What is uterine cancer (womb cancer)?

Introduction :

Each year, more than 360,000 women globally including Singapore are diagnosed with uterine cancer.  No one knows if or when uterine cancer will develop, so it is important to understand the risk factors of the disease. In Singapore, it is the 4th most common cancer affecting women.

First things first, what is the uterus? The uterus, also called the womb, is a hollow, pear-shaped organ located in a woman’s lower abdomen, between the bladder and the rectum. The parts of the uterus include;

  • Cervix – the narrow, lower portion of the uterus.
  • Corpus – the broader, upper part of the uterus (also called the body of the uterus).
  • Myometrium – the outer layer of the corpus; the muscle that expands during pregnancy to hold the growing fetus.
  • Endometrium – the inner lining of the uterus.


So, what is Uterine Cancer?

Uterine Cancer, the most common cancer of the female reproductive tract, occurs when abnormal cells form in the tissues of the uterus. It starts in the uterus and spreads through the blood and lymph systems. The most common type of cancer of the uterus begins in the endometrium (lining of the uterus). A second type of cancer seen in the uterus is uterine sarcoma. This type of cancer of the uterus occurs in the muscle of the uterus.


Symptoms of Uterine Cancer

Abnormal vaginal bleeding, bleeding after menopause, and pelvic pain are common symptoms of uterine cancer. As uterine cancers increase in size or spread to other organs, they can create a sensation of pelvic fullness or interfere with urination or bowel movements. Common symptoms of uterine cancer include:

  • Abnormal vaginal bleeding.
  • Abnormal menses pattern.
  • Vaginal spotting or bleeding after menopause.
  • Pelvic or abdominal pain, pressure or fullness.

Seek immediate medical care if you, or someone you are with, have any of these symptoms.


What are the causes of Uterine Cancer?

The exact cause of uterine cancer is not well understood. It is known that certain conditions or risk factors can increase the risk of getting endometrial cancer. These include obesity, metabolic syndrome, estrogen hormone therapy (without taking progesterone therapy at the same time), polycystic ovary syndrome, never giving birth, early menstruation, late menopause, a family history of uterine cancer, or having a condition called endometrial hyperplasia, in which the lining tissue of the uterus is abnormally thick.


Risk Factors of uterine cancer

There is no way to know for sure if you will get uterine cancer. Some women get it without being at high risk. However, several factors may increase the chance that you will get uterine cancer, including if you:

  • Are older than 50.
  • Have obesity (an abnormally high, unhealthy amount of body fat).
  • Take estrogen by itself (without progesterone) for hormone replacement during menopause.
  • Have had trouble getting pregnant, or have had fewer than five periods in a year before starting menopause.
  • Take tamoxifen, a drug used to treat certain types of breast cancer.
  • Have close family members who have had uterine, colon, or ovarian cancer.

If one or more of these things is true for you, it does not mean you will get uterine cancer. But you should speak with your doctor to see if he or she recommends more frequent exams.


How is Uterine Cancer diagnosed?

When symptoms suggest uterine cancer, the following may be done to make a diagnosis:

  • A detailed medical history – family and personal.
  • A thorough physical examination including a pelvic examination.
  • Ultrasound of the pelvis.
  • Endometrial biopsy or a Dilation and curettage (d & c) and hysteroscopy.


There are steps women can take to prevent or reduce the risk of developing uterine cancer including:

  1. Consider birth control: Talk to your doctor about taking birth control pills that combine estrogen and progesterone. Using a progestin-secreting intrauterine device (IUD) may also reduce risk.
  2. Know your family history: Women who have a hereditary cancer syndrome, such as Lynch syndrome, or a family history of uterine cancer or other cancers may be at higher risk. Knowing your genetics and family history may help you make decisions on screening regimens and prophylactic measures that may help prevent the disease or catch it early.
  3. Lose weight: Obesity is a risk factor for developing uterine sarcoma and endometrial cancer. Regular exercise and maintaining a healthy weight may reduce your risk of developing these and other cancers.
  4. Manage your diabetes: Maintaining blood sugar levels may help reduce your risk of developing uterine cancer.


Finally, you should see your doctor. Get regular checkups with a gynecologist and address issues such as abnormal bleeding or pain.

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