Dr Amita Shah, Medical Director and Head of Obstetrics and Gynaecology, Miracles Mediclinic & Apollo Cradle Hospital, Gurugram
Uterine cancer, also known as endometrial cancer, refers to malignant, at times rapid, cell growth in the uterus. It is a form of gynaecological cancer, others being cervical cancer, ovarian cancer, vulvar cancer, vaginal cancer, and gestational trophoblastic tumour. Gynaecological cancers are a cause of great concern because due to their intimate nature, women are late in reporting them. The cancer that affects the uterus, a pear-shaped organ located in the pelvis area between the bladder and rectum. The incidence of uterine cancer is low in India, categorising it as a rare cancer that increases the challenges of awareness, diagnosis and therefore, treatment.
Types of uterine cancer
The uterus has 3 sections: a) the narrow lower section known as the cervix; b) the broad section in the middle known as the isthmus; and c) the dome-shaped top section known as the fundus. The uterus has 3 layers: the inner layer known as the endometrium, the thickest layer known as the myometrium composed almost entirely of muscle), and the thin outer lining is known as the serosa.One of the commonest cancers affecting a woman’s, it all starts with a tumour when healthy uterine cells grow out of control. The benign types of uterine tumours are:
- Fibroids that occur in the muscle of the uterus.
- Polyps that refer to abnormal but benign growths in the uterus’s lining.
- Endometriosis, a condition in which endometrial tissue is found on the outside of the uterus or other organs instead of lining the inside of the uterus.
- Endometrial hyperplasia is a condition that occurs when an increased number of cells and glandular structures come up in the uterine lining that can be normal or atypical cells, and simple or complex glandular structures. Atypical cells and complex glandular structures increase the risk for developing cancer in the lining of the uterus.
The malignant or cancerous developments inside the uterus are:
- Sarcoma: It develops either in the supporting tissues of the uterine glands or in the myometrium, the uterine muscle. Sarcoma accounts for about 2 to 4 per cent of uterine cancers and the subtypes are endometrial stromal sarcoma, leiomyosarcoma, and undifferentiated sarcoma.
- Adenocarcinoma: The cancer develops from the cells in the endometrium and accounts for more than 80 per cent of uterine cancers. Also known as endometrial cancer, one of its common subtypes is endometrioid carcinoma. Rarer subtypes of uterine adenocarcinomas include serous, clear cell, and carcinosarcoma that combines the characteristics of adenocarcinoma and sarcoma.
Spotting the signs, knowing the risks
The early signs of uterine cancer include vaginal bleeding after menopause; unusual bleeding between periods; pain in the pelvic area; and pain during intercourse. Some women are more at risk of developing this cancer than others. The risk of uterine cancer increases with:
Hormone imbalance: Our ovaries produce two hormones – estrogen and progesterone. Any imbalance in their levels, especially increase in estrogen, can cause changes in the endometrium, and increase the risk of endometrial cancer.
Early menstruation: Early onset of menstruation or late menopause can increase the risk of uterine cancer. Women who have never conceived also have a higher risk.
Age and obesity: Women who have entered menopause are at a greater risk to develop endometrial cancer. They are also more likely to have more than optimal body weight which increases the risk as the excess body fat alters hormonal balance in the woman’s body.
Genetics: Genetic nonpolyposis colorectal cancer is a condition that increases the risk of not only colon cancer but other cancers as well, including uterine cancer.
Uterine cancer can be prevented by: i) maintaining a healthy weight and a body mass index (BMI) less than 25; ii) good management of diabetes for those who have it, including regularly monitoring blood glucose levels and following right diet; and iii) Taking birth control pills as they work in combination of estrogen and progesterone that reduces the risk of unnatural growth of the uterine lining.
