Uterine cancer

The endometrium is the tissue forming the inner lining of the uterus. Uterinecancer (also called endometrial cancer) develops when the cells of the endometrium become abnormal and grow uncontrollably. It is a common type of canceramong women and generally occurs in women who have gone through menopause and are 45 years old or older.

The uterus (also called the womb) is the hollow female organ that supports the development and nourishment of the unborn baby during pregnancy. It has a thick muscular wall and an inner lining called the endometrium. The endometrium is very sensitive to hormones and it changes daily during the woman's menstrual cycle. It is designed to provide an ideal environment for the fertilizedegg to implant itself and begin to grow. If pregnancy does not occur, the endometrium is shed at the time of the menstrual period. The bleeding that occurs during a woman's period is the shedding of the endometrium along with theaccompanying blood and tissue. More than 95% of uterine cancers arise in theendometrium.

Although the exact cause of endometrial cancer is unknown, there are severalfactors that increase a woman's risk of developing this particular cancer. Among them are age, obesity, and having diseases such as diabetes or hypertension. In addition, a woman who has irregular menstrual periods, or had their first period at a young age or are going through menopause at an advanced age have a slightly higher risk for developing endometrial cancer.

Endometrial cancers have a very good chance of being cured because there aresymptoms that are evident very early on in the disease. The most common symptom of endometrial cancer is unusual bleeding or discharge. Especially in women who have gone through menopause, any vaginal bleeding should be brought tothe attention of the doctor immediately. Any abnormal vaginal discharge should also be reported. Pain in the pelvic region and the presence of a lump (mass) are symptoms that occur late in the disease.

If the doctor suspects endometrial cancer, he/she will conduct a series of tests to confirm the diagnosis. The first step will involve taking a complete personal and family medical history. A physical examination, which will include a thorough pelvic examination, will also be done.

The doctor may order an endometrial biopsy. A small piece of endometrial tissue is removed and is sent to a laboratory for examination. If the biopsy tissue looks abnormal, but confirmation is needed, the doctor may perform anotherprocedure known as dilatation and curettage (D &C).

The treatment and prognosis for cancer depends on the type and stage of the cancer The standard treatments available for endometrial cancer are surgery, radiation therapy, hormonal therapy, and chemotherapy.

Surgery is the best option when endometrial cancer is diagnosed at its very early stages. Radiation therapy uses high-energy radiation from x rays and gamma rays to kill the cancer cells. Side effects are common with radiation therapy. Premature menopause and some problems with urination may also occur. Thedecision to use radiation therapy depends on the stage of the disease. Chemotherapy uses anticancer drugs to kill the cancer cells. The drugs are given orally (by mouth) or intravenously. Generally, a combination of drugs is givensince it is more effective than a single drug in treating cancer. Side effects with this treatment include stomach upset, vomiting, appetite loss, hair loss, mouth or vaginal sores, fatigue, menstrual cycle changes, and prematuremenopause. Chemotherapy is usually reserved for women with advanced (stage IV) or recurrent disease because this therapy is not as effective as surgery orradiation.

Hormonal therapy uses drugs like progesterone that will slow the growth of endometrial cells. These drugs are usually available as pills. This therapy isusually reserved for women with advanced or recurrent disease.

Since it is possible to detect endometrial cancer early, the chances of curing it are excellent. In fact, if the cancer is found in its very earliest stage, approximately 96% of patients survive five years or more.

In order to prevent endometrial cancer, women (especially postmenopausal women) should report any abnormal vaginal bleeding to the doctor. Early diagnosisis extremely important in this disease. Controlling obesity, blood pressure,and diabetes can help to reduce the risk of this disease. The use of birth control pills over a long period of time has been shown to reduce the risk ofthis cancer. There is some evidence that women on estrogen replacement therapy after menopause have a substantially reduced risk of endometrial cancer ifprogestins are taken along with estrogen. Doctors routinely prescribe estrogen and progesterone together unless there is a reason why a woman cannot takeprogesterone. Doctors should also pay very close attention to any abnormal vaginal bleeding in women after menopause.

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