Unfortunately, over the past few decades, the number of women who develop cancerous tumors has increased significantly. One of the most common varieties is endometrial cancer of the uterus. Why is it dangerous? The stages of development, treatment and the chances of recovery will be discussed below.
Description of the problem
Endometrial cancer is a malignant tumor that occurs as a result of the growth of cancer cells in the uterine cavity. Most often, this pathology affects women after 45 years. This type of cancer can be treated well, especially if its symptoms have been identified at an early stage of development.
Reasons for the appearance
To date, official medicine does not have accurate data on the causes of the appearance of cancerous tumors. However, there are a number of factors conducive to the appearance of neoplasms:
- diseases of the reproductive system, including inflammation, which a woman encounters throughout her life;
- irregular menstrual cycle;
- the use of drugs that contain the hormone estrogen;
- genetic predisposition (for example, if there were women with cancer in the family, their relatives are at risk);
- promiscuous sexual intercourse, which can also lead to STDs;
- prolonged sexual abstinence;
- late pregnancy (after 30 years);
- abortions and other gynecological operations that involve curettage of the uterine cavity, as such interventions thin and damage the endometrium, thereby provoking malignant processes;
- early menopause (up to 50 years);
- early onset of menstruation (up to 12 years);
- history of diabetes mellitus;
- overweight;
- diseases of the immune system;
- absence or untimely treatment of gynecological diseases.
In addition, doctors note that women who have no children, as well as with hyperplasia, a disease that is not a malignant tumor, but which provokes the proliferation of endometrial cells, are at risk.
Varieties of pathology
There are two main types of uterine endometrial cancer:
- The hormone-dependent form occurs in 70% of all cases of the disease. Neoplasms can occur at the level of an increased hormone estrogen. As a rule, hyperplasia may occur before this. Hormonal failure can also develop in inflammatory diseases of the ovaries, as well as in the presence of a history of other types of cancerous tumors, most often in the chest.
- Autonomous endometrial cancer develops in the case of diseases of the endocrine system that violate its functions. This kind of pathology is most susceptible to women after 60 years with atrophy of endometrial tissues or suppression of the immune system. Autonomous cancer cannot be treated with hormonal drugs; removal of the internal genital organs is most often indicated, since there is a high risk of metastasis to other organs.
The correct treatment is selected depending on the type of cancer.
Manifestations of the disease
Symptoms of endometrial cancer develop gradually, depending on the stage of the disease. Also, their intensity depends on the presence or absence of concomitant pathologies of the genitourinary system. Unfortunately, at the initial stages, the symptoms and signs of cancer of the uterine endometrium are not specific, as a result of which a woman may not attach special importance to them. This is the insidiousness of the disease.
Symptoms of the disease include the following:
- atypical menstruation (too meager or plentiful, and also the duration of which is longer or shorter than usual, lack of menstruation);
- pain in the lower abdomen, which occurs for no apparent reason;
- problems with urination (their soreness, blood clots, difficulty);
- stool disorders (constipation or indigestion);
- vaginal discharge that has an unpleasant odor and an atypical color.
In subsequent stages, the pain syndrome may intensify with weight lifting, intimate life, during menstruation. The general condition also gradually worsens - appetite disappears, a painful skin tone appears, a woman rapidly loses weight, chronic bloating, constipation, weakness, drowsiness and a tendency to overwork, even with minor exertion, occur.
Stages of the disease
The development of pathology occurs gradually. Each of the stages of endometrial cancer has its own characteristics and characteristics:
- At stage 1, there are no clinical symptoms by which the presence of a tumor could be detected. The neoplasm itself is small and does not extend beyond the uterine cavity. In addition, there are malfunctions of the monthly cycle, and in most cases a woman loses the ability to become pregnant.
- Stage 2 is characterized by the growth of a tumor outside the uterus and damage to the mucous membrane of the cervical organ. A woman may experience symptoms of cancer of the uterine endometrium, such as spotting during sexual intercourse, an unreasonable deterioration in overall health, pain in the lower abdomen, and a decrease in appetite. In most cases, these manifestations are insignificant, so a woman may not pay attention to them. A gynecologist can detect a tumor during a routine examination.
- At stage 3, the symptoms and signs of endometrial cancer are much more pronounced. During this period, the tumor can spread to organs located in the abdominal cavity - the ovaries, fallopian tubes. At this stage of the disease, small foci of metastasis can be observed in nearby organs and bone tissue.
- At the 4th stage of uterine endometrial cancer, the neoplasm affects the organs of the small pelvis - the rectum, bladder, vagina, and urinary ducts. Cancer cells spread throughout the body, so metastases can occur in any internal organ. Signs of endometrial cancer in the last stage are pronounced and significantly impede the normal functioning of a woman.
Survival directly depends on at what stage of the disease the therapy was started. So, for example, the prognosis for stages 1 or 2 of the cancer is much more favorable than for the 3rd and 4th degrees of damage to the body.
Cancer spread
At the 3 stages of the development of the disease, metastases in neighboring organs begin to appear. This can happen in several ways:
- The lymphogenous pathway involves the spread of cancer cells through the lymph nodes. At the same time, they significantly increase in size and become painful when touched.
