Understanding Uterine Cancer: Symptoms and Diagnosis

Uterine cancer, often referred to as endometrial cancer, is a significant health concern among Indian women. This type of cancer takes root when normal cells in the uterus begin to change and grow uncontrollably, forming a mass called a tumour. The two predominant types of uterine cancer are endometrial cancer (adenocarcinoma), the most widespread, and the rarer uterine sarcoma.

India reported 16,413 fresh cases and tragically 6,385 lives were lost to endometrial cancer. These figures reflect the increasing prevalence of uterine cancer across the country. Early detection facilitates immediate intervention and relevant treatment options, boosting recovery rates considerably.

Common Early Symptoms of Uterine Cancer

Uterine cancer manifests through a variety of early symptoms. Recognising these symptoms is crucial to prompt a timely consultation with a doctor for further examination. The common early symptoms of uterine cancer range from pelvic or lower abdominal pain, unusual vaginal bleeding before or after menopause, peculiar postmenopausal vaginal discharge, discomfort during intercourse, to changes in menstrual patterns.

Pelvic or Lower Abdominal Pain

Unusual pelvic or lower abdominal pain can sometimes indicate the presence of uterine cancer. The pain may be:

• A sense of heaviness or pressure in the pelvic region
• Distinct pain that doesn't seem connected to the menstrual cycle
• Persistent discomfort that doesn't alleviate with over-the-counter pain relievers

Vaginal Bleeding Before Menopause (Between Periods)

Another significant early symptom of uterine cancer is irregular vaginal bleeding occurring before menopause or between periods. This abnormal bleeding might manifest as spotting or bleeding that happens outside the regular menstrual cycles. A woman should be mindful if she:

• Observes bleeding between periods.
• The flow of blood during periods becomes unpredictably heavy.
• There's spotting after sexual intercourse.

Vaginal Bleeding After Menopause

Postmenopausal vaginal bleeding is a serious symptom that could be indicative of underlying issues such as endometrial cancer. Since postmenopausal bleeding is unusual, it necessitates immediate medical attention for proper diagnosis and treatment.

Postmenopausal Vaginal Discharge (Thin White)

A thin and white postmenopausal vaginal discharge could be an early sign of uterine cancer. Although not all instances of postmenopausal discharge are linked to cancer, any unusual discharge should be examined by a doctor to exclude potential health concerns.

A doctor should be consulted if a woman notices:

• An unusual white, clear or watery discharge.
• Discharge with an unpleasant smell.
• Discharge associated with pain.

Pain During Intercourse

Experiencing pain during intimate activities can also be an early symptom of uterine cancer. This discomfort may arise due to various factors connected with the condition and warrants a medical assessment to discern the underlying cause.

Change in the Periods

Alterations in menstrual patterns, such as increased bleeding or prolonged periods, can be indicative of endometrial cancer. Monitor any changes such as:

• Longer or heavier periods than usual
• Unpredictably early or late cycles
• Spotting between periods

Rare or Less Common Symptoms of Uterine Cancer

Uterine cancer, encompassing endometrial cancer and uterine sarcoma, is usually identified by the hallmark sign of abnormal vaginal bleeding. But it's important to note that there are other less common symptoms as well. These signs, while not as prevalent, play a crucial role in early detection and appropriate treatment of uterine cancer.

Let's delve into these less common symptoms.

Nausea or Vomiting

This may seem surprising, but nausea or vomiting can indeed be a rare symptom of uterine cancer. It may occur due to hormonal changes in the body instigated by the cancer or due to the presence of a tumour that is affecting the digestive system.

Change in Bowel Habit

Occasional constipation or diarrhoea? It could be more than just an upset stomach. Changes in bowel habits can be linked with uterine cancer due to the closeness of the uterus and intestines. Any persistent alterations in bowel function should be evaluated by a doctor.

Unexplained Weight Loss

If a woman is experiencing weight loss without any changes in her diet or exercise routine, it's time to take notice. This unexplained weight loss can be a less common symptom of uterine cancer and may be linked with the body's response to the presence of cancer and its effects on metabolism. It's one of those subtle yet meaningful signs that should not be ignored.

