Uterine Cancer: Causes, Symptoms & Treatment

What is uterine cancer?

Uterine cancer is a cancer that starts in the uterus which is the pear-shaped organ in a woman’s pelvis where a baby develops during pregnancy. It occurs frequently in women as a cancer of the female reproductive system.

Stages of Uterine Cancer

According to the FIGO system, uterine cancer (mostly endometrial cancer) is staged into four categories, showing the level of disease and aiding treatment selection.

Stage I – The cancer cells are found only inside the uterus.

• IA indicates that cancer has stayed in the lining (endometrium) or only extended to less than half of the uterine muscle (myometrium).
• IB: Cancer reaches more than half of the myometrium.

Stage II – There is cancer in the wall of the cervix

• The cervical stroma (tissue) is affected by cancer, but the disease has not spread outside of the uterus.

Stage III – The cancer is found outside of the uterus, but still inside the pelviss

• IIIA: Cancer starts to grow in the outer layer known as the myometrium or in the ovaries/fallopian tubes.
• IIIB: Cancer may affect the vagina or the outer layers of tissue near the uterus.
• IIIC1: The disease has reached the lymph nodes found in the pelvis.
• IIIC2: Cancer has now reached the lymph nodes that are close to the aorta (para-aortic lymph nodes).

Stage IV – Tumors are present in non-close-by organs

• IVA: The cancer gets through the wall lining of the bladder or bowel.
• IVB: Cancer has advanced to other parts of the body, for example the lungs, liver or bones.

Uterine Cancer Symptoms

Uterine cancer in general, tends to make its first symptoms known early and abnormal vaginal bleeding is typically noticed. This way, you may be able to catch the condition early which often leads to superior results.

Early signs of uterine cancer:

• Abnormal vaginal bleeding
• Unusual vaginal discharge
• Pelvic pain or pressure
• Pain during sexual intercourse
• Unexplained weight loss
• Pain or difficulty urinating
• Fatigue

Causes of Uterine Cancer

Cancer of the uterus, which is most frequently endometrial cancer, starts in the lining of the uterus (endometrium). It usually occurs in women who are past menopause but may occur in younger women, particularly those with hormonal imbalances. Although the true cause is not always certain, the following are established causes and risk factors:

• Estrogen Imbalance
• Obesity
• Age
• Diabetes and Insulin Resistance
• Polycystic Ovary Syndrome (PCOS)
• Hormone Therapy
• Family History and Genetics
• Endometrial Hyperplasia
• Nulliparity (Never Having Been Pregnant)
• Radiation Exposure

Uterine Cancer Diagnosis Tests

Many tests are performed to find uterine cancer, find out its kind and see if it has spread. The most common tests used are these:

Pelvic Examination

• Doctor looks for abnormalities in the uterus, ovaries and the areas around them.
• Usually sense anything unusual like lumps, masses or uneven shapes.

Endometrial Biopsy 

• A thin tube is put into the uterus to gather a tiny bit of the endometrial tissue.
• Cancer cells are looked for using a microscope when examining a sample.

Dilation and Curettage (D&C) with Hysteroscopy

• Considered if a biopsy result is not clear.
• D&C: removing tissue from the inside of the uterus with the patient under general anaesthesia.
• A hysteroscope is inserted through the vagina into the uterus to view any suspicious parts and get tissue samples for testing.

Transvaginal Ultrasound (TVUS)

• An instrument called a probe is placed in the vagina to get images of the uterus.
• Effects give information about the thickness of the endometrium; if thicker, it can help diagnose cancer.

Imaging scans (used to see if the cancer has spread)

• An MRI provides excellent images of the uterus and the neighbouring organs.
• CT scan: Finds out if the cancer has reached the lungs, liver or lymph nodes.
• A PET scan allows us to detect where cancer is active in the body.
• To look for metastasis in the lungs.

Blood Tests

• In advanced uterine cancer, CA-125 (a tumor marker) is sometimes elevated.
• Standard tests to check the person’s overall health prior to starting treatment.

Testing for Genetic/DNA Signals (if there is genetic history in the family)

• To look for hereditary conditions, for example Lynch syndrome which raises the risk of developing uterine cancer.

Uterine Cancer Treatment Options

Surgery (Primary Treatment)

The majority of women with uterine cancer will have surgery as the initial treatment.

Types of Surgery:

• Total Hysterectomy: Hysterectomy with removal of the uterus (most common type)
• Bilateral Salpingo-Oophorectomy (BSO): Removal of ovaries and both fallopian tubes
• Lymph Node Dissection: To ensure there is no cancer spread
• Minimally invasive (laparoscopic or robotic) surgery may be utilized in the early stages

Radiation Therapy

Used post-surgery to reduce the chance of coming back or as an alternative to surgery in women who are not fit for an operation.

