Womb (uterus) cancer

About

Womb (uterus) cancer is a type of cancer that affects the uterus. It is a common type of cancer and usually occurs in women aged between 50-70, although it can also occur in younger women. It is estimated that around 8,100 women are diagnosed with womb (uterus) cancer in the UK each year. The four main types of womb (uterus) cancer are endometrial cancer, uterine sarcoma, ovarian cancer, and cervical cancer. Symptoms of womb (uterus) cancer may include vaginal discharge, irregular menstruation, pelvic pain, pain during intercourse, and abnormal bleeding. Treatment for womb (uterus) cancer may include surgery, chemotherapy, radiation, and hormone therapy. It is important to seek medical advice early to ensure an appropriate and effective treatment plan.

Symptoms

The symptoms of uterine cancer can vary depending on the stage of the cancer, but early-stage uterine cancer often does not produce any identifiable symptoms. As the cancer advances, common symptoms may include:

  • Heavy or abnormal vaginal bleeding, particularly if you have gone through menopause
  • Abdominal pain or pressure
  • Changes in urinary or bowel habits
  • Unexplained weight loss or bloating in the abdominal area
  • Pain during intercourse
  • Anemia caused by heavy bleeding
  • A pelvic mass or lump

Causes

The exact causes of womb (uterus) cancer are not completely understood, but certain factors have been linked to an increased risk, including:

  • Age: Womb cancer is more common in women over the age of 50.
  • Hormone replacement therapy: Long-term use of hormones to treat menopausal symptoms such as hot flushes can increase the risk of developing womb cancer.
  • Family history: Women with a family history of womb cancer may have an increased risk of developing the disease.
  • Obesity: Being overweight or obese increases the risk of some types of womb cancer.
  • Endometrial hyperplasia: Endometrial hyperplasia is a condition where the inner lining of the womb thickens, which can lead to an increased risk of developing womb cancer.
  • Previous history of non-cancerous uterus conditions: Women who have had pre-cancerous conditions such as endometrial hyperplasia or endometrial polyps have an increased risk of developing womb cancer.
  • Never having been pregnant: Women who have never been pregnant have an increased risk of developing womb cancer.
  • Tamoxifen: Long-term use of the drug tamoxifen can increase the risk of womb cancer.
  • Estrogen-only Hormone Replacement Therapy (HRT): Long-term use of estrogen-only HRT can increase the risk of developing womb cancer.

Risk factors

The following are some risk factors associated with developing womb (uterus) cancer:

  1. Increasing age – Women over the age of 50 are at an increased risk.
  2. Early menarche (start of periods) – Starting your periods at an early age (before 12 years of age) is a risk factor.
  3. Late menopause – Women who are older when they go through menopause (50 and over) have an increased risk.
  4. Family history of cancer – Having a mother, sister, or daughter with/who had womb cancer increases your risk.
  5. Obesity – Being overweight or obese increases your risk.
  6. Hormone Therapy – Women taking hormone replacement therapy (HRT) for menopausal symptoms are at an increased risk.
  7. Endometrial hyperplasia – A condition in which the lining of the uterus is thicker than normal.
  8. Diet – Eating a diet that is high in meat, fat, and processed foods may increase your risk.
  9. Smoking – Smoking increases the risk of womb cancer.
  10. 0. Infertility – Women who are unable to conceive after trying for a year or more may have an increased risk.

Diagnosis

Womb (uterus) cancer is typically diagnosed after a woman has reported to her doctor any symptoms or changes in her body. A pelvic exam may be performed to check for any abnormal masses or other signs of cancer. Blood tests may be done to look for markers in the blood that indicate the presence of cancer in the body. An ultrasound or computed tomography (CT) scan may then be conducted to determine the size and location of the tumor. Finally, a biopsy of the affected area may be performed to confirm the diagnosis and determine the stage of the cancer.

