Uterine cancer takes a long time to develop. Uterine cancer: how to recognize the disease at an early stage, methods and effectiveness of treatment

Uterine cancer is a malignant tumor of the uterus, which often manifests itself with frequent uterine bleeding. Uterine cancer is one of the most common types of malignant tumors in women.

Causes of uterine cancer

The exact causes of uterine cancer are not yet known, but it has been noted that certain factors increase the risk of developing this disease. An increased risk of uterine cancer is observed:

• In overweight women;
• In women with;
• In women with diabetes;
• In menopausal women taking;
• If started before age 12;
• If occurred at the age of over 55 years;
• If the woman has never been pregnant;
• In older women (the older the woman, the higher the risk of developing uterine cancer);
• In women with;
• In women being treated for breast cancer and taking the medicine Tamoxifen;
• In women who have inherited a special gene that increases the risk of developing uterine and bowel cancer;
• In women who frequently drink alcoholic beverages.

Types of Uterine Cancer

The uterus is a muscular organ, the internal cavity of which is covered with a special type of mucous membrane - the endometrium. Depending on the cells from which the malignant tumor developed, there are two main types of uterine cancer:

• Endometrial cancer (adenocarcinoma)

This is a malignant tumor that grows from the mucous layer of the uterus. 75% of cases of malignant tumors of the uterus are endometrial cancer. This article focuses primarily on endometrial cancer.

• Cancer of the muscular layer of the uterus (leiomyosarcoma)

This tumor is less common, occurring in approximately 15% of uterine cancer cases.

Symptoms and signs of uterine cancer

The main symptoms of uterine cancer are. Uterine bleeding due to uterine cancer can appear at different times of the cycle and, as a rule, is quite profuse.

If a woman has already reached menopause (her periods stopped more than a year ago), then with uterine cancer, uterine bleeding resumes, which can create a false impression of the resumption of the menstrual cycle.

Sometimes uterine cancer can manifest as scanty symptoms that do not stop for weeks.

In later stages of uterine cancer, the following symptoms may appear:

• Pain in the lower abdomen
• with an unpleasant odor
• Losing weight for no apparent reason
• Increased fatigue, weakness

Diagnosis of uterine cancer

A gynecologist may notice signs of uterine cancer during a routine gynecological examination. Uterine cancer may be indicated by an increase in the size of the uterus and a change in its shape (deformation).

To clarify the diagnosis, the doctor may prescribe the following examinations:

• Ultrasound of the uterus

• Hysteroscopy and endometrial biopsy

• Surgery for uterine cancer

Typically, in the early stages of uterine cancer, the first step is surgery to remove the uterus (hysterectomy). To reduce the risk of relapse (tumor growth again), doctors usually remove not only the uterus, but also the uterine appendages (fallopian tubes and ovaries), as well as lymph nodes that may have been affected by the tumor. On our website there are separate articles devoted to this topic: and.

• Radiotherapy

Radiotherapy for uterine cancer can reduce the risk of relapse (re-growth of the tumor) after surgery, or can be prescribed as an independent treatment, or in combination with chemotherapy.

• Hormone therapy

Since endometrial cancer is extremely sensitive to hormonal changes in the body, medications that reduce estrogen levels and increase progesterone levels in the blood can slow the rate of tumor growth.

• Chemotherapy

Medicines used in chemotherapy prevent cancer cells from dividing and tumor growth. These medications may be prescribed as tablets or IVs. Chemotherapy may use one drug or a combination of several drugs.

After treatment for uterine cancer

After completing treatment for endometrial cancer, a woman requires careful monitoring by her doctor. Regular examinations and examinations will allow you to detect recurrence of cancer in time if the disease returns. Discuss with your doctor how often you need to see each other.

Typically, after treatment for stage 1 uterine cancer, a woman is advised to visit her doctor every 6 months for the first year, and then once a year.

