One of the most insidious diseases in women is uterine sarcoma. The prognosis of life with this ailment varies depending on the stage of the pathological process. However, most often it is disappointing. Five-year survival at the initial stage is 47% of all cases. If a cancer is detected in the fourth stage, only 10%. There is no need to talk about positive dynamics even with timely diagnosis and proper treatment.
Disease Description
Uterine sarcoma is a rare but insidious pathology. The neoplasm is formed from undifferentiated elements of the endometrium or myometrium. Cancer occurs in women of all ages, including young girls. It manifests itself in cyclical bleeding, pain in the abdomen, general malaise. Sarcoma is difficult to diagnose in the initial stages of development. The answer to the question of complete recovery depends on the stage of the pathological process, the age of the patient and her state of health. All forms of the disease are characterized by a high degree of malignancy. Therefore, they are difficult to treat.
Uterine Sarcoma Forms
Depending on the location of the malignant cells, the following forms of the disease are distinguished:
- Leymosarcoma is the most aggressive tumor, which can reach a diameter of 5 cm. It is formed exclusively in the soft tissues of the myometrium.
- Endometrial stromal sarcoma develops in the connective support structure of the uterus, is extremely rare (only 1% of all cases of malignant lesions). Two categories of tumors are distinguished: poor-quality and undifferentiated. In the first case, the neoplasm is practically safe for life, slowly progressing. An undifferentiated tumor is accompanied by poor health, which affects the patient's condition.
- Carcinosarcoma forms in the endometrium.
Many people confuse two diseases: uterine sarcoma and cancer. In fact, these are completely different pathologies. Cancers are formed from elements of the epithelium, and sarcomas affect only the connective tissue.
The causes of cancer
Uterine sarcoma refers to pathologies of complex etiology. Scientists put forward several versions explaining its origin. Most of them are sure that the disease develops under the influence of a whole group of factors. This can be a malfunction in the hormonal system or numerous injuries of the uterine body, unsuccessful abdominal surgery, abortion, or any other intervention.
The disease also occurs against the background of embryonic development problems. An equally dangerous factor is the pathological proliferation of endometrial tissues. The development of pathology sometimes leads to improper healing of the site, the removal of the polyp or the fusion of several formations. Neuroendocrine disorders are another cause of sarcoma. A significant role in predisposing factors is given to bad habits, drug abuse. Doctors should be alert and abrupt cessation of ovulation.
Who is at risk?
Gynecologists try to draw the attention of women to the prevention of sarcoma, since it is extremely rare to completely cure this pathology. First of all, it is indicated to those who are in the so-called risk group. These are women:
- suffering from polycystic ovary (the disease provokes hormonal imbalance);
- suffering from breast cancer;
- never giving birth;
- survivors of late menopause (menopause after a 50-year milestone).
A huge role in this matter belongs to hereditary predisposition. It is recommended to monitor the state of health with special attention for women after 40 years of age, whose close relatives were diagnosed with tumor diseases, including uterine sarcoma.
Symptoms and signs of the disease
Very often, sarcoma is called a mute pathology, since there are no obvious signs of it at the initial stage of development. Women are in no hurry to seek help from a doctor, perceiving a worsening condition for stress or less serious illnesses. Even in the later stages of the sarcoma, it may not show characteristic symptoms, continuing to increase in size or mask under fibromyoma.
As the disease progresses and depending on the specific localization of the pathological process, a menstrual cycle is noted. Women complain of pain in the lower abdomen, copious discharge with putrid odor. Appetite also disappears, the skin acquires a yellowish tint. In blood tests, changes are clearly visible.
Late manifestations of sarcoma lead to anemia, persistent weakness, and ascites. Due to metastasis, pleurisy develops in the lungs, and jaundice develops in the liver. The penetration of malignant cells into the spine is accompanied by the appearance of pain in its various departments.
During a gynecological examination, for the purpose of prevention, doctors often diagnose uterine sarcoma. Signs indicating the beginning of the pathological process may be absent. Such a combination of circumstances is considered successful, since timely treatment at times increases the chances of a positive outcome. Gynecologists regularly recall the importance of periodic examinations of women after 40 years, especially before the onset of menopause.
Stages of Sarcoma Development
The disease is characterized by slow development.
- At the initial stage, the sarcoma is a small tumor. It can be limited to the mucous or muscle layer.
- In the second stage, the tumor grows in size, but does not go beyond the uterus. Partial organ infiltration also occurs.
- At the third stage, the neoplasm grows into the body of the uterus, but remains within the pelvis. Sometimes there is metastasis to the ovaries, regional lymph nodes. At this stage, the disease of the uterine sarcoma begins to manifest characteristic symptoms, if they were absent until that moment.
