Uterine Cancer

The abnormal growth of any cells that comprise uterine tissue.

What is Uterine Cancer?

Uterus is the hollow pear-shaped organ in a woman’s pelvis where a fetus (unborn baby) develops and grows. Uterus is also known as the womb. Cancers that arise from the uterus are Uterine cancers. These cancers can arise from the inner or the outer lining of the uterus or the wall of the uterus. The most common site of origin is the inner lining of the uterus and cancers that arise from it are called endometrial carcinoma.

Endometrial carcinoma is one of the most common gynaecological malignancies in developed countries.There are 3 main types of endometrial cancer: carcinomas, sarcomas and carcinosarcomas. Carcinomas also have different subtypes and are the most common type.

Tumors that arise from the wall of the uterus are called sarcomas and those that arise from the outer lining or surface are papillary serous carcinomas that are similar to ovarian cancer.

Risk factors for Uterine cancer

Whereas there are some known risk factors for endometrial cancer, there are no knonw risk factors for the other types of uterine cancer. The risk factors for endometrial cancer are
Age: Endometrial cancer is primarily a disease of postmenopausal women, Geography. The incidence of endometrial cancer is higher in western nations and very low in eastern countries.

Diet: The high rate of occurrence of this disease in western societies and the very low rate in eastern countries suggest a possible etiologic role for nutrition, especially the high content of animal fat in western diets. The majority of women who develop endometrial cancer tend to be obese.

Parity: Nulliparous women (those who haven’t given birth yet) are at 2 times greater risk of developing endometrial cancer.

Other risk factors: Other known risk factors for endometrial cancer include diabetes mellitus, hypertension, endometrial hyperplasia, a family history of endometrial cancer, and use of exogenous hormones.

The Presentation

Bleeding is an early sign of this cancer. And in women post menopause, bleeding usually raises a suspicion, leading to early diagnosis. However, certain types such as serous and clear cell carcinomas and carcinomas may be advanced at the time of diagnosis.

The Treatment

In the early stages, the treatment is surgery (removal of the uterus and lymph glands) followed by radiation therapy and chemotherapy. At times there is a recurrence in the peritoneum or there is peritoneal spread at the time of diagnosis. Some of these patients are candidates for cytoreductive surgery and HIPEC. Endometrial cancer is an uncommon source of peritoneal cancer where as the tumors arising from the wall or the sarcomas and the serous carcinomas have a greater chance of spreading to the peritoneum.

The outcomes with Cytoreductive Surgery and HIPEC depend on the type of uterine cancer, its extent and other patient related factors. When complete removal of the tumor is possible, the outcome is most favourable.