Abdominal Pain

Abdominal pain, especially persistent or severe pain in the lower abdomen and pelvis, can indicate the presence of a tumour or reflect the impact of uterine cancer on surrounding tissues.

Fatigue

Feeling exhausted even after resting properly? It could be more than just tiredness. Cancer-related fatigue, a rare symptom associated with uterine cancer, can be highly debilitating and may be instigated by the body's response to the cancer cells, treatment side-effects or metabolic changes spurred by the disease.

How is Uterine Cancer Diagnosed?

These diagnostic tests collectively play a pivotal role in pinpointing uterine cancer accurately, thereby facilitating appropriate treatment planning for patients.

Physical Examination

The first step in diagnosing uterine cancer usually involves a thorough physical examination, which includes an essential pelvic exam. This initial check-up is instrumental in early detection of the disease and prompts doctors to order further diagnostic tests if any abnormalities are detected.

Diagnostic Tests for Uterine Cancer

To confirm a diagnosis of uterine cancer, several diagnostic tests may be employed:

1. Ultrasounds: These imaging procedures are used to get a detailed view of the uterus. There are two types - abdominal and transvaginal ultrasounds. The former captures images through the abdomen while the latter involves inserting an ultrasound probe into the vagina for clearer pictures of the uterus.
2. Blood tests: Specifically, a CA-125 assay test may be conducted. High levels of CA-125, a protein, in the blood can be indicative of uterine cancer.
3. CT scans and MRI scans: These imaging tests provide detailed images of the uterus and the surrounding tissues, helping doctors ascertain if the cancer has spread.
4. Other tests: This includes endometrial biopsy (a small tissue sample taken from the uterus lining for testing), hysteroscopy (a procedure to visually inspect the uterus), and dilation and curettage (D&C) where a small piece of tissue is scraped from the uterus and tested.

Uterine cancer, a common yet alarming medical condition, exists as an unwelcome reality for many women in India. Despite its prevalence, many remain unaware of its potential threat. There's an undeniable importance attached to early detection of uterine cancer. Timely identification drastically improves treatment outcomes and quality of life for affected women.

Frequently Asked Questions

1. What Causes Uterine Cancer?

Uterine cancer is mainly caused by abnormal growth of cells, some factors such as hormonal imbalance, obesity or genetic mutations can increase the risk.

2. What are The Different Types of Uterine Cancer?

Two primary types are endometrial cancer (most common, starts in the inner lining of the uterus) and uterine sarcoma (rare, begins in muscles or other tissues).

3. What are The Risk Factors for Developing Uterine Cancer?

Risk factors include age (women above 50), obesity, diabetes, hormone replacement therapy, and family history of uterine or colon cancer.

4. What are The Treatment Options for Uterine Cancer?

Treatments include surgery to remove the uterus (hysterectomy), radiation therapy, chemotherapy and hormone therapy.

5. What are The Stages of Ovarian Cancer?

Ovarian cancer is classified into four stages – I (localised within ovaries), II (spread beyond ovaries), III (spread into abdominal cavity) and IV (metastasised to distant organs).

6. What Treatment Options are Available For Ovarian Cancer?

Main options are surgery for removal of tumour, chemotherapy, radiation therapy and targeted therapy.

7. Are There Any Lifestyle Changes That Can Help Prevent Uterine Cancer?

Maintaining a healthy weight, regular exercise and balanced diet can reduce risks. Hormone therapy should be discussed with one's doctor.

8. At What Age Should Women Start Getting Screened for Uterine Cancer?

Screening is usually recommended from age 35-40 if a person has a family history of uterine cancer; otherwise, it is generally advised post-menopause.

9. Are There Any Alternative Treatments for Uterine Cancer?

Alternative therapies such as acupuncture or yoga may help manage symptoms, although they aren’t proven to cure uterine cancer.

10. Can Uterine Cancer Affect Fertility?

Yes, as treatment often involves removal of the uterus, it can directly impact fertility. However, fertility sparing options may be possible in early stages.