Uterine Cancer Treatment
Gynecologic cancers include all cancers that begin in a woman's reproductive organs. The cancer is always named after the body part where it starts. Gynecologic cancers begin in different places within a woman's pelvis, the area below the stomach, and between the hip bones.
Types of gynecological cancer:
• Cervical Cancer: This forms in the cells of the cervix, the narrow lower end of the uterus.
• Ovarian Cancer: This develops in the ovaries on either side of the uterus. Some ovarian cancers can also start in the fallopian tubes.
• Uterine Cancer: This involves cancerous cells in the uterus, a hollow pear-shaped organ in the pelvis where the embryo grows during pregnancy. This type also includes endometrial cancer.
• Vaginal Cancer: This forms in the vagina, a hollow tube-like canal between the bottom of the uterus and the outside of the body, serving as the passage from the cervix to the outside. During childbirth, the baby exits the body through the vagina.
Causes of Uterine Cancer:
The causes of uterine cancer are varied and include factors that increase the likelihood of developing uterine cancer, such as:
• Age over 50.
• Obesity and being overweight.
• Taking estrogen alone (without progesterone) as hormone replacement during menopause.
• Taking tamoxifen, a medication used to prevent and treat certain types of breast cancer.
• Close family members suffering uterine, colon, or ovarian cancer.
• Genetic mutations that increase the risk, including BRCA1 or BRCA2.
• Persistent infection with human papillomavirus (HPV) in the cervix causes 95% of cervical cancer cases if left untreated. Typically, it takes 15 to 20 years for abnormal cells to progress to cancer, but in women with weakened immune systems, such as those with untreated HIV, this process can be faster, taking 5 to 10 years. This virus is transmitted through sexual contact. In most cases, the immune system removes it from the body, but continued infection leads to the growth of abnormal or cancerous cells. The chance of a virgin developing cervical cancer is minimal.
• The causes of cervical cancer in virgins include age over 50, being overweight, and taking hormone therapy that contains only estrogen.
• Risk factors for the development of cervical cancer include the oncogenic type of HPV, immune status, presence of other sexually transmitted diseases, number of births, young maternal age at first pregnancy, reliance on hormonal contraceptives, and smoking.
Symptoms of gynecological cancer:
Symptoms of cervical cancer:
In the early stages, cervical cancer may not cause any signs or symptoms. However, advanced cervical cancer can lead to the following:
• Blood spots or light bleeding between or after menstrual periods.
• Menstrual bleeding that is longer and heavier than usual.
• Increased vaginal discharge.
• Bleeding after intercourse.
• Pain during intercourse.
• Bleeding after menopause.
• Unexplained and persistent pelvic or back pain.
These symptoms may overlap with those of benign cervical conditions. Therefore, it is advisable to visit the best institution in Iraq for uterine cancer treatment, which is the Warith International Cancer Institute, known for having the best cancer specialists in Iraq.
Symptoms of ovarian cancer:
Ovarian cancer may cause the following signs and symptoms:
• Vaginal bleeding (especially after menopause) or abnormal vaginal discharge.
• Pain or pressure in the pelvic area.
• Abdominal, pelvic, or back pain.
• Persistent bloating.
• Feeling full quickly when eating or difficulty eating.
• Changes in bathroom habits, such as frequent or urgent need to urinate or constipation.
Symptoms of uterine cancer:
The effects of uterine cancer are divided into early and advanced symptoms. Early symptoms of uterine cancer include unusual vaginal bleeding outside of menstruation or after menopause. Other signs of uterine cancer include:
• Frequent urination.
• A mass or growth in the vagina.
• Persistent feeling of fullness.
• Thin, white, or clear vaginal discharge.
Advanced uterine cancer symptoms may include pelvic pain or pressure, general fatigue, nausea, loss of appetite, and weight loss.
The effects of uterine cancer do not vary by age. Therefore, the symptoms of uterine cancer in virgins, pregnant women, postpartum women, women over fifty, and postmenopausal women do not differ from those mentioned.
Symptoms of uterine and vaginal cancer:
Initially, most types of vaginal cancer do not cause signs or symptoms. However, if symptoms do occur, they may include:
• Abnormal vaginal discharge or bleeding. Bleeding may be considered abnormal due to its severity, timing (such as bleeding after menopause or between periods), or any bleeding that is longer or heavier than usual.
• Changes in bathroom habits, such as blood in the stool or urine, going to the bathroom more than usual or feeling constipated.
• Pain in the pelvic area and the region below the stomach, especially during urination or sexual intercourse.
How to detect uterine cancer:
• Physical examination: A thorough physical check-up.
• Pelvic ultrasound: This creates images of the uterus and ovaries by using sound waves. When sound waves encounter something dense, such as a tumor or organ, they echo back. A computer then forms an image from these echoes. A pelvic ultrasound typically takes between 15 to 30 minutes. If anything abnormal is detected, the medical staff may suggest a biopsy.
• Abdominal ultrasound: To obtain clear images of the ovaries and uterus, the patient will need a full bladder, so she will be asked to drink water before the appointment.
• Transvaginal ultrasound: This does not require a full bladder.
• Endometrial biopsy: Cells are sent to a pathologist for examination under a microscope.
• Hysteroscopy: This is inserted through the vagina into the uterus, allowing direct visualization of the uterine cavity. During this procedure, tissue can also be removed (biopsy) and sent for further laboratory tests.
• Blood and urine tests: These evaluate overall health and assist in treatment decisions.
• Other tests: To determine if cancer has spread to other body parts, such as X-rays, CT scans, or MRIs. For certain types of uterine cancer, such as sarcomas, a PET scan may be used.
