The uterus is a muscular hollow organ. The upper part is called the uterine body; the two lead into him Fallopian tubes. The lower short and tubular section is called cervix designated. He connects the body with the vagina.
Uterine cancer develops from the upper part of the uterus, the uterine body (corpus). Hence the name corpuscular carcinoma. Unlike many other cancers, uterine cancer usually does not develop from the muscle layer, but from the lining that lines the uterus inside (endometrium). Experts then speak of endometrial carcinoma.
Until the menopause, the uterine lining renewed regularly. Every month, the upper layers are rejected and expelled with the menstrual period. During menopause, there are changes in the mucosa. Individual cells can transform into cancer cells through genetic modification (mutation) - an endometrial carcinoma develops.
Uterine cancer is not allowed Uterine cancer (Uterine carcinoma). This develops from the lower part of the uterus. Both types of cancer differ in terms of early diagnosis, diagnosis and treatment.
Another difference to uterine cancer: vaccine against HPV viruses (human papillopmavirus) is only for the prevention of Uterine cancer. It offers no protection against uterine cancer.
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Symptoms of Uterine Cancer
Symptoms in the early stages
Uterine cancer is difficult to recognize in its early stages as it usually causes no symptoms. For this reason, attention should be paid to the smallest abnormalities. The first indication of uterine cancer is usually an unusual one Bleeding from the vagina on. Especially if it occurs outside the menstrual period or after menopause, women should consult a doctor immediately.
Also one unusually long bleedingshould be clarified by the gynecologist.
Sometimes it comes in addition to spotting or purulent Outflow. Also blow-like Pain in the lower abdomen are possible symptoms. Uterine cancer can also cause pain in the pelvic area or in the back.
Loss in weight and loss of appetite can be more uterine cancer symptoms.
Symptoms in the advanced stage
The larger the tumor becomes, the more pronounced the uterine cancer symptoms become. This is especially true when the tumor of the uterus spread to other organs. Particularly affected are the vagina and the rectum. In the latter case, there may be irregularities in bowel movements and bleeding from the rectum. When the pelvic wall becomes affected, stabbing pains are possible symptoms.
Uterine cancer can also affect the bladder expand. Bleeding from the bladder and urinary irregularities may indicate this. In addition, affected women often get urinary tract infections as a result. It can blood in the urine (Hematuria) and back pain occur.
All mentioned complaints do not necessarily have to be considered Uterine Cancer Symptoms turn out - sometimes they have other causes. An early clarification at the doctor is still advisable.
Uterine Cancer: causes and risk factors
The exact cause of uterine cancer (endometrial cancer) is still unknown. Scientists suspect that various risk factors interact during its development.
The development of uterine cancer probably depends mainly on the female sex hormones, especially the Estrogen, from - almost every endometrial carcinoma is estrogen-dependent in its growth. The hormone ensures that the mucous membrane regularly renews before menopause. It is produced in the ovaries and adipose tissue. Also in the ovaries is the corpus luteum hormone progesterone (a progestin) formed. It counteracts the uplifting effect of the estrogen and also ensures that the mucous membrane is repelled with the menstrual period. Thus, when the effects of estrogen predominate, overgrowth of the endometrium may result, leading to endometrial carcinoma.
That's why especially overweight post-menopausal women are at an increased risk of having uterine cancer: their ovaries are no longer a "protective" progesterone that produces many fatty tissues but continues to produce estrogen.
Even women who have had their first menstruation early or have entered late menopause have a slightly increased risk of endometrial cancer. The same is true of women who have not born children or never breastfed.
While menopause often involves treatment with female sex hormones (hormone replacement therapy). These may only be given in combination with progestins in women who still have a uterus.
The older is also a risk factor for uterine cancer.
Also genetic factors may play a role in the development of uterine cancer. Responsible is a single gene, which will pass with a probability of 50 percent to the next generation. In affected families, in addition to the risk of uterine cancer, that of ovarian and colon cancer is also increased.
Certain hormonal disorders are other risk factors for uterine cancer. In some women, although the uterine lining builds up, but there is no ovulation and thus no subsequent gestagen formation.Or the influence of the progestin is too weak for other reasons to cause expectoration of the thickened mucous membrane. Such unusual thickening of the endometrium, which is not related to the control cycle, is called endometrial hyperplasia. It can occur before and after menopause and lead to endometrial cancer.