Sub-types

The various subtypes of Womb (uterus) cancer include:

  1. Endometrial Carcinoma: This is the most common form of uterine cancer, and is caused by the abnormal growth of cells in the lining of the uterus.
  2. Uterine Sarcomas: Uterine sarcomas are a rare type of cancer that affects the muscles and connective tissue of the uterus.
  3. Cervical Cancer: Cervical cancer is caused by the abnormal growth of cells on the cervix, the lower, narrow end of the uterus.
  4. Germ Cell Tumors: Germ cell tumors are a type of cancer that develops from eggs or cells in the ovaries, uterus, or other parts of the reproductive organs.
  5. Sex Cord Stromal Tumors: Sex cord stromal tumors are a rare type of cancer that develops from the cells that normally make up the ovaries and other reproductive organs.
  6. Choriocarcinoma: Choriocarcinoma is a rare form of cancer that affects the placenta and can spread to other parts of the body.

Treatments

The treatment for womb (uterus) cancer depends on the type of cancer, its stage, the patient’s age, overall health and personal preferences. Treatment typically includes surgery such as total hysterectomy, lymph node removal and lymph node biopsy, chemotherapy and/or radiation therapy. Some less common treatments include hormone therapy, drug therapy, cryosurgery, and stem cell transplant. Each treatment option carries the risk of side effects, which should be discussed with the doctor.

Prevention

The best way to reduce the risk of Womb (uterus) cancer is to maintain a healthy lifestyle. This includes having regular check-ups with your doctor, eating a balanced diet high in fruits and vegetables, exercising regularly, getting enough sleep and avoiding alcohol and tobacco. Additionally, staying away from environmental toxins, such as pollution, and limiting your exposure to radiation can also help to reduce the risk of Womb (uterus) cancer. Vaccinations against certain strains of the human papillomavirus can also help to reduce the risk of Womb (uterus) cancer.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of womb (uterus) cancer. Women are much more likely to be diagnosed with uterine cancer than men, as it is the female reproductive organ. Women are more likely to experience signs and symptoms such as abnormal vaginal bleeding, pelvic pain, and pain during intercourse. Risk factors for the development of uterine cancer in women include early onset of menopause, hormone replacement therapy, obesity, and a family history of the disease.

The management of uterine cancer in women will typically involve hysterectomy (surgical removal of the uterus) in most cases. Other treatments may also include chemotherapy, radiation, and hormone therapy. Since male patients do not have a uterus, the management of uterine cancer in men may include chemotherapy, radiation, or surgery to remove any affected organs.

Nutrition

Nutrition plays an important role in the management of womb (uterus) cancer. Eating a balanced, nutrient-dense diet can help support a patient’s overall health and wellbeing, and may play a role in reducing their risk of recurrence. Nutrients such as folate, carotenoids, and omega-3 fatty acids have been found to be associated with a lower risk of womb cancer and its recurrence. A diet rich in these nutrients can help to ensure the body is receiving the essential vitamins and minerals it needs to function optimally. Additionally, reducing the intake of certain foods such as processed meats, alcohol, and refined carbohydrates can help to reduce the risk of developing or recurrence. Eating plenty of fruits, vegetables, and whole grains can provide the body with more of the nutrients it needs to combat disease.

Physical Activity

Physical activity is thought to play an important role in reducing the risk of developing womb cancer. Regular physical activity is known to reduce estrogen levels, which have been associated with increases risk of womb cancer. Regular physical activity also increases the efficiency of the immune system, which can help combat the development of abnormal cells in the womb. Additionally, regular physical activity helps to maintain a healthy weight, which has been linked to lower risk of developing womb cancer.

Further Reading

  1. https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/womb-uterus-cancer
  2. https://www.cancer.net/cancer-types/uterine-cancer/introduction
  3. https://my.clevelandclinic.org/health/diseases/16409-uterine-cancer
  4. https://medlineplus.gov/uterinecancer.html
  5. https://www.cdc.gov/cancer/uterine/basic_info/index.htm
  6. https://www.cancerresearchuk.org/about-cancer/womb-cancer/types-grades
  7. https://www.cancer.org/cancer/endometrial-cancer/detection-diagnosis-staging/how-diagnosed.html

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