Uterine Cancer (Adenocarcinoma of the Endometrium)

What is Uterine Cancer?

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Uterine cancer (Adenocarcinoma of the Endometrium) is the most common form (85%) of endometrial cancers. The endometrium is the inner lining of the uterus. The lining nourishes a foetus during pregnancy and is shed during menstruation.

Statistics on Uterine Cancer?

Cancer of the uterus (Endometrial carcinoma) is the eighth leading cause of cancer death in females. Most sufferers of uterine cancer are post menopausal women. However, 25% of all cases occur in women under the age of 50. Eastern Europe and the United States have higher rates of uterine cancer. Uterine cancer is uncommon is Asia.

Risk Factors for Uterine Cancer

Risk factors for uterine cancer are associated with exposure to high levels of oestrogens. These include obesity, altered menstruation, late menopause, anovulation (absence of ovulation), low number of offspring, post menopausal bleeding and exogenous estrogens (drugs) eg. Tamoxifen.

Progression of Uterine Cancer

75% of endometrial cancers are confined to the uterus at the time of diagnosis. Uterine cancer can spread to the pelvis and abdomen via relevant lymph nodes. Most are curable with surgery due to the containment of the spread.

How is Uterine Cancer Diagnosed?

To inverstigate uterine cancer a pelvic examination should be followed by an endometrial biopsy or fractional dilation and curettage.

Prognosis of Uterine Cancer

Uterine cancer prognosis depends upon the type of tumor as well as the level of invasion. 75% are confined to the uterus at the time of diagnosis and are therefore more readily curable. 74% of uterus cancer patients are stage I at diagnosis with a 89% five year survival rate.

How is Uterine Cancer Treated?

Uterine cancer (Endometrial adenocarcinoma) is treated with surgery (the extent of which depends upon the stage of invasion) with the possibility of radiation therapy pre and/or post operatively. A hysterectomy with additional removal of the fallopian tubes and ovaries is standard for most uterus cancers. Advanced uterus cancers may recruit the use of progestational agents (hydroxyprogesterone, megastrol, doxyprogesterone) or anti-estrogen agents (tamoxifen). Chemotherapeutic agents are not highly successful against adnvanced uterus cancer but may include cisplatin, carboplatin, doxorubicin, epirubicin, and paclitaxel.