Uterine cancer

definition

In the case of uterine cancer (medical: Endometrial cancer) is a malignant tumor of the uterus.
Usually the cancer develops from the cells of the lining of the uterus. It is one of the most common cancers in women, typically affecting women between the ages of 60 and 70.

The prognosis of the disease depends on the stage of the cancer. If the prognosis in the early stage (stage I) is still very good, the 5-year survival rate for a discovery in stage IV is only an average of 20%.

Read more about this below in the text: Uterine cancer prognosis

Causes of uterine cancer

Generally can no clear statement be taken about why a woman develops uterine cancer.
However, some studies looking into the subject have concluded that certain Risk factors which can increase the risk of developing uterine cancer.

It is also believed that a chronically increased levels of estrogen increases the risk of cancer of the uterus.
So it is assumed that a late onset of menopause (menopause) as well as a early onset of the first menstrual bleeding (Menarche) increases the risk.
Also counts both very overweight as well as the existence of one Diabetes mellitus Disease among the risk factors for the development of uterine cancer.

Also taking certain Hormonal preparations as well as a radiotherapy can increase the risk.
In contrast, it is believed that women who have given birth and women who take the pill have a relatively lower risk of developing uterine cancer.

possible symptoms

A uterine cancer is often caused by a Bleedingthat occurs after menopause is noticeable.

So bleeding is what after menopause occur and frequent irregular bleeding are an indication of uterine cancer.

Also very heavy menstrual bleeding can be a symptom of uterine cancer.
However, the irregular discharge does not always have to be pure bleeding, which is why a flesh-colored discharge can speak for the presence of uterine cancer.

Uterine cancer that is noticeable through irregular discharge is often in the early stages and is usually associated with a favorable prognosis.
However, it should be noted that unusual bleeding after menopause or intermenstrual bleeding an indication of the presence of uterine cancer, but also completely different and harmless causes may be the cause of the bleeding.

Pain usually appear in the later stages of uterine cancer and are therefore more likely atypical.
If there is pain due to uterine cancer, it is im Abdomen localized and can occur both continuously and fluctuating. If pain persists, however, it is often only secondary to the tumor itself, but rather arises from the accompanying Inflammation of the uterus.
Thus, a purulent inflammation of the uterus and the Backlog of menstrual blood in the Make uterus felt with severe pain.

General complaints that can indicate the presence of uterine cancer are a unwanted weight loss, Night sweats, one low physical endurance, as well as one caused by impaired lymph drainage Swelling in one or both legs.

Diagnosis of uterine cancer

A tissue sample can be used to make a diagnosis.

The early diagnosis plays an important role in the therapy and the individual prognosis of uterine cancer.
Often the typical symptoms mentioned above already indicate the disease, which the doctor can clearly determine with the help of certain diagnostic methods.

Because uterine cancer mostly after menopause occurs, you should always check if you have cancer if you have a bleeding.
A doctor can contact a vaginal exam determine if the bleeding is actually coming from the uterus.
At a Ultrasound examination the uterus can be visualized and the thickness of the mucous membrane measured.

A Tissue extraction of the suspicious material provide certainty about the disease. If a more detailed examination of the uterus is necessary, the so-called Hysteroscopy can be applied.
With a special Examination camera In this examination, the uterus and any existing cancer can be assessed. Sometimes a MRI of the pelvis help to distinguish the cancer from the uterus and thus provide the diagnosis.

Therapy of uterine cancer

The treatment of uterine cancer depends on both Stage of the tumor as well as after individual factors the affected patient.
An early start of treatment after diagnosis can greatly improve the individual prognosis of uterine cancer and is therefore recommended.

Whenever possible an attempt is made to completely stop the cancer using one surgery to remove.
This can be done in a open abdominal surgery, as well as minimally invasive through a so-called laparoscopy (Laparoscopy) can be achieved.
To make sure that the entire tumor is removed and to minimize the risk of it recurring, the entire uterus as well as the Ovaries and fallopian tubes removed on both sides.

Depending on how large the tumor is and into which tissue it has already penetrated, the Removal of lymph nodes and tissues that are close to the uterus are considered.
After the operation, it may be necessary to carry out additional radiation to prevent the recurrence of uterine cancer cells.
If an operation is not possible, it is often just one Irradiation of the tumor and therapy with hormone preparations is possible.