After treatment for more advanced uterine cancer, check-ups with your doctor are required every 3 months for the first year, every 3-6 months for the second year, and then once a year.

If uterine cancer cannot be cured

In some cases, even despite adequate and modern treatment, uterine cancer cannot be cured. In this case, the woman is prescribed supportive treatment that helps cope with pain and prolong life for as long as possible.

Uterine cancer (endometrial cancer, cancer of the uterine mucosa, cancer of the uterine body) is a malignant tumor that develops from the tissues of the uterus, which can subsequently spread throughout the body. Today, uterine cancer has become very widespread and ranks fourth among women, second in frequency only to breast, skin and gastrointestinal cancer. Women over 50 years of age are most susceptible to the development of this malignant neoplasm. Since the uterus is a multilayered organ, the type of tumor that develops directly depends on its location

Uterine cancer - causes

There are a number of factors that can aggravate the risk of developing uterine cancer, but the exact cause of the development of this disease has not yet been determined. According to numerous studies, risk factors for developing uterine cancer include: hypertension, smoking, HIV, infection with the human papillomavirus, menstrual irregularities and late menopause, early onset of sexual activity, taking oral contraceptives, early first birth and a large number of sexual partners.

Obesity is a serious risk factor for the development of this disease. If a woman's body weight exceeds the norm by 10-25 kilograms, the risk of developing uterine cancer increases three times, and if a woman's body weight exceeds the norm by 25 kilograms, then nine times.

The following precancerous conditions play a significant role in the occurrence of this malignant neoplasm: scars after birth trauma, erosion, ulcers, leukoplakia and epithelial proliferation (polyps, condylomas), chronic inflammatory processes (endometritis and endocervicitis).

Depending on the nature of the epithelium of various parts of the uterus, adenocarcinoma (glandular cancer) of the cervical canal and uterine cavity and squamous cell carcinoma of the cervix are distinguished. Adenocarcinoma is the main morphological variant with a prevalence of about 70%. A fairly rare tumor that affects the uterus is sarcoma. Tumor differentiation is divided into three degrees: undifferentiated, moderately differentiated and well differentiated.

In addition to differentiation, there are four stages of development of uterine cancer:

Stage 1 – the neoplasm is located in the body of the uterus

Stage 2 – the neoplasm affects the body and cervix

Stage 3 – the neoplasm spreads to the parametrial tissue with metastases in the vagina

Stage 4 – the tumor spreads beyond the pelvis, growing into the bladder and/or rectum

How to reduce your risk of developing uterine cancer

Numerous studies have found that taking combined oral contraceptives (birth control pills) significantly reduces the risk of developing uterine cancer, especially for nulliparous women. It is assumed that the protective effect of contraceptive oral contraceptives develops after one year of regular use of these medications and can last for about ten years from the date of cessation of their use.

Paradoxically, according to research, the risk of developing uterine cancer is significantly reduced in women who smoke (most likely due to early menopause), however, even to prevent cancer, smoking is strongly discouraged, since smoking significantly increases the risk of developing other malignant neoplasms (cancer). cervix, lung cancer, etc.)

Uterine cancer - symptoms

All women over forty years of age are advised to monitor themselves very closely for possible symptoms of uterine cancer. If symptoms are noticed immediately after the onset of this malignant tumor and the woman consults a doctor without the slightest delay, the chances of a full recovery increase significantly. However, unfortunately, uterine cancer is a disease whose obvious symptoms appear only in the later stages.

Signs and symptoms of uterine cancer before menopause

If a woman is in the period of becoming menopausal, irregular bleeding may be observed from the vagina, which becomes scarcer from month to month and comes less and less often.

