Uterine Cancer

The uterus, also known as the womb, is a hollow, pear-shaped organ located between the rectum and the bladder. The uterus is made of three sections: the top section known as the fundus, the middle section known as the isthmus and the lower section known as the cervix. There are two layers of tissue within the uterus. The first is the inner layer called the endometrium, and the outer layer comprised of muscle tissue known as the myometrium.

When considering cancers within a women’s reproductive system, uterine cancer is the most common. This cancer can begin when the uterine cells rapidly change and group uncontrollably, leading to a tumour growth that can be either benign, meaning it can grow in size but will not spread to other tissues, or cancerous, meaning it can spread and grow throughout the body.

Cancerous uterine conditions

• Adenocarcinoma accounts for approximately 80% of all uterine cancers in women. Developing from cells in the endometrium it is most commonly dubbed endometrial cancer. Endometrioid carcinoma is a common endometrial adenocarcinoma, while other types such as serous, clear cell and carcinosarcoma are less common adenocarcinoma cancers.
• Sarcoma makes up approximately 2-4% of all uterine cancers. This type of uterine cancer begins in the tissues that support the uterine glands or in the myometrium – the uterine muscle. Common types of endometrial sarcomas include endometrial stromal sarcoma, leiomyosarcoma and undifferentiated sarcoma.

Non-cancerous uterine conditions

• Fibroids are benign tumours within the uterine muscles
• Benign polyps are growths that occur within the lining of a woman’s uterus
• Endometriosis is the occurrence of the lining of the uterus, known as endometrial tissues, being found on the outside of the uterus or on surrounding organs.
• Endometrial hyperplasia is the increased number of cells within the uterine lining, leading to a higher risk of developing cancer when atypical cells and complex glands are present. Within a woman with endometrial hyperplasia, normal cells or atypical cells can be found, as well as simple or complex glandular structures. It is this combination that will determine the risk of cancer.

Genetics and Uterine Cancer

Uterine cancer is a disease that can be passed on from generation to generation. Lynch syndrome is a uterine cancer that is most commonly inherited from genetics within a family. Lynch syndrome has also been linked to other types of cancer including ovarian, bladder, colon and kidney cancers.

The amin sign of Lynch syndrome is dMMR – DNA mismatch repair defect. This occurs when multiplying cells create an error that are typically fixed by 6 proteins within the body. If a protein is damaged, DNA can accumulate this damaged DNA and pass it through the generations. This is how genetic cancer is spread.

If you have a family history of uterine cancer, you and your family members can be tested through a process called immunohistochemistry (IHC). This process examines your cells and can verify if you are missing one or more of these DNA repair proteins. If you have a family history of uterine cancer, you can be screened through more intensive screening measures. It is also possible for you and your family members to elect to have preventative surgery for uterine cancer. If you test positive for uterine cancer, you can also be tested for Lynch syndrome to help identify this DNA mishap in your family.

Signs and Symptoms of Uterine Cancer

There are several possible symptoms of uterine cancer. A patient may experience a range of these, or none at all. There are other reasons that a person may experience these symptoms, so it is important to note that if these occur this does not solely indicate cancer. It is important to speak with your doctor if you have any of the following:

• Abnormal Pap test results
• Pelvic pain
• Unusual vaginal bleeding or discharge.

All symptoms should be discussed with your doctor as they may provide some insight into an underlying condition. If/when cancer is diagnosed, one of the major treatments will be palliative care. This care works to relieve a patient from their symptoms and helps them live a more comfortable life whilst living with cancer.