How is uterine cancer diagnosed?

Gyneacologist: a doctor specialised to diagnose and treat dieseases of the female reproductive system

Gyneacologic oncologist: a doctor who is a specialist in treating cancer of the female reproductive system.

Oncologist: cancer specialist.

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If you have any of the symptoms mentioned in the previous post (i.e. abnormal vaginal bleeding), you should consult your doctor who will perform a general physical exam and a pelvic exam. Your doctor may also ask you about your symptoms, risk factors and family medical history. When your doctor sucpects of endometrial cancer, you will most likely be referred to a gyneacologist or a gyneacologic oncologist.

Some of the test that your doctor might perform for diagnosis:

Pap Test (Pap Smear)
A pap test is usually used to detect cervical cancer. It involves taking sample of cells from the cervix. It is usually not useful in detecting endometrial cancer because endometrial cancer begins inside your uterus and cells from inside the uterus do not show up in a pap test.

Endometrial Biopsy
This procudure is generally regarded as the first step in diagnosing endometrial cancer. The doctor will insert a narrow tube into the uterus through the vagina and suction out tissues from a few areas of the uterus lining. The tissue extracted will be examined under the microscope in the laboratory. This procudure usually will not take more than a few minutes. It can diagnose more than 90% of endometrial cancer.

Dilation and Currettage (D and C)
If the endometrial biopsy does not provide enough tissue, or if it suggest cancer, you'll likely be advised to undergo a D and C. This is an outpatient procudure and require general anesthesia (concious sedation). It will normally take an hour or so. During this procedure, the servix is dilated (widening) and an instrument called curette is inserted into the uterus through the vagina to try to get tissue samples to be examined under a microscope for cancer cells. You will be advised to stay in the hospital for a few hours or even overnight to recover. Few women will experience any discomfort after this procedure.

Transvaginal Ultrasound
Some patients with medical condition like diabetes, severe high blood pressure, obesity, etc. may not tolerate anesthesia and therefore will be advised for tranvaginal ultrasound to diagnose endometrial cancer.This test show how thick the lining of the uterus is. Ther procedure involve inserting an ultrasound probe into the vagina. If the lining of the uterus is 5mm or less, uterine cancer is unlikely.This also allows the doctor to see the abnormalities of the uterine lining more clearly.

If endometrial cancer is found, you'll need more test to determine whether the cancer has spread to other parts of your body (called staging: determine the extent of the cancer). These tests may include chest x-ray, a computerized tomography scan (CT scan)and a blood test.

When do women usually develop uterine cancer?

Menopause: The menopause is defined as the cessation of menstruation. It occurs around 45-55 years of age of a woman when the ovaries stops producing the female hormone, estrogen.

Menarche: The first menstrual period of a female.

Estrogen: The primary female sex hormone.

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Uterine cancer usually occur between the age of 50-70 years old (average age at diagnosis is 60 years old). Around 75% of cases occurs in post-menopausal (after menopause) women . It may also occur around the time menopause begins.

According to the National Cancer Institute (US), in the United States in 2007, approximately 39,080 new cases are diagnosed and about 7,400 women die from the disease.

The most common of uterine cancer is endometrial cancer. Even though endometrial cancer is the fourth most common cancer in women, following breast, lung, and colorectal cancer, in that order, it is only the eighth most common cause of cancer deaths because it is usually detected in early stages.
Uterine cancer can usually be detected early because the most common symptom is abnormal vaginal bleeding between menstrual periods or after menopause.

When should you see a doctor?
Consult your doctor if you have one or more of the following symptoms:

1) Abnormal vaginal bleeding/discharge (especially after menopause)
2) Painful or difficult urination
3) Painful intercourse
4) Pain in the pelvic area


What are the risk factors of uterine cancer? (What make you more likely to develop uterine cancer?):

1) Obese women
2) Women who have few or no children (nulliparity).
3) Women who began menstruating at a young age (early menarche).
4) Women who had a late menopause ( later than 52 years old)
5) Estrogen replacement theraphy (Hormone theraphy without opposing the estrogen with a progestrogen)
6) Diabetes
7) Hypertension
8) Tamoxifen (Breast cancer treatment)

Most of the risk factors for cancer of the uterus are related to hormones, especially excess estrogen.

What is Uterine Cancer?

Also called: Cancer of the uterus, cancer of the womb.

Cancer is a disease in which certain body cells becomes abnormal and divide itself very fast to produce too much tissue which forms a tumor. The uterus is the hollow, pear shaped organ in the lower abdomen where the baby grows if a women is pregnant.

Uterine cancer is the most common cancer of the female reproductive system. Other types of cancer of the female reporductive system are cervical cancer and ovarian cancer. There are two types of uterine cancers: endometrial cancer (which accounts for 90% of uterine cancer) and uterine sarcomas.

Endometrial cancer happens when cancer begins in the tissue lining the uterus (endometrium). Uterine sarcomas occur when cancer grows in the muscles or other supporting tissues in the uterus.


Endometrial cancer

Adenocarcinoma, which are more common during perimenopause (i.e., transitional years proceeding and following actual menopause) and usually are associated with an early onset of symptoms. It originates in surface cells of the endometrium, and accounts for 75%– 90% of all cases of endometrial cancer.

Other types of endometrial cancer include adenosquamous carcinoma, papillary serous carcinoma and clear cell carcinoma. These three types of endometrial cancer usually have poor prognosis (i.e. more likely to spread and recur).

Uterine sarcoma

Types of uterine sarcoma include carcinosarcoma (most common type), leiomyosarcoma (develop in the muscle layer of the uterus called the myometrium), and endometrial stromal sarcoma (develop in supporting connective tissue).