- The fourth stage is the period of tumor decay and the formation of metastases. Secondary lesions spread to any system of internal organs, affecting the lungs and bone marrow.
Diagnostic Methods
The detection of sarcoma in the initial stages is often difficult due to the absence of obvious symptoms. At the initial consultation with the gynecologist, an anamnesis and related data on cases of oncological pathologies in the closest relatives are found out. Gynecological examination allows you to identify changes in the color of the cervix, to detect signs of neoplasm. Then a series of laboratory and hardware tests are prescribed (blood test, CT scan, MRI, hysteroscopy and ultrasound of the internal organs).
Differential diagnosis of uterine sarcoma eliminates diseases with a similar clinical picture. These include ovarian tumors, benign genital formations, endometrial polyps. Confirmation of the final diagnosis is not possible without a biopsy. During this procedure, the tissue of the tumor is examined under laboratory conditions.
Sarcoma metastases
The neoplasm can scatter metastases along with blood flow, and also grow into adjacent organs. How is the spread of malignant elements? Sarcoma throws its particles into the blood, from where they penetrate the respiratory and skeletal systems, external genitalia. In this case, most often the lesion affects the left side of the lungs. Malignant cells often penetrate the appendages. This complication is usually found with a diagnosis of uterine endometrial sarcoma. Metastases quickly migrate throughout the body, which can cause a fatal outcome.
Treatment options
In medical practice, several methods are used to treat uterine sarcoma. Most often, patients are offered a combined option, which includes surgical intervention and chemoradiotherapy. The operation is carried out only at the initial stages of the pathological process. It allows you to determine the stage of the disease and remove the neoplasm. The amount of intervention depends on the location of the tumor and its size. In the best case, the uterus with appendages is removed, and in the worst, all adjacent organs are removed. In advanced cases, only one surgical intervention will not be enough. Regarding the issue of radiation therapy, today it is one of the most effective options for combating uterine sarcoma disease. The prognosis in this case may also be disappointing. It is prescribed to destroy scattered cancer cells.
Chemotherapy
Chemotherapy courses for uterine sarcoma involve the use of anthracyclines (Idarubicin, Doscorubicin, Epirubicin). These are the so-called antitumor antibiotics. Currently, specialists are actively studying the effect of the drug "Ifosfamide", its use both in monotherapy and in combination with other medicines. With chemotherapy, positive dynamics are observed in 30% of patients.
The use of combination treatment is much more effective, but it has a number of side effects. Positive dynamics is observed from the combination therapy of “Docetaxel” and “Gemcitabine”. It is usually reused for relapses.
What other drugs are used to diagnose uterine sarcoma? Treatment with hormonal drugs is justified only with a low degree of malignancy of the neoplasm.
Forecast
What is the prognosis of uterine sarcoma? Photos of patients who managed to survive this insidious disease inspire hope. However, in most cases, the outcome of the pathology is unfavorable, the probability of relapse is high. What does statistics say about this?
With timely diagnosis of the tumor and surgery, the probability of relapse is 65%. If sarcoma is detected in the later stages, the chances of a re-development of the pathological process are 90%. As a rule, the patient's life expectancy after surgery is 2 years. Statistics confirm that five-year survival after sarcoma treatment is observed only in 40% of cases.
Depending on the stage of the disease, this picture may look like this:
- first stage - 47%;
- second stage - 44%;
- the third stage - 40%;
- the fourth stage - 10%.
However, this is just a study, during which scientists recorded cases of a favorable outcome after treatment of uterine sarcoma. It is hard to say how many patients live with such a diagnosis. When answering this question, it is necessary to know the stage of the disease, the treatment carried out, and cases of relapse. A favorable course is characterized only by those sarcomas that are formed from fibromatous nodes. And in this case, timely diagnosis and treatment is required.
Preventive measures
How to prevent the development of this dangerous disease? First of all, experts recommend to undergo a gynecological examination annually. It is also necessary to follow the doctor’s instructions in the treatment of “female” diseases, especially those related to hormonal disorders. A special role in prevention is given to the issue of pregnancy. Doctors do not recommend delaying the planning of the baby. If for any reason you do not want to try on the role of a mother, you should use contraception and avoid abortion. It is impossible not to mention proper nutrition. The diet should consist mainly of fresh vegetables and fruits. And the amount of animal fats is better to limit. Refuse addictions, spend more time in the fresh air and play sports.
Conclusion
The attention of scientists and doctors is still attracting such a rare disease as uterine sarcoma. The prognosis of life with this ailment cannot be predicted. Although sarcoma is a rare disease, it is on the list of aggressive malignant neoplasms. Even with timely and competent treatment, one can not hope for a positive trend. Pathology can occur in women of all ages. If atypical symptoms and malaise appear, consult a doctor. It is even better to undergo preventive examinations annually. Be healthy!