Types:

• External Beam Radiation Therapy (EBRT): Aims at cancer from the outside of the body
• Brachytherapy (Internal Radiation): Radioactive materials are put inside the vagina or the uterus

Hormone Therapy

• Used predominantly for early cancer in women who desire to preserve fertility or in advanced/recurrent cancers.

Chemotherapy

• Utilized for advanced, aggressive, or recurrent endometrial cancers, particularly high-grade or non-endometrioid ones such as serous carcinoma.

Targeted Therapy

• Utilized for tumors with unique mutations or genetic makeup.

Immunotherapy

• Utilized for recurrent or advanced endometrial cancers with MSI-H (microsatellite instability-high) or mismatch repair deficiency (dMMR).

Uterine Cancer Survival Rate

For endometrial (uterine) cancer, the 5-year survival rate is over 90%, so more than 90 out of every 100 diagnosed women survive for that period. More cases being diagnosed at an early stage accounts for the large number of survivors.

Uterine Cancer vs Endometrial Cancer

Uterine Cancer

• Cancer that starts in the uterus (which is the hollow organ with a shape like a pear where a pregnancy occurs).
• Features many different forms of cancer.

Types of Tumors Found in the Uterus:

Endometrium Cancer

• It commences when cells in the endometrium (that covers the inside of the uterus) start to change.

Uterine Sarcoma (a rare form)

• Begins growing in the muscle or surrounding tissue of the uterus (the myometrium).
• Being more aggressive, they are more difficult for doctors to handle.

Endometrial Cancer

• One subcategory within uterine cancer.
• Begins inside the uterine lining (endometrium).
• Happens most often after menopause.
• Most often develops slowly and is discovered early through unusual bleeding.

How fast does uterine cancer grow?

The speed of uterine cancer growth depends on what type it is, how severe it is and its progress. Here is the general understanding:

How types are characterized and how fast they develop?

Endometrial cancer (~90%) 

• It normally grows slowly, most noticeably in the beginning.
• Early detection usually occurs when abnormal bleeding from the vagina appears such as after menopause.
• A low-grade tumor (Grade 1) grows at a slow rate and usually does not spread to other areas.
• High-grade tumors (Grade 3) expand rapidly and behave aggressively.

Uterine Sarcoma (Uncommon)

• Can develop from between the muscle and the walls of the uterus.
• It is more aggressive, grows faster and spreads more easily than endometrial cancer.
• Tends to spread (metastasize) easily in the early stages to the lungs, liver or abdomen.

Factors Affecting Uterine Cancer Treatment Cost in India

Uterine cancer treatment costs in India vary a lot and depend on various factors. The following are the most important factors that determine how much treatment costs:

• Stage and Type of Cancer
• Type of Treatment Required
• Hospital Type and Location
• Hospital Stay and Facilities
• Doctor’s Experience and Specialization
• Diagnostic and Preoperative Tests
• Post-Treatment Care
• Insurance Coverage and Medical Tourism Packages

Uterine Cancer and Fertility

Fertility in a woman may be strongly affected by uterine cancer, depending on which type it is, how advanced it is and how it is handled. Here is a thorough introduction:

How Uterine Cancer affect Fertility?

Cancer Location

• Many uterine cancers develop in the endometrium (lining of the uterus), whose main job is to help with pregnancy and fetus implantation.
• Natural pregnancy cannot happen if the uterus is damaged or removed.

Surgery (Hysterectomy)

• Total hysterectomy (collectively removing the uterus, fallopian tubes and ovaries) is the most standard and effective form of treatment.
• Fertility is taken away completely by the procedure.

Radiation Therapy

Radiation in the pelvis can harm the uterus and ovaries and as a result:

• Premature ovarian failure (POF)
• Damage to the uterus which makes it hard to carry a pregnancy
• Even if the ovaries are kept intact, the ability to conceive is normally greatly reduced.

Chemotherapy

• Can have a negative effect on a woman’s ovaries, mainly in young women.
• May result in infertility that goes away or is permanent, depending on the drugs given and the patient’s age.

Uterine Cancer Pain Location

The pain from uterine cancer might change a lot, depending on the cancer’s progress, tumor dimensions and spread. Even so, there are areas where injuries are seen more frequently:

Common Pain Locations in Uterine Cancer:

• Pelvic Pain or Pressure
• Lower Abdominal Pain    
• Back Pain
• Pain During Sexual Intercourse (Dyspareunia)
• Pain During Urination or Bowel Movements

Best Hospital for Uterine Cancer Treatment in India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket
• Apollo Hospital, Delhi

Uterine Cancer Treatment Best Doctors list/name

• Dr. Rupinder Sekhon
• Dr. Sabhyata Gupta
• Dr. Rama Joshi
• Dr. Kanika Batra Modi
• Dr. Amita Mahajan

Why Choose GetWellGo for Uterine Cancer Treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for uterine cancer treatment.
• Expert gynae oncologist with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food