During this period, a symptom of uterine cancer should be considered all bloody discharge from the vagina, which does not become rarer or less abundant over time. In addition, uterine cancer can be suspected if menstruation gradually became more scanty and infrequent, and then suddenly began to come more often and intensify

Signs and symptoms of uterine cancer during menopause

If a woman has already reached menopause (menopause) and has not had a period for at least several months, any spotting or any bleeding from the vagina should be considered symptoms of uterine cancer, regardless of their frequency, duration or quantity (scanty or heavy)

Other possible symptoms of uterine cancer

Regardless of age and menopause, possible symptoms of uterine cancer include: bleeding or pain after or during sex; nagging pain in the perineum, lower back or lower abdomen; increased fatigue and noticeable weight loss.

If you have any of the above symptoms, you should immediately consult a doctor, and the sooner this is done, the greater the chances of a full recovery.

In pregnant women, uterine cancer is observed very rarely, and if it is detected during pregnancy, removal of the uterus is indicated to save the woman’s life.

Uterine cancer - diagnosis

Diagnosis of this disease consists of conducting an internal gynecological examination using speculum, which allows the doctor to examine the vaginal part of the cervix and the wall of the vagina itself to exclude causes of bleeding that may be directly related to diseases of these organs. If uterine cancer has spread to larger areas, additional research is carried out through the rectum to clarify the transition of the malignant tumor to the sacrouterine ligaments and pelvic walls. In all cases of any changes, to detect the presence of early forms of cancer, smears are taken from the cervix for cytological examination and a biopsy is performed.

Other diagnostic methods performed include: lymphography, ultrasound tomography, intravenous pyelography, ileocavagraphy, irrigography, sigmoidoscopy, cystoscopy, MRI, CT, fine needle tumor biopsy and lymphangiography. These studies are very important for developing the optimal plan for combined or radiation treatment.

Uterine cancer - treatment

The tactics of treatment directly depend on the general condition and age of the patient, as well as on the clinical stage of the cancer. In most cases, when this disease is detected in the early stages, treatment involves surgical complete removal of both the uterus itself and its appendages (ovaries, fallopian tubes), and sometimes it is necessary to simultaneously remove the pelvic lymph nodes. In later stages of the disease, treatment is carried out with radiation (radiation therapy, radiotherapy) and drugs (chemotherapy). In addition, it is possible to carry out combined treatment, when surgical intervention is followed by intracavitary gamma therapy. For stage 3 uterine cancer, preoperative radiation therapy is indicated. As an independent method, radiation therapy is used in the case of local location of a malignant tumor, as well as for various contraindications to surgery. In the third and fourth stages of the disease, antitumor drugs are effectively used.

In case of timely detection and immediate adequate treatment, the prognosis for future life is quite favorable. Removal (extirpation) of the uterus eliminates not only the affected organ, but also avoids further spread of the process by lymphogenous and hematogenous routes. If you do not see a doctor in a timely manner, the survival rate drops significantly. Even after surgery, for stage 2 uterine cancer the survival rate is about 60%, for stage 3 or more – about 20%.

Among all oncological diseases, cervical cancer ranks fifth; among gynecological oncological pathologies, the disease ranks second after breast cancer. Signs of uterine cancer in women in the initial stages are mild, making diagnosis difficult. In Russia, 17 women out of every hundred thousand suffer from the disease. Survival prognosis depends directly on the stage at which the patient is diagnosed.

The internal cavity of the organ is lined with a special epithelial layer - the endometrium. Cervical cancer is a malignant tumor process that develops from the endometrium. As a rule, the pathology affects women after 45 years of age, but in recent years the number of cases (up to 40%) among younger women has been increasing. There are two types of uterine oncology: autonomous (in which the etiology is unknown, accounting for a third of all cases of uterine oncology) and hormonal (characterized by endocrine metabolic disorders).

The autonomous variety develops as a result of increased estrogen synthesis - the hormone acts on the endometrium, causing increased cell proliferation, changes in their size and properties (hyperplasia). The hormonal type of oncology is often combined with diseases of the endocrine system. In this case, the malignant lesion develops gradually and has a more favorable prognosis.

