Uterine cancer

UTERINE CANCER (Uterine Cancer, Endometrial Cancer)

Uterine Cancer Occurrence

Uterine cancer (uterine cancer, endometrial cancer) originates from the endometrium layer, which covers the inner layer of the uterus. Uterine cancer is also known as uterine cancer. Uterine tumors are divided into benign (benign) and malignant (malignant) tumors. Although benign tumors are generally harmless, malignant tumors can spread to neighboring tissues and organs as well as to other distant organs via lymphatic vessels and blood vessels. It starts to grow again in the tissues and organs they spread and threatens life.

Uterine Cancer Risk Factors

– Thickening of the inner wall of the uterus (endometrial hyperplasia): Endometrial hyperplasia can be observed more especially in those who have excessive and irregular menstrual bleeding, those who have bleeding after menopause and those who are obese.

– Those who have never given birth, have their first menstruation at an early age and enter menopause at an advanced age (those who have their first menstruation before the age of 12 and go through menopause after the age of 55),

Those who receive estrogen therapy alone, which has not been met with progesterone for years as hormone therapy during menopause,

– Those who take uncontrolled Tamoxifen treatment for years for the treatment and prevention of breast cancer,

In women who have undergone radiation therapy to the pelvis,

-Women with close relatives with uterine cancer and colon cancer

uterine cancer is more common.

Despite this, uterine cancer may develop in women with no risk factors, and uterine cancer may not develop in many women with multiple risk factors.

Uterine Cancer Symptoms

– Prolonged menstrual bleeding

-Vaginal bleeding after menopause,

– Abnormal watery, bloody discharge from the vagina,

– Pelvic pain (groin pain) felt more during intercourse and vaginal bleeding after intercourse.

Uterine Cancer Diagnosis

-Examination and blood tests:First of all, physical examination and blood tests should be done,

-Pelvic examination:The shape, size and vagina of the uterus should be evaluated with pelvic gynecological examination.

-Ultrasoundography:In particular, transvaginal ultrasonic examination should evaluate the thickness of the inner part of the uterus (endometrium), pathological structures such as polyps, uterine muscle layer (myometrium), tubes, and ovaries.

-Endometrial biopsy: Endometrial biopsy should be performed with the help of a pipette applied to the inner layer of the uterus, the incoming material should be sent for pathological examination and the presence of cancer cells should be investigated by the pathologist. If cancer is detected, it is determined whether this cancer is low or high grade. High-grade tumors (the tumor tissue is highly differentiated from normal uterine tissue) grow faster than low-grade tumors.

Uterine Cancer Staging

Stage 1:The cancer is confined to the uterine corpus region.

Stage 2:At this stage, the cancer spreads to the cervix region of the uterus.

Stage 3:At this stage, cancer cells have spread to the ovaries and abdomen, to the vagina and lymph nodes, but the cancer is still confined to the pelvis.

Stage 4:At this stage, the cancer may spread to neighboring organs such as the intestines and bladder, and may gradually metastasize to distant organs such as the liver, lung, and bone.

Uterine Cancer Treatment

Because endometrial cancer treatment is a long treatment process and years of follow-up are required, patients are very worried. In this regard, close family circle, friends and doctors should support and show understanding.

In cases of endometrial cancer, which is in the low risk group and limited only to the uterine corpus, the uterus, ovaries, and tubes should be removed by surgical treatment. The operation to remove the uterus (hysterectomy) is performed with an incision made in the lower abdomen, or it can be done with a few small incisions (incisions) made in the abdomen with a procedure called laparoscopy.

In moderate-risk endometrial cancer, lymphatic pathways are also evaluated after removal of the uterus, tubes, and ovaries. Abnormal lymph nodes are removed. In this type of operation, although the cancer is thought to be completely removed by surgery, cancer cells may have spread through lymph and blood, and radiotherapy (adjuvant radiation therapy) should be given in addition to surgical treatment to destroy these cells and prevent the cancer from recurring.

In those with high-risk endometrial cancer, the cancer has spread to other distant sites such as the tubes, ovaries, cervix, vagina, bladder, intestines, lymphatics and liver, bones.

In such patients, all cancerous tissues should be removed by surgical treatment. After the operation, adjuvant treatments such as radiotherapy and chemotherapy should be applied to prevent the spread of cancerous cells.

Treatment Approach of Endometrial Cancer Patients Who Want to Have a Child

The operation of a patient with low-risk endometrial cancer who wishes to become pregnant may be delayed until a child is born under close control. Surgery is performed after giving birth.

Surgery should not be delayed in patients with intermediate or high-risk endometrial cancer. It is not possible for these patients to become pregnant after the operation. However, after the diagnosis of high-grade cancer, if it is desired to have children in the future, the embryos of the patient and his partner obtained by in vitro fertilization can be frozen and given to the surrogate mother in the future, a pregnancy can be achieved. Of course, the biological mother of the baby born in this way is a woman with endometrial cancer and her oocytes are collected. For this reason, the operation to be performed for high-risk endometrial cancer is delayed for up to three weeks.

Premenopausal women should be treated if severe menopausal symptoms occur after this type of operation.

Sexual Life After Uterine Cancer Treatment

After such operations, the vagina may narrow. To avoid problems in sexual life, after the treatment is completed, a vaginal moisturizer or lubricant can be given to relieve vaginal dryness. Vaginal estrogen preparations may be recommended for those with low-risk endometrial cancer, if necessary. If necessary, vaginal narrowing can be prevented by using vaginal dilators.

Kiss. Dr. Kutlugul Yuksel

Gynecology and Obstetrics Specialist

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