Both of these hormones are found in some forms of HRT (Hormone replacement therapy); women without a womb need only to take estrogen – containing HRT whereas those with a womb must take a form which also contains progesterone.
Ovarian tumours (growths) that produce estrogen.
- Treatment with the hormone tamoxifen.
It has been found that the combined oral contraceptive pill (the pill) has a protective effect against endometrial cancer so that women who are on the pill are less likely to develop this condition. This protective effect lasts for a few years after the pill has been stopped.
How to diagnose uterus cancer?
Cancer of the womb is diagnosed by the taking of a sample of tissue from the womb lining (biopsy) and sending it for analysis. Taking the sample can be done in a number of ways.
One method involves placing a small tube into the womb and then sucking samples of the womb lining into the tube with the use of a syringe. This can be done in outpatients.
Alternatively a quick general anesthetic can be given as an inpatient following which samples of womb lining are scraped off using a special instrument. At the same time the inside of the womb can be inspected using a small flexible telescope called a hysteroscope to enable the specialist to examine the womb lining.
What is the treatment for uterus cancer?
If caught at an early stage, endometrial cancer can be cured in most cases by removal of the womb, Fallopian tubes (the tubes leading to the ovaries) and the ovaries usually followed by radiotherapy. A hormone treatment (progesterone) is also available.
If the diagnosis is made reasonably early and the womb, Fallopian tubes and ovaries are removed, the outlook is usually excellent.
Some endometrial cancers, however, are highly malignant and invade rapidly. In these cases the outlook is much less favorable. Surgery may be supplemented with radiotherapy. A hormone treatment (progesterone) is also available. The hormone progesterone may also be used as a treatment.
If not caught early enough, endometrial cancer can spread to other parts of the body and is, unfortunately, fatal in some cases.
Prevention of uterus cancer
Endometrial cancer cannot be prevented, although the taking of the oral contraceptive pill appears to have some temporary preventative effect.
Early detection of the problem is important as this provides a better chance of cure. Any signs of vaginal bleeding in the menopause, or a persistent change in periods should be reported to your doctor.