MEDICAL SECOND OPINION

Uterus Cancer

Overview

The uterus is a part of the female reproductive organ, where the embryo-fetus grows and develops throughout the pregnancy. The uterus, which looks like a face-down pear, lies between the bladder and the rectum. It continues with the vagina at the caudal side, and Fallon tubes that extend to the ovaries are located in the right and left horns of the womb.
The uterus has three layers: the endometrium, which lines the uterine cavity and hosts secretory glands; the myometrium, the middle layer of muscles; and the perimetrium, the outermost membrane.

Uterine cancer is also called endometrial cancer, as it originates from the cells of the endometrium – the innermost layer of the uterine wall. Other types of uterine cancer originate from tissues forming the uterine wall.

Risk Factors:

It is not clearly known what causes the uterine cancer.
•    The risk factors of the uterine cancer are as follows:
•    Changes in the balance of the female sex hormone,
•    Early onset of menstruation,
•    Never having get pregnant,
•    Age,
•    Obesity,
•    Hormone therapy for breast cancer
•    Genetic factors,
•    Some dietary factors

Symptoms:

•    Possible symptoms of the uterine cancer are as follows:
•    Vaginal bleeding after menopause,
•    Abnormal bleeding, spotting
•    Bleeding between menstrual cycles,
•    Vaginal discharge
•    Pelvic pain,
•    Unknown and unintended weight loss,
•    Advanced stage uterine cancer, if spreads, may cause more symptoms.

Prevention:

The first step of treatment should be alleviating risk factors that help the onset of the disease. Weight control, healthy nutrition, careful use of hormones after menopause, reasonable use of birth control pills, and regular exercise are preventive measures that the patient should apply before getting sick. It is thought that birth control pills reduce the risk.

Diagnosis:

A woman with symptoms suggestive of uterine cancer should immediately visit her doctor. If health history, family history, physical examination, and pelvic examination point to suspicious findings, further investigation will be planned. Initially, your doctor may consider a transvaginal ultrasound that uses an ultrasound probe inserted into the vagina. Thus, it may be possible to collect preliminary information about the characteristics and thickness of the endometrium.

Your doctor may employ hysteroscopy to learn the origin of the suspicious findings. A thin and flexible tube is advanced into the uterine cavity through the vaginal canal, and the innermost wall of the uterine cavity is examined after the cavity is filled in with saline. Biopsy specimens can be collected from areas that lead to suspicion during the procedure.
Suppose the limited hysteroscopic biopsy sample cannot provide definitive information about the diagnosis. In that case, tissue specimens are collected from more significant areas of the interior uterine wall by dilatation and curettage. Cancer cells are searched by examining these specimens under a microscope.

Treatment:

After the definitive diagnosis is made, the first step to be taken should be to determine the stage of the cancer (that is, whether it is limited in the uterus or spread to nearby and distant tissues and organs). Your doctor will determine the stage (I to IV) of your cancer based on a set of stringent criteria. You may think uterine cancer is broadly staged as local, limited, regional, and distant.

Generally, cancer phases are symbolized by the Roman numbers I to IV. Stage IV is the most advanced stage of cancer. Each patient's treatment is planned by considering stage, age, general health status, and personal preferences.

Treatment modalities for uterine cancer include chemotherapy, hormone therapy, radiotherapy, and surgical interventions. These therapies aim to eradicate the tumor, enhance the quality of life, and mitigate symptom severity in more advanced stages. Furthermore, these treatment strategies can be combined or as standalone options.

Chemotherapy

Chemotherapy involves the use of pharmaceuticals to eliminate cancer cells. The potent components within these drugs are designed to eradicate cancerous cells. The administration of chemotherapy drugs can occur either through intravenous means or orally. In cases where the drug is delivered intravenously, a fine tube, known as a catheter, is introduced into a central vein, facilitating the distribution of the chemotherapy medication from this catheter for the duration of the treatment
One or more chemotherapy medicines may be administered according to the response of the cancer to the treatment and the type of cancer. After chemotherapy is given for a certain period, treatment is paused. After the completion of this defined "break" period, treatment resumes. Each of these periods is called a cycle. In the early stage uterine cancers, chemotherapy may be started before or after the surgery to both improve the outcomes of surgery and enhance the survival rates.

In advanced-stage cancers, chemotherapy aims to relieve symptoms, improve quality of life, and extend life as much as possible.
Side effects of chemotherapy are secondary to the chemotherapeutic agent and dose. The most common side effects seen in chemotherapy drugs include malaise, nausea, vomiting, mouth sores, hair loss, and inflammation in the digestive system. Your doctor will also treat side effects caused by chemotherapy. In case the side effects become severe enough to threaten your health, your doctor may advise you to suspend the treatment or to take another chemotherapy medicine.

Hormone therapy:

The primary purpose of hormone therapy is to administer progesterone to stop the growth of endometrial cancer cells and to decrease the amount of estrogen in the body to suppress the growth.

Radiotherapy:

Radiation therapy aims to kill cancer cells by using high-powered energy beams.
If the radiation source is out of the body and beams are directed to the cancer, this treatment is called external radiotherapy. On the other hand, if the radioactive agent is put into the area where cancer is present by a needle or catheter, the method is called internal radiotherapy (brachytherapy).

Although radiation therapy can also be used as first-order therapy for cancer, generally, it is used to kill cells that are not removed by surgery. In the first-line treatment, radiotherapy and chemotherapy, also known as chemoradiotherapy, are administered together.

The side effects of radiotherapy vary depending on the body region where the radioactive rays are transmitted. Your doctor will explain the risks that apply to you.

Surgery:

The surgical approach is based solely on the removal of the uterus (hysterectomy) or removal of the cervix, ovaries, and fallopian tubes along with the uterus (hysterectomy and bilateral salpingo-oophorectomy).

Removal of the uterus will make it impossible to have a child in the future, and once the ovaries are removed, you will be menopausal.

The surgeon removes lymph nodes at the last phase of the operation. Lymph nodes are examined under a microscope to determine the spread of the cancer.

Posing inquiries regarding uterine cancer treatment, post-treatment life, rehabilitation, pain control, clinical trials, and any other concerns you have about uterine cancer to your doctors will assist you in engaging with your treatment plan and reducing your worries.

Created at 15.06.2024 04:03
Updated at 15.06.2024 04:03

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