Causes and Risk Factors for Uterine CancerUnfortunately, we cannot pinpoint what causes uterine cancer, but we are aware of risk factors that may increase the likelihood of it developing. Uterine cancer most often occurs in women who are post-menopausal, regardless of what type of uterine cancer. Younger women can develop the disease, but much less often than women who have gone through menopause.
In cases of uterine sarcomas, we know that prior pelvic radiation therapy treatment may increase the risk in some women. It is also evident that uterine sarcomas occur more frequently in African-American women than Caucasians, though the reason is unclear.
Fortunately, we know more about endometrial cancer than we do about uterine sarcomas. Researchers have identified several known risk factors, including:
- never being pregnant
- beginning menstruation before age 12 and continuing through age 50 or more
- being diabetic
- use of estrogen replacement therapy (ERT)
- personal or family history of breast or ovarian cancer
- use of Tamoxifen, a breast cancer treatment drug
Symptoms of Uterine CancerThe most common symptom of uterine cancer is vaginal bleeding that occurs after menopause. In women who have yet to go through menopause, vaginal bleeding not related to menstruation is experienced. Vaginal bleeding is considered abnormal when:
- periods are heavy and prolonged
- heavy spotting occurs between periods
- more than one period in a cycle month
- bleeding occurs before and/or after sex
- bleeding occurs in women who are post-menopausal
With endometrial cancer, the most common and first experienced symptom in abnormal vaginal bleeding. Other symptoms include a watery vaginal discharge, pain during sexual intercourse, and pelvic pain.
Diagnosing Uterine CancerIf uterine cancer is suspected, a thorough pelvic exam will first be done by a gynecologist. This is an excellent time to discuss personal and family medical history, symptoms, and to ask questions. If you haven't had a recent Pap smear and are due for one, the gynecologist may do one at this along with the pelvic exam. Pap smears very rarely ever detect uterine cancer, but one may be done to rule out other cervical conditions.
To confirm the presence or absence of cancer, an endometrial biopsy is necessary. An endometrial biopsy can be done in the gynecologist's office and takes only a few moments to complete. Most women report feeling moderate pain and cramping that lasts only through the biopsy and some mild cramping following the biopsy.
Another method of obtaining endometrial tissue samples is through a dilation and curettage (D&C). During a D&C, the uterus is scraped with a instrument called a curette. You are given an anesthetic so you will not feel anything during the procedure, but you can expect mild cramping afterwards.
If biopsy samples reveal uterine sarcoma or endometrial cancer, then the cancer is staged. Staging refers to how far the cancer has spread to nearby tissue or organs.
Treating Uterine CancerTreatment options heavily depend on the type and stage of uterine cancer, but surgery is the most common type of treatment for all types. It is also when some cases of uterine cancer is staged. Surgery to treat uterine cancer includes:
- hysterectomy - surgical removal of the uterus
- hysterectomy with bi-lateral salpingo oophorectomy - surgical removal of the uterus, fallopian tubes, and ovaries
- lymph node dissection - removal of pelvic lymph nodes during hysterectomy that are later screened for cancer
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Preventing Uterine CancerBecause we don't know exactly what causes uterine cancer, prevention can be difficult. We can avoid the the known the risk factors, but many times there are risk factors we cannot avoid like age, race, and family history.
It is difficult to prevent uterine sarcomas because the risk factors are unavoidable. We know that prior radiation therapy may increase the risk, but it should not be avoided for the sake of uterine cancer prevention.