Uterine cancer: symptoms, causes and how to treat it

Definition

What is uterine cancer?

Uterine or uterine cancer is a type of disease that develops in the lining or lining of the uterus which is characterized by the growth of a malignant tumor. The uterus is an empty, pear-like organ that lies between the bladder and rectum in a woman's body.

This organ serves as a place for the fetus to grow and develop during pregnancy. The part of the uterine wall is called the endometrium, and just below it is the connecting organ to the vagina called the cervix or cervix.

Cancer that attacks a woman's uterus is of two types, namely:

Endometrial cancer

Endometrial cancer is cancer that attacks the lining of the uterus. This type of cancer is very common in women.

Based on the appearance of abnormal cells, endometrial cancer is divided into endometrioid cancer, uterine carcinoma, squamous cell carcinoma, small cell carcinoma, and clear cell carcinoma.

Uterine sarcomas

Uterine sarcomas are cancer that begin in the muscles and tissues that support the uterus. This type of cancer is quite rare compared to endometrial cancer.

Uterine sarcomas are then divided into several types, depending on the type of cancer cells first appeared.

Uterine leiomyosarcoma attacks the myometrium (uterine muscle), endometrial stromal sarcoma attacks the stroma (supporting tissue in the endometrium), undifferentiated sarcoma attacks the muscles or stroma and develops rapidly.

How common is this cancer?

This cancer is quite common in Indonesian society. According to 2018 Globocan data, new cases of uterine and cervical cancer reached 32,469 people with a death rate of up to 18,279 people.

Cancer of the uterus is the second largest type of cancer affecting women after breast cancer.

Signs & symptoms

What are the signs and symptoms of uterine cancer?

In the early stages (stage 1), either endometrial cancer or uterine sarcoma, it usually does not cause signs, symptoms, or characteristics characteristic of women.

Generally, symptoms will be felt when they enter an advanced stage, namely stage 2, 3, or 4 (late).

More specifically, identify the following symptoms of uterine cancer that generally occur:

There is abnormal bleeding or vaginal discharge

About 85-90% of women with endometrial cancer and uterine sarcomas experience vaginal bleeding. That is why, irregular menstruation or bleeding after menopause is one of the symptoms of uterine cancer.

Apart from bleeding, excessive vaginal discharge can also be a sign of uterine cancer sufferers. which is probably often underestimated.

Pelvic pain and swelling in the abdomen

The next symptom is pelvic pain and feeling of swelling in the abdominal area due to the development of a tumor. These symptoms are usually a sign that the cancer has entered an advanced stage.

Every person who has uterine cancer is very likely to experience signs or features that are different. So, there may also be patients who experience other symptoms not listed above.

When to see a doctor?

You should immediately see a doctor if you experience the above symptoms of cancer. Especially if these symptoms worry you and they get worse over time.

Cause

What causes uterine cancer?

The cause of uterine cancer in women, be it endometrial cancer or uterine sarcoma, is not known with certainty. However, scientists argue that most cancer cells have estrogen and / or progesterone receptors on their surface.

This allows for the interaction between the receptors and hormones, making cell growth increase and even become abnormal so that it can cause cancer. The mechanism is still being observed by scientists in research.

In addition, scientists are also observing DNA changes in certain genes that have the potential to trigger uterine cancer.

Risk factors

What increases the risk of uterine cancer?

Although the cause of uterine cancer is not known with certainty, scientists have found various factors that can increase the risk of this disease, namely:

1. Increasing age

Most people with this type of cancer are women who have experienced menopause, which is to be precise around the age of 45 years and over.

2. Hormonal changes

Changes in female hormones can increase endometrial cancer. These abnormal levels can be caused by estrogen therapy to treat menopause and taking the drug tamoxifen, which is a drug to treat and prevent breast cancer.

3. Excess weight or obesity

The increased risk of endometrial cancer and uterine sarcoma can be caused by obesity. This is because excess fat tissue can increase the production of estrogen so that it can change the normal levels of body hormones.

In other words, the higher the amount of fat in your body, the more estrogen is produced by your body. This condition can lead to the development of cancer cells in the reproductive organs.

4. Poor diet and lazy exercise

Frequent consumption of high-calorie foods and lazy exercise can make you obese. This can increase the risk of endometrial cancer or uterine sarcoma.

5. Certain health conditions

Apart from obesity, other health problems, such as having diabetes, eye cancer, breast cancer, polycystic ovary syndrome, tumors in the ovaries, and Lynch syndrome can increase a person's risk of cancer in these reproductive organs.

