In the early stages, uterine cancer or endometrial cancer is usually easy to treat. Different treatment methods are possible depending on the patient. The uterine cancer should not be confused with the cervical cancer .
What is Uterine Cancer?
In medicine, uterine cancer is also known as endometrial cancer. The term endometrial carcinoma is derived from the words carcinoma (malignant tumor) and endometrium (uterine lining).
As the name endometrial cancer suggests, uterine cancer usually develops in cells in the lining of the uterus. Alternative technical terms for uterine cancer are, for example, the terms corpus carcinoma or uterine carcinoma. Doctors also differentiate between two different types of uterine cancer: the so-called estrogen-dependent carcinoma (type I carcinoma) and the estrogen-independent carcinoma (type II carcinoma).
From a statistical point of view, endometrial cancer primarily affects older women (on average women in their 7th decade or later). In Germany, uterine cancer is one of the most common cancers that affect women.
The causes that lead to endometrial cancer have not yet been conclusively clarified. It is assumed, however, that the female sex hormone estrogen, through its influence on the mucous membrane of the uterus, also has an effect on endometrial cancer.
In medicine it is currently assumed that the risk of developing uterine cancer increases roughly with the life span in which the body is exposed to high concentrations of estrogens; This period can be increased, for example, by a very late onset of menopause (the point in time at which a woman has the last menstrual period) or by puberty that starts early.
The risk of developing estrogen-dependent endometrial cancer can be increased if various risk factors are present. These include, for example, diseases such as high blood pressure or lipid metabolism disorders, but also long-term use of hormone preparations that only contain estrogen.
Symptoms, ailments & signs
- vaginal bleeding after menopause
- possibly abdominal pain
- Blood in the urine
- Urinary tract infection
- less often back pain
Diagnosis & course
For example, early-stage uterine cancer can be diagnosed with palpation examinations of the cervix or with smears carried out by a gynecologist (specialist in gynecology). Endometrial cancer may also be indicated by bleeding that occurs during menopause.
A suspected diagnosis of uterine cancer can, for example, be supported by an ultrasound examination. A so-called scraping (removal of uterine lining tissue) can also provide information about existing cancer cells.
The course that an endometrial cancer shows depends, among other things, on the stage of development at which the uterine cancer is detected: If endometrial cancer is in an early stage and is limited to the lining of the uterus, the prognosis is usually very good. At an advanced stage, endometrial cancer can form daughter tumors that affect, for example, the lungs or liver. This can make healing difficult.
Uterine cancer is treated surgically in almost all cases. During the operation, neighboring organs and anatomical structures can be damaged. Another complication is nerve damage, which can lead to paralysis and numbness. The urinary bladder can also be temporarily impaired. In addition, there are more and more adhesions in the abdominal region.
When treating uterine cancer, complications such as swelling due to lymphatic congestion tend to develop. In some cases, serious and life-threatening complications occur. These include peritonitis and an intestinal obstruction. In addition, inflammatory channels often develop between the urethra and the bladder and between the vagina and the rectum.
Infections, wound healing disorders and excessive scarring can occur. These are often associated with a loss of function, pain or allergies. Young patients in particular often go through menopause after the operation. Cervical cancer may be treated with chemotherapy. Other temporary complications such as hair loss, diarrhea and nausea can occur. It cannot be ruled out that these symptoms are chronic.
If uterine cancer is diagnosed late or not treated, metastases should be mentioned as a complication. These cause additional discomfort and can no longer be treated later on. If left untreated, uterine cancer leads to death.
When should you go to the doctor?
As a preventive measure, women should always see a gynecologist for an annual check-up. In these examinations, cancer screening takes place by palpating the uterus and taking a vaginal smear, which enables early detection of uterine cancer. In addition, it is necessary to consult a doctor as soon as irregularities in the abdomen are noticed. If there are changes in the menstrual cycle due to the absence of menstruation or prolonged bleeding, a doctor should be consulted.
If you experience pain in the abdomen, intermenstrual bleeding or discomfort during sexual activities, a doctor is advisable. If there is a general feeling of illness, if there is a reduced performance or if there is fatigue, the signs should be discussed with a doctor. Recurring blood in the urine, urinary tract problems or inflammation should be medically examined and treated. Severe weight loss, loss of appetite and restlessness are indications of existing irregularities that should be discussed with a doctor.
If bleeding occurs again after the menopause, this is considered unusual. A doctor’s visit is necessary so that the cause can be determined. If the vaginal discharge changes, there is an odor in the genital area or swelling of the abdomen, it is advisable to consult a doctor. If general well-being decreases and the need for sleep increases, the observations should be discussed with a doctor.