In addition, uterine cancer can develop following the administration of an anti-estrogen called tamoxifen develop. Tamoxifen is often used in the therapy of breast cancer. Also after one radiation treatment the risk of developing uterine cancer is increased. However, with these therapies, the benefits of treatment for other cancers are greater than the risk of uterine cancer.
Uterine cancer: examinations and diagnosis
An endometrial carcinoma can be diagnosed in several ways.
The first means of choice is the Ultrasound examination of the vagina (vaginal ultrasonography). In addition, the gynecologist may undergo changes in the mucosa scan sensing. Often it is necessary to one tissue sample (Biopsy). This is examined in the laboratory. This can be used to determine whether there is a benign or malignant change and at what stage the uterine cancer is located.
With a hysteroscopy can confirm the suspicion of uterine cancer. This procedure is carried out on an outpatient basis. A small rod (hysteroscope) is inserted into the uterus via the vagina. It can also be easily taken a mucous membrane sample.
With imaging techniques, the spread of uterine cancer can be assessed. These are the magnetic resonance imaging (MRI) and computed tomography (CT) available. These examinations are carried out in the hospital.
If there is a suspicion that the uterine cancer is no longer limited to the uterus, further examinations will be carried out. This is how about with a bubble mirror (Cystoscopy) and one Reflection of the rectum (Rectoscopy) checked whether the tumor on the bladder or the intestine has spread.
The most important therapy for uterine cancer is surgery. Depending on the aggressiveness and stage of the cancer, other treatments can be added, such as one Chemotherapy. Another option for treating uterine cancer is hormone therapy in certain cases.
Uterine cancer: surgery
In most cases of endometrial cancer, surgery is the best treatment method. How much tissue is removed depends on the stage of the cancer. If the uterine cancer has not spread too much, the uterus, fallopian tubes and ovaries are removed.
In more advanced stages, it may be necessary to additionally cut out the lymph nodes around the pelvis and along the abdominal aorta, the tissue around the uterus, and part of the vaginal vault. If the tumor has already spread to the bladder or intestine, more tissue must be removed.
Only in exceptional circumstances, surgery for uterine cancer in favor of other treatments is dispensed with. This is the case, for example, when the operation is too risky - for example, because the general condition of the woman is very bad or pre-existing conditions exist such as a severe cardiovascular disease. Even in menopausal women who still want to have children, hormone therapy may be tried first.
Uterine cancer: radiotherapy
A radiotherapy after Uterine cancer surgery is indicated, although the vaginal vault was affected by the cancer. It should thereby be prevented from recurrence of the tumor. In addition, if the uterine cancer is too advanced for surgery or can not be completely removed, radiation is given.
Uterine cancer: chemo
If the cancer of the uterus can not be operated on, if there is a high risk of relapse after the procedure or if a new tumor has already developed, chemotherapy will be carried out. The appropriate medicines are given to the patient by means of infusion administered. In some cases, a combination of chemotherapy and radiotherapy may be useful.
Uterine cancer: hormone therapy
As part of the hormone therapy for uterine cancer, the patients receive artificial luteal hormones (progestogens), usually in tablet form. They should counteract the estrogen effect so far that the growth of the estrogen-dependent tumor is inhibited - the disease is not uncommon but still continues. A cure can not be achieved with hormone therapy.
As a rule, hormone treatment in uterine cancer is only used when neither surgery nor radiotherapy is possible. Even with women who want to have a child, the tumor growth can be slowed down using the hormones at least until pregnancy is possible. After delivery, doctors recommend the removal of the uterus because of the high risk of relapse.
Uterine cancer: disease course and prognosis
Five years after the diagnosis "uterine cancer" about 80 percent of the patients still live (five-year survival). In individual cases, the prognosis depends on various factors. In addition to the general state of health, especially the stage in which the carcinoma is located at the time of diagnosis has an influence on the chances of recovery.
If the cancer of the uterus is detected early and therapy is started immediately, the prognosis is good. On the other hand, it becomes more difficult if the uterine tumor has already formed secondary tumors (metastases). These settle preferentially in the lung or in the bones and are more difficult to treat. Therefore, it is important for every woman to seek medical attention and clarify the cause of possible symptoms of uterine cancer (bleeding beyond the menstrual period or after menopause).
Fear of a relapse
Some women are very worried that the tumor may reoccur after a surviving uterine cancer disease. This mental stress can significantly affect the performance and quality of life of those affected. Regular check-ups, psychological counseling and talks in a self-help group for women with uterine cancer can help here!