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Uterine cancer

Uterine cancer is the most common type of reproductive cancer in women.  The incidence of uterine cancer is more in western women. In India, the number of new cases of uterine cancer is 25.7 per 100,000 women per year. The number of deaths was 4.6 per 100,000 women per year. Uterine cancer starts when the otherwise normal and healthy uterine cells grow out of control and form a tumor. The cancerous tumor is malignant and can spread to the other parts of the body.

Signs and Symptoms

The signs and symptoms may vary from patient to patient. The commonly observed symptoms are as follows.

  • Abnormal vaginal bleeding which can be foul smelling or pus-like or blood-tinged
  • Change in menstruation: Increased flow, duration or frequency of periods.
  • Bleeding after menopause or spotting
  • Pain during sexual intercourse
  • Pain in the pelvic region
  • Pressure sensation in pelvis, lower abdomen, back or legs
  • Pain or difficulty in urination
  • Pain during bowel movements
  • Blood in the urine or stools
  • Edema in the abdomen (ascites) or legs (lymphedema)
  • Weight loss

How to find out whether I have uterine cancer?

We do the following tests that are crucial for diagnosing Uterine Cancer:

  1. Blood tests:
  • Complete blood count (CBC): CBC is done to check for anemia due to vaginal bleeding. It also helps the doctor by providing a baseline for comparing future blood tests during and after the treatment.
  • Tumor marker tests: High levels of the tumor marker Cancer antigen 125 (CA125) suggests the presence of advanced or metastatic uterine cancer.
  • Blood chemistry tests: Blood urea nitrogen (BUN) and creatinine are checked for kidney function. Higher levels may suggest that cancer has spread to the ureters or kidneys. Alanine aminotransferase (ALT), aspartate transaminase (AST) and alkaline phosphatase are measured to check the liver function. Higher levels may suggest that cancer has spread to the liver.
  • Biopsy: In a biopsy, a sample of body tissue is drawn and then studied in a pathology laboratory. The lab report confirms whether cancer cells are present or not in the sample. For uterine cancer, two types of biopsy may be done
  • Endometrial biopsy: This procedure involves removal of a small tissue sample of from the inner lining of the uterus which is called as endometrium. The tissue sample is derived by using a thin tube which is inserted through the cervix. This procedure takes few minutes. After the procedure, the patient may have vaginal bleeding and cramps. These symptoms subside soon. The doctor may prescribe NSAID (nonsteroidal anti-inflammatory drug) to control pain. Endometrial biopsy is the most widely accepted test for accurate diagnosis of uterine cancer.
  • Dilation and curettage (D&C): This procedure is usually done if the result for endometrial biopsy is inconclusive. D&C is performed in the operating room. The patient is given anesthesia before the procedure. During this procedure, the cervix, is widened (dilated), then a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue or endometrial out growth. A D&C is often accompanied with hysteroscopy so the doctor can have a clear view of the lining of the uterus during the procedure. Once the sample is drawn, it is tested for cancer cells.
  • Pap smear: It is a screening procedure for cervical cancer. In this procedure, a small sample of cervical tissue is obtained and studied to detect cancer.
  • Transvaginal ultrasound: Ultrasound helps to detect tumor in the uterus, check whether the tumor is growing in the muscle layer of the uterine wall and determines the thickness of the endometrium (inner lining of the uterus). It also helps to find out the extent of spread of cancer to other pelvic areas.
  • Computed tomography (CT scan): A CT scan gives a detailed image of the tumor by using x-rays from different angles. It helps to determine the size of the tumor and also detects any recurrence of the tumor after treatment. A contrast medium may be given to the patient to drink or can be injected into the patient’s vein before the procedure, to provide a better view of the image.
  • Magnetic resonance imaging (MRI): MRI uses magnetic fields to produce the detailed images of the structures of the body. It helps to measure the size of the tumor. A contrast medium is injected into the patient’s vein to obtain a better view of the internal structures. MRI is often suggested for women with low-grade cancer to determine the extent of growth of cancer into the uterine wall. This helps to determine if the fertility of the patient can be preserved.
  • Cystoscopy: This procedure is done if the patient has difficulty during urination or if there is blood in urine. This helps to determine if the cancer has spread to the urinary bladder and urethra.
  • Proctoscopy: This procedure is done if the patient has pain in bowel movements or blood in stools. This helps to determine if the cancer has spread to the rectum.
  • Barium enema: It is an imaging test where a contrast medium (barium sulphate) and x-rays are used to get an image of the large intestine and it helps to detect intestinal and rectal cancer.

Management of Uterine cancer

  • Medical Intervention:
    • Radiation therapy: Radiation therapy uses the high energy x-rays or other particles to destroy the cancer cells.
    • Chemotherapy: It involves the use of drugs to destroy the cancer cells.
    • Hormone therapy: Hormone therapy is used to slow down the growth of certain types of uterine cancer cells.
  • Surgical Intervention: The common surgical procedure for uterine cancer includes
    • Hysterectomy: Based on the extent of cancer, the surgeon will perform a simple hysterectomy where he will remove the uterus and cervix or a radical hysterectomy where the surgeon removes the uterus, cervix, upper part of the vagina and nearby tissues.
    • Lymphadenectomy: In this procedure, the surgeon removes the lymph nodes near the tumor to prevent the cancer from spreading.

Why choose Apollo Diagnostics?

We have the expertise of 34 + years in healthcare. Our labs are equipped with EQUAS (External Quality Assurance System) and loaded with full automated machines to ensure error free reports, with a quick turnaround time, and at an affordable price. For your convenience, we offer free home collection of samples.

For appointments, please call 4444 2424.

Reference

  1. Uterine cancer guide. http://www.cancer.net/cancer-types/uterine-cancer/statistics. Accessed on 11/10/2017.
  2. Canadian cancer society. http://www.cancer.ca/en/cancer-information/cancer-type/uterine/signs-and-symptoms/?region=on. Accessed on 11/10/2017


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