Figure uterus

Figure uterus
  1. Uterus -
    uterus
  2. Uterine tip -
    Fundus uteri
  3. Uterine lining -
    Tunica mucosa
  4. Uterine cavity -
    Cavitas uteri
  5. Peritoneum cover -
    Tunica serosa
  6. Cervix -
    Ostium uteri
  7. Uterine body -
    Corpus uteri
  8. Uterine constriction -
    Isthmus uteri
  9. Sheath - vagina
  10. Cervix - Cervix uteri
  11. Ovary - Ovary
  12. Fallopian tubes - Tuba uterina

You can find an overview of all Dr-Gumpert images at: medical illustrations

Fig. Position and shape of the uterus in the female pelvis
  1. Uterus - uterus
  2. Uterine tip - Fundus uteri
  3. Uterine lining -
    Tunica mucosa
  4. Uterine cavity - Cavitas uteri
  5. Peritoneum cover - Tunica serosa
  6. Cervix - Ostium uteri
  7. Uterine body - Corpus uteri
  8. Uterine constriction - Isthmus uteri
  9. Sheath - vagina
  10. Pubic symphysis -
    Pubic symphysis
  11. Urinary bladder - Vesica urinaria
  12. Rectum - Rectum

forecast

Overall, uterine cancer is usually one cancer disease progressing relatively well. This is mainly due to the fact that the disease is usually recognized relatively early due to its early symptoms.

Forecasts are the Stage assigned which was present at the time the disease was diagnosed.
The 5-year survival rate in a diagnosis of uterine cancer in one Stage I. is around 90%. This rate decreases in stage II, at which about 80% of women are still alive after 5 years.
In stage III and IV, the tumor has already spread and the 5-year survival rate is 40% and 20%, respectively.
The probability that after 5 years the cancer returning is relatively minor.

All in all only about 6% of all women diediagnosed with the most common type of uterine cancer.
With the Removal of the uterus as well as the fallopian tubes and the surrounding tissue can therefore cause a complete healing can be achieved.
A cure is often not possible only when an operation is not possible or there are metastases in other organs.

Stages of uterine cancer

In order to better classify uterine cancer at diagnosis, stages have been developed that serve this classification.
Also the Therapy and prognosis depends crucially on the stage at which the uterine cancer was at diagnosis.

In addition to a number of different subgroups and classification systems, a rough distinction can be made between stages I-IV.

  • in the Stage I. is the cancer on the Uterus limited and only affects the lining or the muscular body of the uterus.
  • in the Stage II the cancer is already penetrating cervix in front.
  • Stage III is when the tumor is the Fallopian tubes, the vagina, or surrounding lymph nodes infested.
  • For uterine cancer in the Stage IV either penetrates the bladder or the Intestines before, or it could Distant metastases of cancer can be found in other organs.

Metastases of uterine cancer

If the uterine cancer has metastasized, it means that Tumor cells either via the Lymphatics or, less often in the case of uterine cancer, about the Bloodstream affecting other organs to have.

A metastasis of uterine cancer is thus a tumorwhich originally appeared in the uterus, but now also occurs in other organs.
When making a diagnosis of uterine cancer, attention should always be paid to whether there are already metastases.
Do this imaging studies performed throughout the body. It can be both a local spread of cancer as well as one Spread to organs further away exist.

Common local places where uterine cancer metastases are found are the surrounding lymph nodes as well as the Fallopian tubes and the vagina.

If metastases occur at more distant locations, one speaks of Distant metastases.
These can occur in the lungs or bones, for example. Especially in the presence of distant metastases the prognosis deteriorates of uterine cancer strong.

Is Uterine Cancer Hereditary?

Certain genes have been linked to the development of uterine cancer through intensive research.
If the so-called HNPCC syndrome (Hereditary Non Polyposis Colon Cancer Syndrome) In addition to the increased likelihood of developing other forms of cancer, there is also one increased likelihood for developing uterine cancer in the course of life.
Carriers of this gene variant can do that Syndrome with 50% probability of their offspring pass on.
However, this does not mean that if these gene variants are present, uterine cancer must definitely be expected. Likewise, the lack of the gene variant does not mean that uterine cancer cannot develop.

vaccination

There is currently no vaccination that can help against the development of uterine cancer.

So can the Vaccination against HPV (human papillomaviruses) indirectly against the development of tumors of the Cervix protect, a protection against the development of uterine cancer is not guaranteed.
In general, both types of cancer differ greatly from one another and colonization with a human papillomavirus has not yet been linked to the development of uterine cancer.

Even if so far no vaccination or other preventive measures are known which can safely protect against the development of uterine cancer, this can be done through the medical research definitely change.
So is the vaccination against the human papillomavirus, which takes place before the development of cervical cancer can protect, only available since 2006.