Uterine Cancer

Uterine cancer includes two types of cancer: endometrial cancer (more common) and uterine sarcoma (rare). Treatment options include surgery, radiation, chemotherapy, and hormone therapy. Early detection is key. Consult a healthcare professional for more information. 

Types Of Uterine Cancer

Uterine cancer, also known as endometrial cancer, primarily occurs in the lining of the uterus (the endometrium) and is classified into different types based on the histological characteristics of the cancer cells. The two main types of uterine cancer are:

• Endometrioid Adenocarcinoma: Endometrioid adenocarcinoma is the most common type of uterine cancer, accounting for approximately 80-90% of cases. It tends to be less aggressive and is usually detected at an earlier stage.

• Serous Carcinoma: Serous carcinoma is a less common but more aggressive type of uterine cancer, making up about 5-10% of cases. Serous carcinoma tends to be diagnosed at a more advanced stage and is more likely to metastasize beyond the uterus. In addition to these primary types, there are some rarer forms of uterine cancer, including:

•  Clear Cell Carcinoma: Clear cell carcinoma is a less common subtype that tends to have a poorer prognosis. It is characterized by the presence of clear cells in the cancer tissue and is often diagnosed at an advanced stage.

• Undifferentiated/Unclassified Carcinoma: This category includes tumors that do not fit into the above-defined types. They tend to be more aggressive and challenging to treat.

Causes Of Uterine Cancer

Uterine cancer, also known as endometrial cancer, has several risk factors and contributing factors associated with its development. While the precise causes are not always clear, the following factors are known to increase the risk of uterine cancer:

• Hormonal Imbalances: Hormonal imbalances, particularly high levels of estrogen relative to progesterone, are a significant risk factor for uterine cancer. This imbalance can stimulate the growth of the uterine lining (endometrium) and increase the likelihood of malignancy.

• Obesity: Obesity is strongly linked to an increased risk of uterine cancer, especially in postmenopausal women. Fat tissue can produce and store excess estrogen, contributing to hormonal imbalances and the growth of endometrial cells.

• Hormone Replacement Therapy (HRT): Prolonged use of estrogen-only hormone replacement therapy (HRT) without progesterone in postmenopausal women can elevate the risk of uterine cancer. Combination HRT with both estrogen and progesterone is often prescribed to lower this risk.

• Age and Menopause: Uterine cancer is most common in postmenopausal women aged 50 and older. The risk increases with age, particularly in women who have never been pregnant.

• Hereditary Factors and Genetic Syndromes: A family history of uterine or colorectal cancer can increase the risk. Some hereditary syndromes, such as Lynch syndrome (hereditary non-polyposis colorectal cancer or HNPCC), can significantly elevate the risk of uterine cancer.

• Polycystic Ovary Syndrome (PCOS): PCOS is a condition characterized by hormonal imbalances, irregular periods, and the presence of numerous small cysts on the ovaries. Women with PCOS may have higher levels of estrogen, which can increase the risk of uterine cancer.

 The treatment of uterine cancer, also known as endometrial cancer, varies based on the stage of the disease, the patient's overall health, and individualized considerations. The primary treatment options for uterine cancer include surgery, radiation therapy, chemotherapy, hormonal therapy, and targeted therapy. Here is an overview of the procedures involved in treating uterine cancer:

• Surgery:
  • Surgery is often the primary treatment for uterine cancer, particularly in early-stage cases. The most common surgical procedure is a total abdominal hysterectomy, which involves removing the uterus, cervix, and sometimes the fallopian tubes and ovaries. Lymph nodes in the pelvic and para-aortic regions may also be removed to check for cancer spread.
  • For some patients, a minimally invasive approach, such as laparoscopic or robotic-assisted surgery, may be considered, which involves smaller incisions and faster recovery times. In cases of advanced disease, cytoreductive or debulking surgery may be performed to remove as much cancer as possible.

• Radiation Therapy:
  • Radiation therapy uses high-energy X-rays to target and destroy cancer cells. It can be employed as either adjuvant therapy after surgery to eliminate any remaining cancer cells or as primary therapy for patients who are not candidates for surgery.
  • External beam radiation therapy delivers radiation from outside the body, while brachytherapy involves placing radioactive sources directly inside the uterus.
• Chemotherapy:
  • Chemotherapy uses drugs to kill or slow the growth of cancer cells. It is typically considered for advanced or recurrent uterine cancer and may be used in combination with radiation therapy.
  • The choice of chemotherapy drugs and regimen is tailored to the specific needs of the patient and the characteristics of the cancer.
• Hormonal Therapy:
  • Hormonal therapy may be used for certain types of uterine cancer, particularly those with estrogen or progesterone receptor-positive status. It includes the use of hormones or hormone-blocking medications to control or inhibit cancer growth.
• Targeted Therapy:
  • Targeted therapies are drugs designed to target specific molecules or pathways in cancer cells. In some cases, targeted therapy drugs like pembrolizumab may be considered for the treatment of advanced or recurrent uterine cancer.