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Uterine Cancer

Uterine Cancer - What it is

Uterine cancer arises from the uterus or womb. The uterus comprises of 2 layers - the uterine lining and the muscle layer. The uterine lining is also known as the endometrium. It comprises of many blood vessels and go through phases of increasing thickness before being shed as monthly menses.

The most common type of uterine cancer are those arising from the endometrium known as carcinoma whereas those arising from the muscle are known as sarcoma (rare).

How common is Endometrium Cancer?

There are about 454 cases diagnosed annually according to the Singapore Cancer Registry 2011-2015. It is the 4th most common women’s cancer and most common female genital tract cancer in Singapore.

Age of Onset

Endometrial cancer can affect women of any age, although in 70% of cases, endometrial cancer occurs after the age of 50 years.

Uterine Cancer - Symptoms

 

The main clinical sign is abnormal vaginal bleeding (e.g. post menopausal bleeding, irregular menstrual bleeding, menorrhagia) or vaginal discharge and occasionally pelvic pain.

Although there may be other reasons that can cause vaginal bleeding, such as cervix infection or trauma, you should seek early medical attention. Many cancers of the uterus and cervix do present with bleeding. If detected and treated early, there is a higher chance of cure.

Uterine Cancer - How to prevent?

Uterine Cancer - Causes and Risk Factors

 
In about 40% of patients, no risk factors are identified.

Factors associated with endometrium cancer include obesity and diabetes mellitus. Unopposed oestrogen stimulation e.g. oestrogen-only pills is a strong risk factor. Patients with the condition called polycystic ovarian syndrome are also at risk.

Uterine Cancer - Diagnosis

Ultrasound of the pelvis is useful to demonstrate whether there is any abnormality (e.g. thickening) of the endometrium. However, to diagnose endometrial cancer, an endometrial biopsy is necessary. This can be achieved via outpatient aspiration of endometrial contents (e.g. pipelle or Explora endometrial sampling devices) or as a minor day surgical procedure called dilatation and curettage with hysteroscopy. Specimens of the endometrial biopsy are sent for microscopic analysis.

Uterine Cancer - Treatments

 
The mainstay of treatment for uterine cancer is surgical removal of the uterus with fallopian tubes and ovaries as well as the draining lymphatics. It will also allow the doctors to assess the extent of spread of the cancer (stage of the cancer). Following the surgery, additional or adjuvant treatment such as radiotherapy, hormonal treatment or chemotherapy may or may not be required depending on the stage, grade and subtype of cancer.

Prognosis of Endometrium Cancer

The overall prognosis of endometrial cancer is good if diagnosed in the early stage.

Uterine Cancer - Preparing for surgery

Uterine Cancer - Post-surgery care

Uterine Cancer - Other Information

 
I am on hormone replacement therapy. Is there any risk of getting cancer?

Studies show that combined hormone replacement therapy, known as HRT in short (progestin and oestrogen) may help menopause symptoms in women who still have a uterus without increasing their risk of endometrial cancer. Before starting, you should ask your doctor, who knows your personal medical history, for the risks and benefits of the therapy.

American Cancer Society http://www.cancer.org
National Cancer Institute http://www.nci.nih.gov
Information about post-menopause hormone use www.cancer.gov/clinicaltrials/digest-postmenopausal-hormone-use
Information about menopause www.womenshealth.gov/Menopause/

For further enquiries on uterus cancer, please call the Cancer Helpline at (65) 6225 5655 or email to cancerhelpline@nccs.com.sg.
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