Endometrial cancer is considered a “disease of civilization”; the exact causes of the tumor are unknown. The following risk factors exist:

• late menopause at the age of 55 years;
• lack of ovulation for a long time;
• late menarche (first menstruation);
• hormonal infertility;
• diabetes mellitus, obesity;
• polycystic ovary syndrome;
• long-term treatment with estrogen-based drugs (without gestagen) or anti-estrogenic drugs;
• lack of pregnancy experience;
• heredity.

Early symptoms

In most cases, there are no symptoms when a tumor forms. Signs of uterine cancer in the early stages include uterine bleeding that is in no way related to menstrual bleeding. This symptom is observed in most women. Young girls may be bothered by light leucorrhoea. It should be noted that discharge is not always a symptom of cancer; it accompanies many pathologies of the genital area. This significantly affects the diagnosis of the disease. The following discharge is observed:

• plentiful;
• scanty;
• one-time;
• repetitive;
• periodic.

Symptoms of early stage uterine cancer are usually mild. There may be pain in the lower abdomen, mucous (or watery) discharge bothers elderly patients. If the lesion affects the bladder, pain may occur when urinating.

Signs in later stages

Some signs of uterine oncology in women are not accompanied by a clear clinical picture, but are detected during a gynecological examination without special studies. The following symptoms are identified:

• refusal to eat, weight loss;
• increased fatigue, weakness, decreased performance;
• bloody or purulent (at stages 3 and 4 - putrefactive) discharge (including after sexual intercourse);
• pain in the pelvic area (abdomen, lower back, sacral area);
• swelling in the legs;
• intermenstrual discharge;
• low-grade fever;
• vomiting, nausea;
• abdominal ascites (fluid accumulation);
• pyometra (inflammation of the uterus);
• spread of metastases to lymph nodes, liver, bones (leading to fragility, brittleness, fractures);
• stenosis (fusion) of the cervix;
• gastrointestinal disorders (constipation or diarrhea).

Tumor diseases of the genital organs in women account for about a quarter of all cases of cancer.

In recent years, there has been a rejuvenation of cancer in this location.

At the current level of development of medicine, a neoplasm detected at stages 0 and 1 of development can be treated in 80-100% of cases. It is not possible to achieve a significant reduction in the mortality rate from malignant tumors of the uterus due to the reluctance of women at risk to undergo regular examinations.

Faced with this pathology, many ask questions regarding life expectancy. We will try to answer the question of how long people live with uterine cancer in this article.

Influence of factors on life expectancy

The development of the clinical picture in cancer is like an iceberg; ¾ of the time from the division of the first pathological cell to death from a disintegrating tumor occurs during the latent period of tumor growth.

When we discover a 2-centimeter tumor at the age of 40, we must realize that it began to develop at least 10 years ago, but was overlooked due to its small size and lack of symptoms. It is the stage at which the process is diagnosed that is the prognosis for the life and health of the patient.

The principles of staging are based on the morphology and size of the tumor, its location, its invasion of neighboring organs and structures, the degree of damage to the lymphatic system, and the presence of distant metastases.

Even with a detailed study of the patient’s process and classification according to modern standards, it will not be possible to accurately determine his life expectancy due to the individuality of each person. In addition to the histological structure and position of the cancer in relation to surrounding tissues, the following factors are of great importance:

• age (the younger the body, the greater the chance of overcoming the disease);
• state of health before diagnosis (immunodeficiency states reduce resistance and suggest the addition of infections, which aggravates the condition and shortens life);
• the presence of chronic diseases (for diseases of the cardiovascular and respiratory systems at the stage of decompensation, it is impossible to carry out surgical procedures even to a limited extent, which makes even the initial forms of cancer incurable);
• allergic diseases (may limit the possibilities of both surgical and chemotherapy treatment).

The totality of all the above points determines how long a particular person will live.

