Uterine Cancer

Uterine Cancer

The foremost cause identified as the highest risk factor for developing uterine cancer is prolonged exposure to estrogen hormone stimulation alone (1).

Risk factors for uterine cancer (1)

Symptoms of cervical cancer:

Most commonly, abnormal bleeding from the vagina (1).

Diagnosis of the disease:

The diagnosis is typically made by examining tissue from the cervix. This can be done by a medical professional using a device similar to a suction tube inserted into the cervix to collect tissue for pathological examination, or by scraping the cervix to obtain tissue for pathological examination (1).

Complications of the procedure using a device similar to a suction tube inserted into the cervix to collect tissue for pathological examination are very rare. For example, cervical perforation is found in only 1-2 out of 1,000 individuals undergoing this procedure (1).

The reliability of the Pap test in detecting cervical cancer is not trustworthy. This is because 30-50% of cervical cancer patients have abnormal cells that have already shed and cannot be detected by the Pap test (2).

The accuracy of examining cervical tissue using a device similar to a suction tube inserted into the cervix for pathological examination is 90-98% when compared to scraping or excising the cervix for pathological examination in menstruating women (3).

Hysteroscopy, which involves visualizing three-dimensional images inside the cervix and introducing fluids into the cervix, and cervical scraping should be performed on patients with a tight cervix or patients who cannot tolerate the pain associated with these procedures or who do not have sufficient tissue obtained from suctioning the cervix for pathological examination (1).

The main standard treatment for cervical cancer is surgery to assess the extent of the disease, including removing the cervix, the cervical mouth, both ovaries, and sampling the yellow fluid in the cul-de-sac and the yellow fluid along the large blood vessels in the abdominal cavity for pathological examination (1).

Stages of Uterine Cancer (4 Stages):

Stage 1: Cancer is confined to the uterus and is divided into:

Stage 1A: Cancer has not spread to the muscular layer of the uterus or has spread but not beyond half of the thickness of the muscular layer.

Stage 1B: Cancer has spread to half or more of the thickness of the muscular layer of the uterus.

Stage 2: Cancer has spread to the connective tissue of the cervix, known as the stroma.

Stage 3 is further divided into:

Stage 3A: Cancer has spread to the outermost layer of tissue surrounding the uterus, called the serosa, and/or the fallopian tubes.

Stage 3B: Cancer has spread to the birth canal and/or the tissue adjacent to the uterine opening (parametrium).

Stage 3C is divided into the following substages:

Stage 3C1: Cancer has spread to the lymph nodes in the pelvic area.

Stage 3C2: Cancer has spread to the lymph nodes beside the major blood vessels in the abdominal area (para-aortic lymph nodes).

Stage 4 is divided into:

Stage 4A: Cancer has spread to the bladder or the mucous lining of the intestinal wall.

Stage 4B: Cancer has spread to other organs within or outside the abdominal cavity, or to the lymph nodes in the groin area.

The treatment for uterine cancer depends on the stage of the disease and the type of cancer cells. The doctor will recommend appropriate treatment options after evaluating the pathological findings and assessing the stage of the disease.

References:

1.            Berek and Novak's gynecology 16th edition

2.            Zucker PK, Kasdon EJ, Feldstein ML. The Validity of Pap smear parameters as predictors of endometrial pathology in menopausal women. Cancer 1985;56:2256-2263

3.            Van Hanegem N, Prins MM, Bongers MY, et al. The accuracy of endometrial sampling in women with postmenopausal bleeding: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2016; 197:147-155.

4.            FIGO Committee on Gynecologic Oncology. Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. Int J Gynecol Obst 2009;105:103-104.

For more information, please contact the Obstetrics and Gynecology Department, located on the second floor of Building 2.

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