Uterine Cancer

Source: Adapted from Family Medical Adviser, Reader’s Digest

What is uterine cancer?

The uterus, commonly known as the womb, is a muscular organ that forms part of the female reproductive system. It allows an embryo to be implanted in its inner wall and nourishes the growing fetus with its mother’s blood. It lies in the pelvis just behind the bladder. In adult women, the non-pregnant womb is about 8cm (3in) long and about 5cm (2in) wide.

The womb looks like a pear with the narrow end pointing downwards. This part is the cervix, which opens into the vagina; the upper part or body of the uterus opens into the fallopian tubes. Both the cervix and the body of the uterus can be affected by health problems.

Uterine cancer usually develops in the endometrium—the lining of the uterus. It is often preceded by abnormal overgrowth of the endometrium—known as hyperplasia. The disease tends to affect women after menopause.

The most common symptom of uterine cancer is postmenopausal bleeding or a bloodstained vaginal discharge. In younger women, heavy periods or bleeding between periods may be warning signs. Diagnosis involves taking a biopsy of the uterine lining for investigation. Uterine cancer cannot be detected with a cervical smear. Women at increased risk for uterine cancer include those who:

• Are clinically obese;
• Have had no children;
• Have a late menopause;
• Are on hormonal treatment for breast cancer, for example, tamoxifen;
• Are on estrogen replacement therapy without progestogen: an excess of estrogen in the body increases the risk of uterine cancer especially if progesterone levels are low.

Who is at risk for uterine cancer?

Giving birth, and the normal ageing process, weaken the pelvic floor—a term used to describe the muscles and ligaments that support the uterus and vagina. This can result in a uterine prolapse, a condition rarely seen before menopause. In a prolapse, the uterus descends from its normal position into the vagina; in the most severe cases the uterus protrudes out of the vagina. A surgical repair or a hysterectomy may be recommended.

Treatment for uterine cancer

Uterine cancer is treated by a full hysterectomy to remove the womb, fallopian tubes and ovaries. If the cancer has spread, a course of radiotherapy might be needed. If uterine cancer is caught and treated early, the chance of survival for five years or longer is more than 80 per cent.