Prognosis depending on the type of cancer

Uterine cancer changes the life expectancy of any person differently, depending on the level of damage and morphology. Cervical cancer has a positive prognosis compared to endometrial cancer, which is more favorable in the case of the hormone-dependent variant.

Neoplasms of the cervix are visual localizations, which simplifies their detection, and the introduction of a Pap test (screening to detect atypical cells) into the mandatory examination list at the gynecological chair allows you to diagnose this type of cancer at stage T0.

If cancer is recognized locally, a cone biopsy, which is performed for the purpose of histological examination, leads to a complete recovery of the patient, the survival rate reaches 90-100%. In stages I and II, there is already a need for hysterectomy with adnexa, and about 30-60% recover. Only about 10% of patients manage to survive more than 5 years when cervical cancer is detected at stage T4.

Endometrial cancer (adenocarcinoma), due to improved detection and treatment of cervical cancer, is overtaking it in the number of patients. Its two main forms (hormone-dependent and autonomous) differ morphologically, require a different therapeutic approach and have a different prognosis.

Hormone-dependent tumors cause a clear clinical picture with uterine bleeding and general disturbances of endocrine metabolism, which forces women to seek help. This point is in some sense positive, since an autonomous variant of adenocarcinoma can develop and disseminate to other tissues with minimal symptoms.

Due to the low aggressiveness of hormone-dependent neoplasms, they do not metastasize for a long time and respond well to treatment with an integrated approach (surgery, chemotherapy, radiation therapy and hormone therapy). The five-year survival rate is up to 90% when diagnosed at stages T0 and T1, 70% at stage T2 and decreases to 50% at stages T3, T4.

Autonomous cancer

Autonomous cancer is usually found in advanced stages and in women under 50 years of age. Low histological differentiation of the tumor makes it malignant and worsens the prognosis.

Hormones help in treating the disease, and the immunosuppression characteristic of this form provokes the addition of various infections. Prognostically unfavorable is the spread of endometrial cancer to the cervix and detection of the process during pregnancy.

Leiomyosarcoma, which can metastasize beyond the pelvis, is considered relatively rare but malignant. Lethal outcomes are caused by cancer intoxication and distant metastases to organs. The mortality rate in the first 5 years reaches 80% of cases.

How to prolong life with uterine cancer?

In order to maintain the quality of life at a decent level for as long as possible and extend its life, you should:

1. Follow the recommendations and prescriptions of your doctor.
2. Lead a healthy lifestyle as much as possible (give up bad habits, stick to a balanced diet, follow a daily routine).
3. Sanitize chronic foci of infection, which will reduce the risk of infectious diseases.
4. Maintain a positive mindset. Inner harmony and balance extend life.

The support of loved ones is of great importance, without which the patient cannot cope. A sufficient amount of attention and empathy will help you avoid depression and maintain the meaning of existence.

Palliative care in the final stages of the tumor process comes down to the treatment of infectious and non-infectious complications, adequate pain relief, care for the patient if he is unable to care for himself, and the same psychological support from friends and relatives.

You should not trust traditional methods of treatment; any traditional therapy can only supplement the main list of prescriptions. Wanting to try all the delights of alternative medicine on yourself, the condition not only does not get better, but may even worsen. If at least one of the folk methods could really cure cancer, then it would have long ago entered practical medicine.

Those who are faced with pathology should be reminded that life expectancy also depends on you; you should not give up, because this is a century in which every new day can become the day of the discovery of a cure for cancer.

And for people who are not urgently interested in this problem, the advice would be relevant not to avoid preventive gynecological examinations and to seek help from specialists if they detect the slightest changes in themselves that are suspected of malignancy.

Endometrial cancer (the inner layer of the uterus) is one of the most common cancers among Russian women. It accounts for 7.7% of all malignant tumors. The higher the economic level of a country, the more common this disease is.