6. Pelvic area radiotherapy

Radiation rays can damage DNA in body cells. For this reason, people who undergo long-term radiation therapy in the pelvic area have a high chance of developing this type of cancer in the next 5 to 25 years.

Diagnosis & treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What tests are done to diagnose uterine cancer?

To make a diagnosis of uterine cancer, your doctor will ask you to undergo a series of medical tests, including:

• Physical test. The doctor will ask you what symptoms you feel. Then, the doctor will also check your medical history and your family.
• Hysteroscopy. A test to see the condition of the uterus in more detail by inserting a small tube called a hysteroscope into your vagina.
• Uterine biopsy. In a biopsy technique, the doctor will take a sample of uterine tissue and check whether the cells are cancerous or not.
• Imaging test. The next test to see the condition of the uterus is an imaging test, which is a CT scan, ultrasound, MRI, or PET scan.
• Blood test. Checking your blood can help you measure high levels of CA-125 in your blood, which is a sign of uterine cancer.

The above tests in some cases can help detect cancer earlier. However, most doctors will perform a pelvic exam and a PAP smear.

How to determine the stage of uterine cancer?

After the above health tests are carried out, the doctor can determine the stage of the cancer you have. More specifically, the staging of uterine cancer is:

• Stage 1: cancer cells only in the uterus.
• Stage 2: cancer cells have spread to the cervix.
• Stage 3: cancer cells have spread to the vagina, ovaries, and / or lymph nodes.
• Stage 4: Cancer cells have spread to the bladder, rectum, or organs located far from the uterus, such as the lungs or bones.

What are the treatment options for uterine cancer?

In order to avoid the danger of uterine cancer spreading to other healthy tissues and organs, treatment must be done immediately. Here are some ways to treat this cancer, based on stages 1,2,3, and 4 (end):

1. Operation

Surgical or surgical procedures are the main treatment options for uterine cancer. Depending on which part of the uterus is removed, surgery is divided into 3 types, namely:

• Hysterectomy (removal of the uterus).
• Bilateral salpingo-oophorectomy (removal of the uterus, fallopian tubes, and both ovaries).
• Lymph gland dissection (removal of the uterus and surrounding lymph glands).

The side effects of this cancer treatment are bleeding, infection, or fertility problems.

2. Chemotherapy

Stage 1, 2, 3, or 4 uterine cancer can be treated with chemotherapy, which is using drugs that can kill cancer cells while reducing the size of the tumor.

The drugs commonly used to treat this type of cancer are:

• Paclitaxel (Taxol^®)
• Ccarboplatin
• Doxorubicin (Adriamycin^®)
• Liposomal doxorubicin (Doxil^®)
• Cisplatin
• Docetaxel (Taxotere^®)

Side effects of chemotherapy that may occur are hair loss, nausea, vomiting, and diarrhea, as well as body fatigue.

3.Radiation therapy (radiotherapy)

Apart from chemotherapy and surgery, another method that is usually taken is radiotherapy. This treatment relies on radiation beams to kill cancer cells in the body.

Radiotherapy can also cause side effects including skin problems, body fatigue, and nausea and vomiting.

Home care

What are some lifestyle changes or home remedies that can be done to treat uterine cancer?

The home treatment for treating the symptoms of cancer of the uterus or endometrium is to adopt a healthy lifestyle.

You need to go on a cancer diet, adjust your activities, and follow other treatments that doctors recommend as a way to deal with symptoms of uterine cancer.

However, you should not carelessly follow alternative medicine or traditional medicine as a treatment effort. For example, taking the herbal curcumin medicine or relying on natural plants, such as turmeric.

The reason is, how to treat cancer naturally has not been proven effective and it is feared that it can cause side effects and allergies that interfere with the main treatment.

Prevention

How do I prevent uterine cancer?

The precautionary measure for cancer of the uterus or those that attack the endometrium is to reduce the various risks, namely by:

• Take birth control pills

The use of contraceptives is known to reduce the risk of uterine cancer. However, on the other hand, it can also increase the risk of other types of cancer. Therefore, consult a doctor first.

• Maintain ideal body weight

You can get this by maintaining your diet, such as increasing your intake of spinach, cauliflower, broccoli, tomatoes, papaya and oranges to reduce the risk of uterine cancer. In addition, balance it with regular exercise.

• Perform treatment for endometrial disorders

If you have endometrial problems, get checked for the condition and follow the treatment recommended by the doctor so that it does not get worse and lead to cancer.

• Get doctor care for Lynch syndrome

People with this syndrome are at high risk of developing cancer, so they need treatment and supervision from a doctor so that the risk does not increase.