Uterine Cancer: An Overview

The uterus, otherwise known as the womb, is an inverted pear-shaped organ of the female reproductive system which sits between the bladder and the rectum. It plays a role in menstruation, gestation and childbirth. Uterine cancer occurs when abnormal cells in the uterus begin to grow uncontrollably. It is the fourth most common cancer in women and the most common gynecologic cancer in the US. Recognizing the risk factors and symptoms of uterine cancer is essential for early detection and successful treatment.

The uterus is a hollow, thick-walled muscular organ at the centre of the female reproductive system. It is supported by various ligaments in the pelvis and the pelvic floor musculature. The uterus connects to the fallopian tubes on both sides, which function to carry eggs from the ovaries to the uterus. At the lower end of the uterus, the cervix opens into the vagina, which serves as the birth canal and the passage for menstrual flow. The uterine wall is also made up of 2 layers:

• Endometrium: The inner lining of the uterus.
• Myometrium: The middle, thick muscular layer of the uterus.

Additionally, the surface of the uterus is covered by the perimetrium, a thin outer membrane.

The uterus is a central part of the female reproductive system, allowing the fetus to develop during gestation and contracting to push the baby out during labour. It is also involved in the menstrual cycle, during which the uterine lining thickens and subsequently sheds if fertilisation does not happen.

Uterine cancer occurs when cells in the uterine tissues become abnormal and start to grow out of control. There are 2 main types of uterine cancers, endometrial cancer/uterine lining cancer and uterine sarcoma, each originating from different parts of the uterine wall.

Learn more: Types of Uterine Cancers

Uterine cancer is a growing cause for concern, with incidence and mortality rates increasing by 0.7% and 1.5% respectively each year from 2013 to 2022. Lifestyle and biological factors may increase the risk of a woman developing uterine cancer particularly in the developed world. These include:

• Obesity: Obese women have a higher risk of developing uterine cancer with an estimated 2-3 fold increase in risk.
• Diabetes: Diabetic women have a higher risk of developing uterine cancer.
• Reproductive history: Women who have early menarche, late menopause or have not given birth before have a higher risk of developing uterine cancer.
• Genetics: Women with a family history of uterine cancer or Lynch syndrome have a higher risk of developing uterine cancer.
• Medication: Certain medications such as estrogen-only therapy and tamoxifen (for breast cancer therapy) increase the risk for uterine cancer.

Uterine cancer often presents clear symptoms. However, these can easily be confused with that of other medical conditions. Hence, seeking medical attention is vital to accurately determine your condition. Some of these symptoms include:

• Abnormal uterine bleeding coming through the vagina
• Pelvic pain
• Postmenopausal vaginal discharge
• Uterine enlargement

Early detection, diagnosis and treatment is crucial to increase the chances of survival. As there are currently no standard screening tests for uterine cancer, recognizing the symptoms and seeking timely medical attention is crucial to identify uterine cancer early.

Patients who develop symptoms should undergo diagnostic tests such as transvaginal ultrasound or an endometrial biopsy to detect the presence of uterine cancer.

Learn more: Diagnosing Uterine Cancer

Uterine cancer is treated primarily by surgery, with removal of the uterus and often the fallopian tubes, ovaries and lymph nodes which drain the uterus. More serious cases are treated with local radiation, chemotherapy or immunotherapy.