- The hematogenous pathway is observed when cancer cells enter the bloodstream and spread with it throughout the body. At the same time, pathogenic cells can settle absolutely in any organ or bone tissue and begin their reproduction.
- Implantation metastasis involves the growth of a tumor in nearby organs, as well as bone and adipose tissue.
Unfortunately, those stages of cancer that are characterized by the presence of metastases in other organs cannot be cured. Therapy in such cases is aimed at reducing the pain syndrome, as well as at slowing down the division of cancer cells and the spread of metastases in healthy organs.
Factors Contributing to Metastasis
The risk of cancer cells sprouting into other organs depends not only on the stage of the disease, but also on such moments:
- localization of the neoplasm in the organ;
- woman's age (the older the patient, the higher the likelihood of metastases);
- the degree of differentiation of the neoplasm (the composition of the tumor from different cells that have a greater or lesser rate of reproduction).
These and other factors that may affect the course of cancer treatment are clarified during clinical trials.
Diagnosis of the disease
It is very important not to neglect regular preventive examinations by a gynecologist, since only a competent specialist can detect cancer in the initial stages of the disease. Diagnosis of endometrial cancer involves the following measures:
- A medical survey in which the patient must describe in detail the complaints and report the duration of the unpleasant symptoms, if any. In addition, it is important to give the doctor detailed information about the menstrual cycle - its regularity, soreness, profusion, duration.
- An analysis of the patient’s gynecological card provides information on previous gynecological diseases, childbirth and other factors that could affect the onset of the tumor.
- Gynecological examination on a chair with palpation of the external and internal genital organs and, in particular, the cervix.
- Transvaginal ultrasound helps to identify the neoplasm, assess its condition and size, as well as its location.
- Biopsy for a detailed study of uterine tissue. It is taken with an aspirator, which is inserted into the uterine cavity and absorbs part of the endometrium of the organ.
- Hysteroscopy - an internal examination of the state of the uterus using a hysteroscope - an apparatus in the form of a hard or soft tube with a lens system and a lighting device at the end. The device is inserted into the uterine cavity, which allows the doctor to examine the organ in detail from the inside. This device also allows you to take part of the affected endometrium for further research.
- A fluorescence study makes it possible to detect a neoplasm in the early stages. For this, a fluorescent solution is injected into the uterine cavity. Cancer cells actively absorb it and become noticeable to the doctor.
- Computed or magnetic resonance imaging, as well as an x-ray, is prescribed in case of suspected metastasis to other internal organs.
In addition, women with suspected cancer of the uterine endometrium are prescribed blood or urine tests for tumor markers.
Uterine Cancer Therapy
Different treatment is prescribed depending on the degree of development of the disease. Often, complex methods are used:
- Surgical intervention that involves removal of the uterus. In some cases, the organ is removed along with the appendages and lymph nodes, if they are affected by cancerous changes. To date, for the treatment of endometrial cancer at an early stage, laparoscopy is used, which is less traumatic. However, with a large area of organ damage, abdominal surgery is required, which is performed by dissecting the abdominal cavity.
- Radiation therapy involves the effect of ionizing radiation on the cancer area. Often it is used in combination with a surgical operation. If removal for some reason is not expected, then brachytherapy is possible - implantation of a radiation source into the tumor. Thus, irradiation of other organs is minimized.
- Chemotherapy is considered the most common cancer control method of any kind. It is used for widespread cancer. The most commonly used drug complex of substances such as cisplatin, doxorubicin, cyclophosphamide. Unfortunately, this technique has many side effects: alopecia (baldness), osteoporosis, nausea, vomiting, diarrhea.
- Hormone therapy is indicated when progesterone hormone receptors are detected in the tumor. Such treatment is selected individually by a doctor oncologist. Its advantage is the absence of side effects. However, if the tumor does not show a reaction to hormones, then such treatment is ineffective.
Signs of cancer of the uterine endometrium can significantly impair the quality of life, or even shorten it. That is why it is important to begin treatment at the initial stage, when the disease is most susceptible to complete cure.
Forecast
The chances of a complete cure for cancer completely depend on the stage of the disease, as well as on the correctly prescribed treatment complex. Survival with a highly differentiated tumor (developed cells that do not tend to grow too fast) is about 95%, and with a low-differentiated neoplasm (immature stem cells that divide very quickly) only 18%. A type of neoplasm is determined at the stage of diagnosis.
Unfortunately, at stage 4 of the cancer, the survival rate is extremely small, and all treatment is reduced to maintaining the patient’s condition, reducing the symptoms of endometrial cancer, as well as slowing down the division of cancer cells and metastasis of other internal organs.
Within three years after the end of treatment, all patients without exception need to undergo a full diagnosis twice a year, which includes a gynecological examination, ultrasound diagnosis, x-ray, urine and blood tests. This is necessary to prevent recurrence of the disease or its timely detection.
Pathology Prevention
Unfortunately, to date, there are no methods that could completely exclude the possibility of the formation of malignant tumors. However, there are factors that can minimize their appearance:
- Weight control and preventing overweight.
- Elimination of bad habits, such as smoking and drinking alcohol.
- Regular treatment of chronic diseases and preventing their progression.
- Timely therapy for gynecological problems.
Secondary prevention includes the timely detection of malignant tumors and the choice of the right therapy.