Uterine Cancer: Symptoms, Diagnosis and Staging
Did you know that uterine cancer is the most common form of reproductive cancer in women?
Uterine cancer symptoms and disease are estimated to be diagnosed in 3.6% of women in 2020 and is expected to be one of the rising female cancers in the next decade. However, if caught early, your chances for full recovery improve dramatically.
The uterus is a female pear-shaped organ containing the endometrial lining and is where fetal development occurs. Uterine cancer begins in the uterine lining (endometrium) and is also known as endometrial cancer. In addition, another less common uterine cancer can be found in the uterus called uterine sarcoma and is harder to treat.
Causes of Uterine Cancer
Causes of uterine or endometrial cancer are unclear. What is known is that normal cells in the lining of the uterus begin to mutate to abnormal ones. Their DNA structure changes then replicates rapidly causing a cancerous tumor to form. If not caught early, these cells can continue growing and may invade other tissues and spread to other areas of the body.
Typically women with uterine or endometrial cancer experience abnormal vaginal bleeding before their cancer is identified. If diagnosed early, they have a high probability of being cured with surgical removal of the uterus.
While vaginal bleeding may be a sign of something less serious such as non-cancerous uterine fibroids or pre-cancerous endometrial tissue, testing is the only way to rule out a cancer diagnosis. If you have gone through menopause, any bleeding is abnormal and needs to be checked immediately.
It is important to speak with your doctor or visit with board certified gynecologic oncologist, Dr. Richard Drake if you think you may be experiencing abnormal bleeding.
Other symptoms may include:
- Pelvic pain
- Abnormal bleeding between menstrual cycles
- Post menopausal vaginal bleeding
How Is Uterine Cancer Diagnosed?
Often this cancer is found and diagnosed after you have had surgery for what is thought to be a non-cancerous fibroid or tumor. At that point, your doctor may contact a gynecologic oncologist who is board certified and highly specialized and trained in treating cancer of the women’s reproductive systems.
In the office of board certified gynecologic oncologist, Dr. Richard Drake, the following tests may be part of your diagnosis:
- Endometrial lining tissue sampling, visualization and testing – this is usually performed by biopsy, dilation and curretage (D and C) or in conjunction with a hysterectomy Once the sampling is completed, the tissue is sent to the lab for testing. If uterine cancer cells are found, the report will indicate the cancer type and grade.
Endometrial biopsy – this procedure may be done in the office and involves inserting a small tube through the cervix and into the uterus to sample the uterine lining.
Hysteroscopy – a tiny telescopic wand is passed into the uterus through the cervix. Saline solution is then injected to expand your cervix for best viewing. This procedure can be done while you are under light anesthesia. If a polyp or tumor is to be removed, general anesthesia may be used.
Dilation and curretage – at times the biopsy results are not certain or conclusive that you have uterine cancer. At this point, a D&C may be recommended. During this procedure, your cervix is expanded and instruments used to remove more endometrial tissue and sometimes involve a hysteroscopy.
- Cystoscopy or proctoscopy – this test would be used if there is a suspicion of cancer spread to the bladder or rectum. A tiny-lighted tube is used to view the inside of the bladder or rectum to inspect for cancerous tissues or masses.
- Imaging Tests – Transvaginal Ultrasound-is used to produce sound waves inside the vaginal area to show pictures of your uterus, pelvic organs and possible tumor. May also include an hysterosonogram with saline for better visualization of the uterine lining.
- Computed Tomography (CT) – high intensity X-Ray scan usually recommended to determine if uterine cancer has spread to other organs and to assist with needle-guided biopsy of tumors.
- Magnetic Resonance Imaging (MRI) – uses magnetic fields and radio waves to provide pictures of specific tissues in your body and outline any abnormalities that may indicate cancer. These are often recommended to determine if your cancer has spread to areas such as the brain or spinal cord. Biopsies would still be needed to confirm the cancer and grade.
- Positron Emission Tomography (PET) – uses an injectable solution of radioactive glucose (sugar) known to move toward and be absorbed quickly by cancer cells. This helps identify spreading uterine cancer cells that show up in the radioactive solution throughout your body.
- Chest X-Ray – always performed prior to surgery and provides additional information on any uterine cancer or sarcoma that may have spread to the lungs.
If you are seeking specialized uterine cancer diagnosis or second opinion treatment contact Dr. Richard Drake’s office to schedule your appointment.
Uterine and Endometrial Cancer Staging
According to the American Cancer Society, cancer staging is one of the most important factors in treatment planning and is the best predictor of the success of your of treatments.
Dr. Richard Drake and his specialized team work together to diagnose and stage your cancer following all testing.
The staging for endometrial and uterine cancer is assigned based on the FIGO (International Federation of Gynecology and Obstetrics) system as well as consistent with the American Joint Committee on Cancer TNM staging systems.
Both systems classify or stage uterine cancer based on 3 factors:
- Size and spread of the tumor (T) into the uterus or nearby organs or tissues
- Lymph node (N) infiltration or spread into the pelvis or aorta
- Metastasis (M) or spread to distant areas throughout the body
Your treatment plan is based on discussions with you about the test findings, diagnosis and staging of your cancer. Dr. Drake and his team encourage your full participation and shared decision-making in the process.
The following endometrial or uterine cancer treatments may be recommended:
Surgery or minimally invasive surgery is the most common treatment for uterine cancer. This usually involves a form of laparoscopic removal or robotic hysterectomy of the uterus and any other effected reproductive organs or tissues.
The surgical procedures that may be used include:
- Simple or total hysterectomy
- Radical hysterectomy
- Robotic laparoscopic hysterectomy with possible bilateral salpingo-oophorectomy (BSO)-removal of both fallopian tubes and ovaries
- Robotic radical hysterectomy with sentinel lymph node mapping (SLN) or pelvic lymph node dissection
- Fertility-sparing procedures
With uterine cancer, you may need radiation therapy prior or after surgery. Radiation therapy treatment is performed quickly. It may include internal radiation therapy with insertion of a small canister containing a radioactive material into the vagina for a short few minutes. External radiation treatment uses specialized high energy X-rays to destroy cancer cells.
Chemotherapy is administered either intravenously or orally and is used to treat and destroy cancer cells. These may be given at the office or home.
If you are seeking specialized uterine cancer diagnosis, treatment or a second opinion contact Dr. Richard Drake’s office to schedule your appointment.
Schedule My Uterine Cancer Testing and Diagnosis
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