Womb cancer is a kind of cancer that starts mostly in the lining of the womb. The womb is a pear–shaped muscular bag that holds the baby during pregnancy. This type of cancer is also termed as womb or uterine cancer. The rates of womb cancer are higher in older women as compared to women younger than 40.
The prevalence of endometrium or womb cancer is quite large. The third most common tumour of the genital tract in Sub Saharan Africa is the cancer of the womb. In recent research, approximately four to eleven percent of cases were womb cancer.
Types of Womb Cancer
The following are the three types of womb cancer
Adenocarcinomas
Endometrial cancer is the most common type of womb cancer, Almost all types of womb cancers are adenocarcinomas. These are cancers of the glandular cells of the endometrium and they start in the epithelium. There are three types of adenocarcinoma. They include endometrioid adenocarcinomas, clear cell carcinoma and uterine serous carcinoma.
Endometrial cancer can also be classified into two types:
Type One endometrial Cancer
These are mostly endometrioid adenocarcinoma and are mostly caused by excess estrogen in the body. They tend to grow slowly and less likely to spread.
Type Two endometrial Cancer
They are fast growing and they spread faster than Type one. They are not caused by excess estrogen. Examples include clear cell and uterine serous carcinomas.
Uterine Sarcoma
It is also termed as Sarcoma of the womb. They are a type of soft tissue sarcoma and the cancer cells develop from the muscle layers of the womb. The most common form of uterine sarcoma is Leiomyosarcoma (cancer of muscle wall).
Uterine Carcinosarcoma
This type of cancer is also termed as carcinosarcoma of the womb. It is a rare kind of womb cancer. This type of cancer is mixed with both endometrial cancer and sarcoma features when looked at microscopically.
Symptoms of Womb Cancer
The following are symptoms of endometrial or womb cancer
- Abnormal bleeding – This is the most common symptom of womb cancer. Any bleeding after menopause, between periods should be checked out. Abnormal bleeding can be a characteristic of many other benign conditions like fibroids, endometriosis.
- Another rare symptom is blood in urine with either a high level of blood sugar, thrombocytosis (high platelet count) or anaemia (low level of red blood cell)
Causes/risk factors for Womb cancer
The main cause of womb cancer is not clear. However, the following is a list of probable risk factors for getting womb cancer:
Hormones
Fluctuations in the balance of these estrogen and progesterone can cause changes in the endometrium. Conditions like PCOS, diabetes, irregular ovulation can increase the risk of getting womb cancer. Taking hormones after menopause that contain estrogen but not progesterone increases the risk of endometrial cancer.
Age
The risk of getting womb cancer is increases with age. Younger women have a lower risk of womb cancer while most women diagnosed with womb cancer have had menopause.
Overweight/obese
Excess fat in the body is linked to making excess estrogen which can be a risk factor for getting endometrial cancer. When more estrogen id produced in the body, the lining of the womb builds up, which in turn increases the risk of getting endometrial cancer.
Birth history
According to research, if women has more children, then there is a lower chance of having womb cancer. This is because high levels of progesterone occur during pregnancy and estrogen levels are low.
Menstrual History
If a woman starts menstruation at a young age or has menopause later increases the risk of womb cancer.
Thickened womb lining
If a woman has a thickened womb lining, so the chance of womb cancer is also increasing. The symptoms of thicker womb lining include heavy periods, bleeding between periods, bleeding after menopause.
Family History
According to research, girls with a family history of endometrial cancer have a higher risk of developing the disease. .
Hormonal therapy
Taking the hormone Tamoxifen for breast cancer can increase the risk of getting womb cancer.
Diagnosis
The following steps are helpful for doctors to diagnose cancer.
Pelvic exam
Your doctor may manually palpate your womb to feel for any masses or lumps.
Transvaginal ultrasound scan
It uses the sound waves having a high frequency to create the picture of the body, which shows the lining of the endometrium and the whole view of the womb and pelvis.
Hysteroscopy
This involves your doctor inserting a thin, flexible, lighted tube with a lens (hysteroscope) through your vagina and cervix into your uterus to view inside your womb and your endometrium.
Biopsy
The doctor can take a sample of the tissue from your womb to test for cancer cells in the laboratory. This can be done using aspiration biopsy or during a hysteroscopy.
Staging
Stages of womb cancer help to distinguish the spread of the disease. The doctor may recommend treatment strategies after staging cancer.
Stage 1
This is very early stage cancer and is means the cancer is confined within the uterus. It means the cancer. It means the cancer may have grown no more than halfway into the myometrium (stage 1A) or the cancer has grown halfway or more into the womb (stage 1B)
Stage 2
At stage 2, the cancer cells has spread from towards the womb to the cervix.
Stage 3
At stage 3, the cancer cells have spread to the pelvis. t means the cancer has spread into the outer covering of the womb (stage 3A), or the vagina and parametrium (stage 3B) or to nearby lymph nodes.(stage 3B).
Stage 4
At this stage, this means the cancer has spread to other body organs like the ladder or colon (stage 4A) or liver, brain, lungs, or bones (stage 4B)
Treatment
The following treatments can be used for womb cancer
Surgery
This could be either:
- Laparoscopic surgery – This involves making a number of small cuts through your skin, inserting a a laparoscope in it to view the entire uterus and taking out the uterus. This is mostly used for stage 1 and 2 cancers.
- Hysterectomy: This involves removing your womb and cervix. Your doctor might take out the ovaries and fallopian tubes as well (bilateral salpingo oophorectomy )
Chemotherapy
This treatment cytotoxic drugs to kill cancer cells. they can be taken as a tablet or injected into a vein. This can be used after surgery to kill any remaining cancer cells or before surgery to shrink a tumour. Example of chemo drugs used include Carboplatin, Paclitaxel, Doxorubicin, Cyclophosphamide, Cisplatin.
Radiotherapy
This treatment option involves the use of gamma rays. These rays are high–frequency X-rays that help to kill the cancer cells. It may be internal or external radiotherapy. It can be used in combination with chemotherapy to kill any remaining cancer cells or before surgery to shrink a tumour. In some cases, both types can help to control the symptoms of advanced cancer.
Hormone therapy
This involves taking drugs to lower the hormone levels in your body. This is especially helpful for cancer that is hormone dependent.
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