Treatment & Therapy
The best chance of recovery from uterine cancer is usually seen as a result of surgery. A common surgical procedure for endometrial cancer is called a hysterectomy (removal of the uterus). If the uterine cancer is treated surgically, it is also possible for the surgeon to determine the spread of the endometrial cancer.
If an endometrial carcinoma still leaves tumor residues after a surgical procedure, these can be treated, among other things, by using radiation therapy (for example, electron or X-rays are used).
In individual cases it can happen that, in the case of endometrial cancer, the entire uterus could be removed, but the uterine cancer had come very close to the vagina; postoperative local (locally limited) irradiation is possible here.
A radiation therapy can be carried out also when endometrial cancer has spread and, for example, pelvic lymph nodes are affected. Such irradiation usually takes place externally; so from the outside. Radiation therapy for early uterine cancer can also be used as an alternative to surgery, but due to the statistically lower chances of recovery, this usually only takes place when surgery is not possible.
Outlook & forecast
Endometrial cancer is one of the most curable types of cancer in women. If they are recognized early in the first or second stage, the chances of a complete cure are usually still quite good. It also depends on the type of cervical cancer. Type I has a better prognosis than type II at every stage.
In the initial stages, attempts are made to prevent a full hysterectomy and only to remove the tumor. However, this is different in each individual case and depends on the location of the tumor, its extent, the options for surgical removal and the general health of the patient. If the patient’s fertility cannot be maintained, there is the option of freezing egg cells before treatment – this is mainly offered to young patients without children.
If, on the other hand, endometrial cancer is discovered in the third stage, the chances of a cure are also still quite good, but consequential damage is to be expected. Fertility can be severely impaired by surgical removal and subsequent cancer therapy.
In the fourth and final stage, when the endometrial cancer has already spread, the prognosis worsens immensely. At this stage, the tumor has already spread to adjacent organs such as the bladder and intestines. Since there are many lymph nodes here, further spread is not unlikely.
Actively preventing endometrial cancer is hardly possible. However, since the chances of a cure for uterine cancer in the early stages are usually very good, regular check-ups with a gynecologist (gynecologist) can help ensure that endometrial cancer can be detected and treated at an early stage. Visits to the doctor in the event of heavy bleeding during menopause can also be useful.
After treatment for uterine cancer has been completed, check-ups with a gynecologist are scheduled every three to six months for the first three years. In the fourth and fifth year, a six-monthly check is sufficient. The gynecologist conducts a conversation and a gynecological examination.
During the conversation, not only physical complaints are relevant, but also psychological, social and sexual ones. Patients who have no symptoms usually do not need imaging tests or special blood tests. Imaging methods such as ultrasound, MRI or computed tomography are used if symptoms arise during the course.
These include abdominal pain, bleeding, back pain, constipation or the urge to urinate. These symptoms could indicate a relapse of the uterine cancer. They should be taken seriously and discussed with the treating gynecologist, regardless of the recommended check-ups.
Regular participation in follow-up examinations by the gynecologist is necessary in order to be able to recognize and treat possible relapses at an early stage. If the uterine cancer recurs, there are various effective therapies to choose from, depending on the size and location of the tumor.
If a relapse, a recurrence of the endometrial cancer after the end of therapy, is detected at a later point in time due to inadequate follow-up care, the prognosis and the chance of recovery may decrease.
You can do that yourself
Curing uterine cancer requires medical treatment and, in most cases, surgery. In everyday life, therefore, the possibilities for self-help are limited to mental and psychological stabilization. This can be done in different ways, which prove to be very individual.
Support from self-help groups, for example, can be beneficial. Sick and recovered people can exchange ideas here in a protected setting. They share their experiences, give helpful tips and talk about their feelings. This can give the patient hope and renewed confidence. In mutual exchange, fears can be reduced and open questions can be discussed.
Different relaxation methods have also proven themselves. The exercises of methods such as yoga, meditation, Qi Gong or autogenic training have the goal of mental relaxation and the reduction of stress. Cognitive measures, the development of positive thoughts and optimism also help during the illness, as they strengthen the general well-being.
In addition, a healthy lifestyle and individual leisure activities can build up strength and strengthen the immune system. A healthy diet rich in vitamins supports the organism. In addition, sufficient exercise in the fresh air and light sporting exercises improve life satisfaction. The application is to be carried out depending on the physical condition. A stable social environment has proven to be particularly effective.