Uterine Cancer Treatment in Faridabad, Delhi NCR, India

Overview

Uterine cancer, commonly known as endometrial cancer, involves the abnormal growth of cells in the uterus, the organ where fetal development occurs. It primarily manifests as two types:

• Endometrial Cancer: The most prevalent type, originating in the lining of the uterus (endometrium).
• Uterine Sarcoma: A rarer, more aggressive form that develops in the muscle or connective tissue of the uterus.

Associated Anatomy

Uterine cancer specifically affects the uterus, also known as the womb, which is central to female reproductive health.

Symptoms of Uterine Cancer

Early detection is crucial for effective treatment. Key symptoms to watch for include:

• Excessive Menstrual Bleeding: Heavy bleeding during periods or between cycles.
• Postmenopausal Bleeding: Spotting or prolonged bleeding after menopause.
• Abnormal Vaginal Discharge: Particularly in postmenopausal women, discharge that is watery or blood-tinged.
• Pelvic Pain: Persistent cramps or pain in the pelvic region.
• Painful Urination: Discomfort and blood-tinged urine.
• Bowel Movement Difficulties: Trouble during bowel movements.
• Lower Back and Leg Pain: Frequent pain in these areas.
• Discomfort During Intercourse: Pain during sexual activity.
• Unexplained Weight Loss: Sudden loss of weight and a decrease in appetite.

Causes of Uterine Cancer

Uterine cancer typically arises from:

• DNA Mutations: Changes in the DNA of endometrial cells can lead to abnormal cell growth, forming tumors that may spread to other organs.
• High Estrogen Levels: Estrogen regulates uterine tissue growth. Abnormally high estrogen levels, without sufficient progesterone, can cause excessive endometrial cell proliferation, leading to cancer.

Stages of Uterine Cancer

• Stage I: Cancer is localized within the uterus and has not spread beyond its confines.

• Stage II: Cancer has spread to the cervical tissue.
• Stage III: Cancer has extended to the fallopian tubes, ovaries, vagina, or nearby lymph nodes but remains within the pelvic region.
• Stage IV: Cancer has spread to the bladder, rectum, or distant organs like the liver or lungs.

Diagnosis and Testing for Uterine Cancer

To diagnose uterine cancer, a range of tests may be employed after an initial pelvic exam and symptom assessment:

• Transvaginal Ultrasound: Imaging to assess the uterus.
• Hysteroscopy: A visual examination of the uterine lining.
• Endometrial Biopsy: Tissue sampling for cancer cell analysis.
• Dilation and Curettage (D&C): Scraping of the uterine lining to test for cancer.
• CT and MRI Scans: Advanced imaging to check for tumor spread.
• CA-125 Assay: Blood test to detect cancer markers.
• Complete Blood Count (CBC): General health assessment.

Treatment Options for Uterine Cancer

• Surgery: The primary treatment is a hysterectomy, which may include the removal of fallopian tubes and ovaries. Minimally invasive techniques like laparoscopy and robotic-assisted surgery are often used.
• Radiation Therapy: High-energy radiation is used, especially in advanced stages, to prevent cancer recurrence.
• Chemotherapy: Administered intravenously or orally to kill cancer cells, either pre-surgery to shrink tumors or post-surgery to prevent recurrence.
• Hormone Therapy: High-dose progesterone is introduced to counteract estrogen, slowing cancer growth before surgery.
• Targeted Therapy: Drugs that specifically target cancer cells, often used alongside radiation and chemotherapy.
• Immunotherapy: Drugs that boost the immune system’s ability to fight cancer by blocking proteins that inhibit immune response.
• Palliative Care: Focuses on symptom management and improving quality of life for those living with cancer.

Risk Factors for Uterine Cancer

• Age: Increased risk for women over 45.
• Genetic Predisposition: Family history of endometrial, breast, or colorectal cancer.
• Obesity: Higher BMI can stimulate excess estrogen production.
• Menstrual Irregularities: Early menarche, late menopause, or erratic periods increase risk.
• Diabetes and Hypertension: Often linked to obesity, these conditions raise cancer risk.
• Past Cancer History: History of ovarian, colon, or breast cancer, and PCOS.
• Diet and Inactivity: High-fat diets and lack of exercise.
• Hormone Therapy: Use of tamoxifen or menopausal estrogen therapy can elevate estrogen levels.
• Radiation Exposure: Previous radiation therapy can damage DNA, increasing cancer risk.

Possible Complications of Uterine Cancer

• Uterine Perforation: A potential risk during D&C or biopsy procedures.
• Anemia: Due to excessive blood loss.
• Radiation Complications: Vaginal atrophy and bladder fistulas may occur.

Prevention Strategies for Uterine Cancer

• Primary Prevention:
  • Weight Management: Maintain a healthy BMI below 25.
  • Healthy Diet: Include vegetables and reduce fat intake.
  • Active Lifestyle: Regular exercise to prevent obesity-related diseases.
  • Estrogen Regulation: Use oral contraceptives or progestin-enriched IUDs.
  • Breastfeeding: Reduces estrogen levels naturally.
• Secondary Prevention:
  • Regular Checkups: Early detection through regular screenings, especially for those with PCOS or unusual vaginal bleeding.
  • Prophylactic Surgery: Consider hysterectomy for those with a strong family history of gynecological cancers.

Diagnosis Differentials for Uterine Cancer

• Pre-Menopausal Women: Conditions like fibroids, endometriosis, adenomyosis, and ovulatory dysfunction.
• Post-Menopausal Women: Endometrial atrophy, hyperplasia, atrophic vaginitis, and cervical polyps.

Prognosis for Uterine Cancer

• Expected Outcomes: The five-year survival rate is 93% for localized tumors and 85% for non-localized tumors, varying from one year to over 10 years depending on the stage.
• Disease Progression: Untreated uterine cancer can spread to nearby organs and distant sites, increasing mortality if not managed.

Epidemiology of Uterine Cancer

• Global Prevalence: Uterine cancer is the sixth most common cancer in women worldwide, with lower prevalence in India compared to Western countries.
• Incidence Rate: In Delhi, the incidence rate is 4.3 per 100,000 women.

Pathophysiology of Uterine Cancer

• Genetic Mutations: DNA changes and protein secretion can lead to endometrial hyperplasia and adenocarcinoma. Mutations in the FGFR2 protein are linked to approximately 12% of uterine carcinoma cases.