The only exceptions are eastern countries (Japan), where food traditions are somewhat different from the West. The average age at which this type of cancer is detected is 65 years, and detection of a tumor before 50 years of age is very rare.

What is endometrial cancer?

Tumors of the inner layer of the uterus are called endometrial tumors. This layer is surrounded by muscles that form the body of the uterus (myometrium), and all this is covered with a thin serous membrane. Cervical cancer is not an endometrial tumor; it is a separate disease with completely different causes and prognosis.

Risk factors for endometrial cancer

All of the above factors are not the direct causes of uterine cancer; they only increase the risk of cancer.

Polycystic ovary syndrome

Polycystic ovaries is a syndrome in which each ovary simultaneously contains 12 or more follicles. The reason for this phenomenon is considered to be a disrupted exchange of sex hormones: male and female. Girls and women with this syndrome usually have an irregular menstrual cycle, infertility and “masculine” signs: excess hair growth, abdominal fat, a rough voice. The risk of uterine cancer increases due to metabolic failure. In addition, obesity may be an additional risk factor.

Obesity and excess dietary fat intake

Excess weight increases the risk of uterine cancer by 2-3 times. This applies to women with a body mass index of more than 25. This increase in risks is associated with an excess of estrogens synthesized by adipose tissue. The same mechanism also operates when eating large amounts of animal fat. It has been proven that in countries where the diet is dominated by fats and there are few vegetables, the risk of developing endometrial tumors is much higher.

Hormone replacement therapy

It is believed that in women over 55 years of age, long-term replacement therapy increases the risk of uterine cancer by 2-3 times. It should be taken into account that the risk when taking outdated drugs (containing only estrogens in large quantities) was sevenfold. Modern means, including, have a right to exist. Therefore, the main rule of replacement therapy is timely prescription according to strict indications, using the latest drugs.

Immunohistochemical study

When a tumor is detected, it is necessary to find out whether it is sensitive to hormonal treatment. To do this, the number of receptors for estrogen and progesterone is determined by immunochemical analysis.

Forecast

It is very important to establish all prognostic factors in order to select adequate and appropriate treatment options. The worse these factors are, the more aggressive the therapy should be.

Treatment of endometrial cancer

Most cases of uterine tumors are treated comprehensively, using three main methods: surgery, radiation and chemotherapy. This combination significantly increases 5-year disease-free survival.

Surgical method

The main operation for endometrial cancer is. It is often necessary to remove nearby lymph nodes and tissue affected by the tumor.

Radiation therapy

Irradiation of the uterine area and adjacent tissues is carried out for advanced cancer that is sensitive to rays. This method is also used in patients for whom surgery is contraindicated. These are older women who often suffer from liver, heart and kidney diseases.

Chemotherapy

Chemotherapy drugs (doxorubicin, cisplatin) for uterine cancer do not give as impressive results as for other tumors. They are used for advanced processes, as well as for contraindications to surgery.

Hormone therapy

Another stage of combined treatment for endometrial cancer can be hormonal drugs (progestagen derivatives), since some tumors are sensitive to these substances. The drug regimen is designed for 2-3 years. Given the frequent side effects, tumor sensitivity and differentiation are examined before starting therapy.

Observation after therapy

After surgery and completion of treatment, the woman should be regularly monitored by a doctor. In the first year it is necessary to be examined every 4 months, in the second year - once every 6 months, then - once a year. In recent years, recommendations have emerged to monitor patients every 4 months for the first three years. If signs and symptoms of uterine cancer appear that are suspicious of relapse, then you need to make an unscheduled visit to the doctor.

Endometrial cancer survival

Due to early diagnosis and improved therapy, uterine cancer can be treated quite successfully. Thus, the 5-year survival rate of patients with stage I is up to 98%, with stage II – about 70%, with stage III – 32%, and stage IV – about 5%.

Prevention

• Having at least one pregnancy
• Long-term breastfeeding
• Physical activity