• Pap smear: This is a test for cervical cancer. Following a positive HPV test (or any other screening method), the medical staff can check for changes in the cervix (such as cancerous cells) that could develop into cervical cancer if left untreated, through a Pap smear.
• CA125 Tumor marker test: This is commonly used to help diagnose and monitor the efficacy of treatment plans for uterine cancer.
• Sentinel lymph node biopsy: This diagnostic surgical tool helps identify hidden lymph node metastases in patients with uterine tumors. Its high accuracy makes it a suitable technique for evaluating lymph nodes, as identifying affected nodes is crucial for treatment planning. If affected nodes are found, surgery is not performed, and the patient may undergo chemotherapy or radiation therapy. Therefore, the sentinel lymph node biopsy aids in determining the surgical stages of endometrial tumors and selecting the optimal treatment.
Stages of uterine cancer:
Uterine cancers are categorized into four stages:
• Stage I: Cancer has not spread outside the uterus.
• Stage II: Cancer has spread to the cervix.
• Stage III: Cancer has spread to the vagina, ovaries, or lymph nodes.
• Stage IV: Cancer has spread to the bladder or other distant organs from the uterus. Therefore, it is considered the advanced stage of uterine cancer.
Uterine cancer treatment in Iraq:
Uterine cancer is treated in several ways, depending on the type of gynecological cancer and its extent. Treatment may include surgery, radiation therapy, chemotherapy, and palliative care to provide supportive care and pain management.
• Surgical treatment for uterine cancer: The uterus is removed due to cancer, a procedure known as total hysterectomy. If the fallopian tubes and the 2 ovaries are also removed, this is called bilateral oophorectomy. Ovaries are often removed to reduce the risk of cancer recurrence, as they produce estrogen, a hormone that may promote cancer growth.
• Radiation therapy for uterine cancer: This involves the use of high-energy rays (similar to X-rays) to kill cancer cells. Internal radiation therapy, or brachytherapy, involves injecting a radioactive source inside the uterus. This localized radiation therapy is available at Warith International Cancer Institute. Radiation therapy may be used after hysterectomy for stage II and III cancers.
• Chemotherapy for uterine cancer: This involves the use of chemical drugs to shrink or eliminate uterine cancer. The medications may be in the form of pills taken by the patient or injected into the veins, or sometimes both.
• Hormonal therapy for uterine cancer: Hormonal therapy is usually given if the cancer has spread or recurred. It is also sometimes used if surgery is not an option. Progesterone is the main hormonal treatment for women with uterine cancer, as it helps shrink certain types of cancer and manage symptoms.
• Targeted therapies: This type of cancer treatment targets cancer cells to stop or slow their growth or spread. Warith medical team may recommend genetic testing to determine the appropriate targeted therapy for you.
• Colposcopy or visual inspection of the cervix: This is used to locate and assess the cancer, followed by:
• Thermal Ablation: using a hot probe to destroy cells.
• Cryotherapy: using a cold probe to freeze cells.
• Removal of abnormal tissue: using an electrically heated loop.
Prevention of uterine cancer:
No known method exists to prevent uterine cancer. However, the following may reduce the risk of developing uterine cancer:
• Not using oral contraceptives.
• Maintaining a healthy weight and being physically active.
• Taking progesterone if estrogen is used.
Prevention of cervical cancer:
Cervical cancer awareness and access to information and services are essential for lifelong prevention and control. HPV vaccination at ages 9-14 years is also a highly effective way to prevent HPV infection and therefore cervical cancer and other HPV-related cancers. The vaccine can be given in one or two doses. Women with weakened immune systems should receive two or three doses.
Early detection of cervical cancer:
Among all types of gynecological cancers, only cervical cancer has screening tests that can detect it early. Women should be screened for cervical cancer through regular Pap smears every 5 years after the age of thirty. If the test results are good by age 65, no further screening is necessary. Women with HIV should be screened every 3 years starting at age 25. Cervical cancer rarely causes symptoms, which is why regular cervical cancer screening is important, even for those vaccinated against HPV.
What is the difference between uterine fibroid and uterine cancer? Can uterine fibroid turn into cancer?
Uterine fibroids are completely benign tumors that arise from the smooth muscle tissue within the uterus, and they do not turn into cancer. Therefore, having uterine fibroids does not increase the risk of developing other gynecological cancers.
Is it possible to cure uterine cancer?
Fortunately, endometrial cancer is often diagnosed at an early stage because many women notice unusual bleeding. If cancer is detected early and has not spread to other organs, a hysterectomy can cure it. Thus, the cure rate for endometrial cancer is high.How many years does a patient with cervical cancer live?
The prognosis for women with uterine cancer depends on several factors, including age, overall health, the timing of diagnosis, and the stage of cancer. Generally, younger women and those diagnosed at early stages have the best outcomes. Fortunately, most women with endometrial cancer, the most common type of uterine cancer, are diagnosed at an early stage when it is often treatable. After treatment, women should continue regular follow-ups; if cancer recurs, it can be detected and treated promptly.Is uterine cancer fatal?
Many women wonder if uterine cancer is dangerous. Uterine cancer is not fatal when diagnosed and treated in its early stages, where the cure rates are high in the best cancer treatment hospital in Iraq.The difference between cervicitis and uterine cancer:
Cervicitis and uterine cancer are two different conditions involving the uterus. Cervicitis refers to inflammation of the cervix and surrounding tissues due to infection, causing irritation, redness, congestion, and abnormal vaginal discharge. In contrast, uterine cancer refers to the growth of abnormal cancerous cells in the uterine tissues.Does uterine cancer come back after removal?
For most cases of uterine cancer, treatment is effective. However, in some instances, uterine cancer can recur either in the uterus or another part of the body. Therefore, the best oncology center in Iraq is keen to follow up with its patients.