Uterine cancer
-
endometrial cancer
Uterine (endometrial cancer) is one of the
most common cancers in women.
The uterus is made up
of different tissue types that can give rise to
different kinds of uterine cancer.
Endometrial cancer begins in the lining of the
uterus (endometrium). The uterus is a hollow,
pear-shaped organ where a baby develops during
pregnancy. Endometrial cancer most often occurs
after the reproductive years, in women between the
ages of 50 and 70.
Endometrial cancer is often detected at an early
stage because it frequently produces vaginal
bleeding between periods or after
menopause. If
discovered early, this slow- growing form of cancer
is likely to be confined to the uterus. Removing the
uterus surgically often eliminates the cancer. In
fact, early-stage endometrial cancer is successfully
treated more than 80 percent of the time. However,
the death rate from endometrial cancer has increased
over the past 10 years. Researchers aren't sure why.
Signs and symptoms
Endometrial cancer often develops over a period of years. Your first
clue that something is wrong may be vaginal bleeding that's uncommon for
you.
Most cases of endometrial cancer develop in postmenopausal women whose
periods have stopped. However, about 20 percent of cases affect younger
women. Signs and symptoms may include:
-
Heavy periods or
bleeding between periods
-
Vaginal bleeding
or spotting during perimenopause (the time just before menopause) or
after menopause
-
A pink, watery or
white discharge from your vagina
-
Pelvic pain,
especially late in the disease
-
Pain during
intercourse
-
Weight loss
Some endometrial cancers may reach an advanced stage before signs and
symptoms are present. But this is rare.
Causes
Healthy cells grow and divide in an elegant and orderly way to keep your
body functioning normally. But sometimes this growth gets out of control
— cells continue dividing even when new cells aren't needed.
In endometrial cancer, cancer cells develop in the lining of the uterus.
Why these cancer cells develop isn't entirely known. However, scientists
believe that the levels of estrogen in a woman's body play a role in the
development of endometrial cancer. Factors that can increase the levels
of this hormone and other risk factors for the disease have been
identified and continue to emerge. In addition, ongoing research is
devoted to studying changes in certain genes that may cause the cells in
the endometrium to become cancerous.
Risk factors
The female reproductive system consists of two ovaries, two fallopian
tubes and a uterus. The ovaries produce two main female hormones —
estrogen and progesterone. The balance between these two hormones
changes each month, helping the endometrium thicken in case pregnancy
occurs or shed tissue if it doesn't.
When the balance of these two hormones shifts toward more estrogen —
which stimulates growth of the endometrium — a woman's risk of
developing endometrial cancer increases. Factors that increase levels of
estrogen in the body include:
-
Many years of
menstruation.
If you started menstruating at an early age — before age 12 — and
continue to have monthly periods into your 50s, you're at greater
risk of endometrial cancer than a woman who menstruated for fewer
years. The more years you have a monthly period, the more exposure
your endometrium has had to estrogen.
-
Never having
been pregnant.
The body produces more progesterone during a pregnancy, helping
protect you from endometrial cancer by lowering levels of estrogen.
If you've never been pregnant, you don't get the benefit of this
protection.
-
Irregular
ovulation.
Ovulation, the monthly release of an egg from an ovary in
menstruating women, is regulated by estrogen. Irregular ovulation or
failure to ovulate can increase your lifetime exposure to estrogen.
Ovulation irregularities have many causes, including obesity and a
condition known as polycystic ovary syndrome (PCOS). This is a
condition in which hormonal imbalances prevent ovulation and
menstruation. Treating obesity and PCOS can help restore your
monthly ovulation and menstruation cycle, decreasing your risk of
endometrial cancer.
-
Obesity.
Ovaries aren't the only source of estrogen. Fat tissue can change
some hormones into estrogen. Being obese — defined roughly as being
30 pounds or more overweight — can increase levels of estrogen in
your body, putting you at risk of endometrial cancer and other
cancers. A high-fat diet also can add to your risk by promoting
obesity. Some scientists even think that fatty foods may directly
affect estrogen metabolism, further increasing a woman's risk of
endometrial cancer.
-
Diabetes.
This is a risk factor for endometrial cancer mainly because obesity
and type 2 diabetes (formerly called adult-onset or noninsulin-dependent
diabetes) often go hand in hand. However, some data suggest that
women who have diabetes, whether they're obese or not, are at
greater risk of endometrial cancer.
-
Estrogen
replacement therapy (ERT).
Estrogen stimulates growth of the endometrium. Replacing estrogen
alone after menopause may increase your risk of endometrial cancer.
However, taking synthetic progestin, a form of the hormone
progesterone, with estrogen — combination hormone replacement
therapy — causes the lining of the uterus to shed and actually
lowers your risk.
-
Ovarian tumors.
Some tumors of the ovaries may themselves be a source of estrogen,
increasing estrogen levels.
Other factors that can increase your risk of endometrial cancer include:
-
Age.
Most endometrial cancers develop over many years. Therefore, the
older you are, the greater your risk. Endometrial cancer most often
occurs in women between the ages of 50 and 70.
-
Family history
of endometrial cancer.
Endometrial cancer can run in some families, especially those who
have an inherited risk of certain types of colon cancer. If colon
cancer and endometrial cancer run in your family, you may have an
inherited risk of these cancers.
-
Personal
history of breast cancer or ovarian cancer.
Some of the same risk factors for breast cancer and ovarian cancer
also increase your risk of endometrial cancer.
-
Prior pelvic
radiation treatment.
Radiation of the pelvic region to treat ovarian cancer or another
cancer can damage cells, sometimes increasing the risk of developing
a second cancer such as endometrial cancer.
-
Tamoxifen
treatment.
Endometrial cancer has been found in two out of every 1,000 breast
cancer patients who have been treated with the hormonal drug tamoxifen. The drug acts like an estrogen, causing the uterine
lining to grow. If you're being treated with this hormone, see your
doctor for an annual pelvic examination and be sure to report any
unusual vaginal bleeding.
-
Hereditary
nonpolyposis colorectal cancer (HNPCC).
This inherited disease is rare and results in colon cancer at a
young age. The cause is an abnormality in a gene important for DNA
repair. Women with HNPCC are at high risk of uterine cancer.
Having risk factors for endometrial cancer doesn't mean you'll get the
disease. It means that you're at risk and should be alert to possible
signs and symptoms of the disease. Conversely, some women who develop
endometrial cancer — and often a more aggressive form — appear to have
no risk factors for the disease.
Uterine cancer
-
endometrial cancer
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