Uterine cancer is a malignant tumor that is localized in the body or neck of an organ. Clinical symptoms of uterine cancer at an early stage can most often be absent or mild, so the disease is often diagnosed at the last, advanced stages, which are difficult to treat and often have an unfavorable prognosis.
Therefore, an important role belongs in the timely diagnosis, and detection of a malignant neoplasm before the pathological process spreads to other organs. Every woman needs to know the first signs of uterine cancer at an early stage and, if they appear, immediately contact a gynecologist to clarify the diagnosis and immediately begin treatment.
Causes of uterine cancer
The exact causes of the onset of a malignant process in the uterus have not been thoroughly studied to date, however, it is known that the development of this disease may be due to certain negative factors:
early onset of the first menstruation;
late onset of menopause;
lack of pregnancy and childbirth;
polycystic ovaries, a hormonally active tumor in them;
long-term use of hormonal drugs with estrogen and gestagens;
the use of antiestrogenic drugs (Tamoxifen);
The occurrence of uterine cancer, as a rule, is associated with complex disorders of the metabolism of carbohydrates and fats, and hormonal balance.
Classification of uterine cancer
According to the microscopic structure, uterine cancer can be divided into the following morphological types:
squamous cell carcinoma;
clear cell cancer;
glandular squamous cell carcinoma;
undifferentiated cancer, etc.
In accordance with the morphological type, the degree of malignancy of the neoplasm is determined. For example, undifferentiated uterine cancer has a poor prognosis, while with squamous cell cancer, the patient’s chances of recovery are quite high.
A malignant tumor can be characterized by exophytic growth (grows into the lumen of the uterus), endophytic (grows into the thickness of the muscular walls), or mixed.
Uterine cancer: the first signs and symptoms after menopause
When a cancerous tumor develops in the uterus, a woman develops abnormal vaginal bleeding. This symptomatology invariably accompanies this disease and may have some differences, which are determined by the functional state of the woman’s reproductive system.
Given the direct relationship between the development of such sociopathology and hormonal imbalance in the female body, uterine cancer is usually diagnosed during menopause, when hormonal changes occur.
The clinical picture of uterine cancer depends on the phase of extinction of the reproductive function.
The first symptoms of uterine cancer in a
Women In women of childbearing age before the onset of menopause, a malignant neoplasm is manifested by uterine bleeding that is not associated with the menstrual cycle. In addition, once-alertness should be caused by changes in the nature of menstruation – they become more abundant and prolonged (lasting more than seven days).
The first signs of uterine cancer in postmenopausal women
After a woman enters menopause (when menstruation is absent for at least one year), the appearance of any vaginal bleeding is considered abnormal, especially if it has a watery consistency mixed with blood, which refers to the first and pronounced symptoms of uterine cancer. As the malignant process develops, uterine bleeding, as a rule, becomes more intense and becomes permanent.
However, it must be understood that the presence of the above disorders is not always associated with the development of cancer. Similar symptoms can accompany endometriosis, fibroids (benign neoplasm), endometrial polyposis, etc. Therefore, when they first appear, you should not panic, but immediately contact a gynecologist for a comprehensive examination.
Other signs of uterine
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cancer Late-stage uterine cancer may present with the following symptoms:
pain in the pelvic area – constant, prolonged, intense, aggravated by menstruation and sexual intercourse. If their appearance is associated with a malignant neoplasm in the endometrium, this symptom may indicate the spread of the pathological process;
iron deficiency anemia – due to constant heavy blood loss, the level of hemoglobin decreases, as a result of which characteristic symptoms of anemia appear: weakness, dizziness, shortness of breath associated with even minor physical exertion;
intoxication – with an oncological disease, patients gradually feel worse, which is due to the toxic effects of metabolic products of oncological cells. In the last stages of cancer, these signs are accompanied by increased irritability, loss of appetite, nausea, and fatigue.
With the progression of sociopathology, the above signs are supplemented by pain in the lower extremities, back, pelvic region, and other disorders associated with damage to the malignant process of adjacent organs and tissues.
Uterine cancer: diagnosis
The main task of diagnosticians in the case of suspected uterine cancer is to establish the localization, stage of the malignant process, morphological structure, and degree of differentiation of the neoplasm.
Gynecological studies are carried out to determine the increased size of the uterus, the presence of tumor infiltration, rectovaginal and parametric fiber, and enlarged appendages.
If uterine cancer is suspected, a cytological examination of the biomaterial obtained by aspiration biopsy from the uterine cavity and smears from the cervical canal is prescribed. To obtain material for subsequent histological examination, an endometrial biopsy or separate diagnostic curettage is performed during hysteroscopy.
The most important diagnostic screening test for uterine cancer is an ultrasound examination, which is performed to determine the size of the uterus, its contours, the structure of the myometrium, the nature of the malignant process, the depth of neoplasm invasion, localization, metastatic processes in the lymph nodes of the small pelvis and ovaries.
A visual assessment of the degree of widespread oncological process in the uterus can be given by diagnostic laparoscopy.
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To rule out distant metastasis of uterine cancer:
ultrasound examination of the abdominal organs;
computed tomography of the abdominal cavity and organs of the urinary system.
Diagnosis of uterine cancer requires differentiation of oncopathology with diseases such as endometrial polyps, endometrial hyperplasia, adenomatosis, and submucosal uterine fibroids.
Uterine cancer: treatment
When choosing a therapeutic tactic, the specialists of the oncology clinic of the Yusupov hospital take into account the stage of the malignant process, the accompanying background, and the pathogenetic variant of the neoplasm.
For the treatment of uterine cancer in the Yusupov hospital, they use:
At the initial stage of the development of a malignant tumor, an organ-preserving operation can be performed – endometrial ablation, during which the basal layer and part of the underlying myometrium are destroyed.
Other operable cases may require panhysterectomy or extended hysterectomy with simultaneous bilateral adnexectomy and lymphadenectomy.
With the defeat of the myometrium and the spread of the oncological process in the postoperative period, radiation therapy is used on the pelvic area, vagina, and regional metastases.
The composition of the complex therapy of uterine cancer, according to indications, includes chemotherapeutic treatment with the use of cisplatin, doxorubicin, and cyclophosphamide.
Given the sensitivity of a malignant neoplasm to hormonal treatment, a therapeutic course is prescribed using antiestrogen, progestogen, and estrogen-progestin preparations.
Organ-sparing treatment of uterine cancer (endometrial ablation) requires subsequent induction of the menstrual ovulatory cycle with combined hormonal drugs.
The oncology clinic of the Yusupov Hospital is equipped with the latest high-tech equipment for high-quality diagnostics, which guarantees the most accurate research results. The tactics of treating uterine cancer are developed by highly qualified experienced oncologists of the clinic individually for each patient, taking into account the stage and type of cancer, the presence of concomitant pathologies, and the general condition of the patient, and many other important nuances. Our specialists make every effort to achieve high results in cancer treatment and prolong the life of patients.
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