Uterine corpus cancer is the most prevalent gynecological malignancy in the United States. This cancer originates in the uterine corpus, the main body of the uterus. Early detection is important for effective management. This article provides an overview of its signs, diagnosis, staging, and treatment options.
Understanding Uterine Corpus Cancer
Uterine corpus cancer refers to malignancies that develop in the main body of the uterus. The most common form is endometrial cancer, which arises from the endometrium, the inner lining of the uterus. Endometrial cancer accounts for over 80% of uterine corpus cancer cases, making it the most frequently diagnosed gynecologic cancer. Less common but more aggressive types, such as uterine sarcomas, originate in the muscular wall (myometrium) or connective tissue of the uterus.
Several factors can increase the likelihood of developing uterine corpus cancer. Age is a primary risk factor, with most diagnoses occurring after menopause, typically around age 60. Obesity is a significant contributor, as it can lead to increased estrogen exposure, which fuels the growth of many endometrial cancers. Other hormonal factors, such as unopposed estrogen therapy, and certain genetic syndromes like Lynch syndrome, also elevate risk. Additionally, conditions like diabetes and high blood pressure are associated with an increased risk.
Recognizing the Signs
The most common symptom is abnormal vaginal bleeding. This can manifest as bleeding or spotting after menopause, which warrants immediate medical attention. For individuals still menstruating, abnormal bleeding might include unusually heavy or prolonged periods, or bleeding between cycles.
Other potential indicators include unusual vaginal discharge that could be watery, blood-tinged, or foul-smelling. Some individuals might experience pelvic pain or pressure, discomfort during intercourse, or changes in urinary or bowel habits. While these symptoms can indicate other less serious conditions, their presence, particularly abnormal bleeding, should prompt a visit to a healthcare provider for evaluation.
Diagnosis and Staging
Diagnosis typically begins with a thorough medical history and a pelvic examination. Imaging tests like transvaginal ultrasound are often used to visualize the uterus and assess endometrial thickness. While these can identify potential issues, they are not definitive for cancer.
The most accurate diagnostic method is an endometrial biopsy, where a small tissue sample is taken from the uterine lining for microscopic examination. This procedure can often be done in a doctor’s office. If the biopsy is inconclusive or insufficient, a dilation and curettage (D&C) might be performed, involving scraping tissue from the uterine lining under anesthesia. Once cancer is confirmed, staging determines the disease’s extent, guiding treatment decisions and prognosis. Staging systems, such as the FIGO system, classify cancer into stages I through IV, indicating whether it is confined to the uterus, has spread to nearby structures like the cervix or lymph nodes, or has metastasized to distant organs.
Treatment Approaches
Treatment for uterine corpus cancer is highly individualized, depending on the cancer type, stage, and the patient’s overall health. Surgery is the primary treatment for most cases, especially for early-stage disease. A hysterectomy, which involves removing the uterus, is commonly performed. This often includes a total hysterectomy (removal of the uterus and cervix) or a radical hysterectomy (removal of the uterus, cervix, and surrounding tissues). The fallopian tubes and ovaries are also frequently removed in a bilateral salpingo-oophorectomy. Lymph node dissection, removing nearby lymph nodes, is often part of surgery to check for cancer spread and determine stage.
Following surgery, or as a standalone treatment for advanced or inoperable cases, adjuvant therapies may be utilized to eliminate remaining cancer cells and reduce recurrence risk. Radiation therapy uses high-energy rays to destroy cancer cells, delivered either externally (external beam radiation therapy) or internally (brachytherapy). Chemotherapy involves powerful drugs administered intravenously or orally to kill cancer cells throughout the body, often used for more aggressive or widespread disease.
Hormone therapy is another option, particularly for hormone-sensitive endometrial cancers, using medications like progestins to slow cancer cell growth by altering hormone levels. Targeted therapies focus on specific molecules involved in cancer growth, while immunotherapies leverage the body’s own immune system to fight cancer cells. These treatments offer additional options for advanced or recurrent cancers.
Prevention and Outlook
While not all cases of uterine corpus cancer are preventable, certain lifestyle adjustments can help reduce risk. Maintaining a healthy weight is important, as obesity is a significant risk factor due to its impact on estrogen levels. Managing conditions like diabetes and high blood pressure also contributes to risk reduction. Regular gynecological check-ups and promptly reporting any unusual symptoms, especially abnormal vaginal bleeding, are crucial for early detection.
The outlook for individuals diagnosed with uterine corpus cancer generally depends on the stage at which the cancer is discovered and the specific type. Most cases are diagnosed at an early stage, when the cancer is confined to the uterus, leading to a favorable prognosis. The five-year survival rate for endometrial cancer is approximately 81%, with higher rates for early-stage diagnoses. Following treatment, regular follow-up care is essential to monitor for recurrence and manage any long-term effects.