uterine cancer

Uterine cancer: description

The uterus (uterus) is a muscular hollow organ. The upper part is called the uterine body; the two fallopian tubes flow into it. The lower short and tubular section is called the cervix. He connects the body with the vagina.

Cervical cancer develops from the upper part of the uterus, the uterine body (corpus). Hence the name corpuscular carcinoma. In contrast to many other cancers, uterine cancer usually does not develop from the muscle layer, but from the mucous lining inside the uterus (endometrium). Experts then speak of endometrial carcinoma.

Until the menopause (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.

Cervical cancer is not allowed cervical cancer (Cervical carcinoma). This develops from the lower part of the uterus. Both cancers 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 cervical cancer. It offers no protection against uterine cancer.

Cervical Cancer: Facts and Figures

Cervical cancer is one of the most common cancers in women. Each year, about 12,000 new women develop uterine cancer. The mean age of onset is around 68 years; before the age of 40, endometrial carcinoma rarely occurs. Well over half of those affected fall ill with menopause after menopause. Healing chances and prognosis – if the carcino carcinoma is discovered at an early stage – are good. The majority of sufferers can be cured.

Cervical cancer: symptoms

Everything important to the typical signs of uterine cancer can be read in the article uterine cancer – symptoms.

Cervical 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, ab – 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, the yellow-body hormone progesterone (a progestogen) is 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 and, subsequently, endometrial carcinoma may occur.

Therefore, especially overweight women after menopause have an increased risk of developing uterine cancer: their ovaries do not produce 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 never born children or never breastfed.

During menopause, treatment with female sex hormones (hormone replacement therapy, HET) is common. These may only be given in combination with progestins in women who still have a uterus.

The Age is also a risk factor for uterine cancer.

Also genetic factors can 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 else the influence of the progestin is too weak for other reasons to cause expectoration of the thickened mucosa. 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 be named after the gift of an anti-estrogen tamoxifen develop. Tamoxifen is widely used in the treatment 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 (Vaginalsonografie). Besides, the gynecologist may undergo changes of the mucous membrane 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 (Hysteroscopy) can confirm the suspicion of uterine cancer. This procedure is performed 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.

Imaging can be used to assess the spread of uterine cancer. These are the magnetic Resonance Imaging (MRI) and the Computed tomography (CT) available. These examinations are done in the hospital.

If it is suspected that the uterine cancer is no longer limited to the uterus, further investigations are carried out. So will about one cystoscopy (Cystoscopy) and one Reflection of the rectum (Rectoscopy) to see if the tumor has spread to the bladder or intestine.

Uterine cancer: treatment

The most important therapy for uterine cancer is surgery. Depending on the aggressiveness and stage of the cancer, other treatments may be added, such as 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 severe cardiovascular disease. Even in menopausal women who still want to have children, hormone therapy may be tried first.

Uterine cancer: radiotherapy

Radiation therapy after cervical cancer surgery is indicated, although the vaginal vault was affected by the cancer. It is thereby a recurrence of the tumor can be prevented. In addition, if the uterine cancer has already progressed too far for surgery or could not be completely removed, radiation is given.

Uterine cancer: chemotherapy

If the cancer of the uterus can not be operated on, if there is a high risk of relapse after surgery or if a new tumor has already developed, chemotherapy will be used. The appropriate drugs are administered to the patient by infusion. 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 if neither surgery nor radiotherapy is possible. Even with women who want to have a child, the growth of tumors using hormones can be slowed down at least until pregnancy becomes 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 carcino-carcinoma is 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 when the uterine tumor has already formed metastases. These preferentially settle in the lungs or bones and are more difficult to treat. Therefore, it is important that any woman in case of possible symptoms of uterine cancer (bleeding outside the menstruation or after menopause) immediately seek medical attention and clarify the cause.

Fear of relapse

Some women are very anxious that the tumor may recur after a surviving uterine cancer disease. This mental stress can seriously affect the performance and quality of life of those affected. Regular check-ups, psychological support and talks in a self-help group for women with uterine cancer can help here!