Uterine cancer

All relevant information regarding the uterine cancer, one of the most frequent gynecological pathologies. The uterine cancer is one of the most frequent diagnosed in women in Spain, after breast cancer, colon and rectum, and lung. 

DESCRIPTION

Uterine cancer refers to the different types of cancer that can start in different parts of the uterus. The most frequent are the endometrial cancer, cervical or cervical cancer and uterine sarcoma.

El endometrial cancer originates in the inner lining of the uterus and is the most common cancer originating in the organs of the female reproductive system. In the European Union, between 1 and 2 women in every XNUMX develop endometrial cancer at some point in their life.

El cervical cancer, Also called cervical cancer occervical cancer, forms in the cervix, the lower part of the uterus that connects to the vagina. Chronic infection of the Human papilloma virus is the main cause in most cases of cervical cancer, a cancer that can be diagnosed in preinvasive stages by gynecological examination and performing cervical cytology or Pap smear.

El uterine sarcoma represents between 1 and 3 percent of gynecological cancers and usually forms in the myometrium, the outer muscular layer of the uterus.

RISK FACTOR'S

Factors that can increase the risk of endometrial cancer, the most common uterine cancer, include the following:

• Obesity and overweight.
• Diabetes.
• Family history (mother, sister, daughter) of uterine, ovarian or colon cancer.
• Personal history of breast or ovarian cancer.
• Premature first menstruation and / or late menopause.
• Changes in the balance of female hormones:
  • By hormone therapy for breast cancer
  • By taking hormones after menopause that contain estrogen but not progesterone.
• Absence of pregnancies.
• Aging: the risk increases as the age of the woman increases.
• Chronic Human Papillomavirus Infection

CAUSES AND PREVENTION

The causes of uterine cancer are not clear, but the risk can be reduced by maintaining healthy lifestyle habits and having regular gynecological exams every year.

• Eat a balanced diet.
• Maintain a healthy weight.
• Get regular moderate exercise.
• Do not smoke.
• Get vaccinated to prevent human papillomavirus infection.
• Get your gynecological check-up regularly annually.
• If you have abnormal blood loss or bleeding in menopause, go to your gynecologist without delay

Annual gynecological check-ups

It is very important to carry out an annual gynecological review exhaustive and complete from the age of 25 to, if applicable, achieve an early diagnosis. If cervical cancer is diagnosed in the early stages, the rate of completion is very high.

In the annual gynecological check-up the genital tract is checked,  with special attention to the detection of gynecological cancer, uterus and ovary, the breast cancer and sexually transmitted infections and other pathologies such as endometriosis, polycystic ovaries o polyps in the uterus.

SYMPTOMS OF UTERAL CANCER

The most common symptoms of uterine cancer are the following:

• Abnormal vaginal bleeding or discharge.
  • Bleeding or discharge between menstrual periods.
  • Periods heavier or longer than normal.
  • Bleeding or discharge after menopause.
• Pain in the pelvic area.
• Pain in the abdomen or a feeling of having a full abdomen.
• Pain during sex.
• Difficulty, discomfort, or pain when urinating.
• Unintended weight loss.

If you detect any of these symptoms, go to your gynecologist as soon as possible to do the medical tests that allow us to rule out the uterine cancer or reach a sure diagnosis and initiate appropriate treatment.

DIAGNOSTIC TESTS

The diagnostic tests that are usually performed to rule out uterine cancer or to reach a certain diagnosis may include an initial physical examination, a diagnostic hysteroscopy, imaging tests and a biopsy uterine tissue.

• Interview with the gynecologist: collection of information on the patient's personal and family risk factors.
• Gynecological examination- A physical exam that examines the uterus, vagina, ovaries, and rectum.
• Hysteroscopy: direct visual examination of the interior of the uterus by means of an endoscope (a very thin and flexible tube equipped with a camera) in consultation, on an outpatient basis and without anesthesia.
• Vaginal gynecological ultrasound.
• Biopsy: taking a small sample of uterine tissue for later analysis.

FORECAST

La survival of endometrial cancer, the most common uterine cancer, depends on the stadium (I a IV) in which it is diagnosed.

If the diagnosis is early and the cancer is detected in an initial phase, the survival rate after treatment is very high, but if it is diagnosed in more advanced stages, when the cancer has spread, survival is significantly reduced.

• Stage I: The tumor is in the uterus and there has been no spread to other parts of the body.
• Stage II: The tumor has spread from the uterus to the cervix, without spreading further.
• Stage III: The tumor has spread outside the uterus (ovaries, vagina, etc.) but is still in the pelvic area.
• Stage IV: The tumor affects the rectum, bladder, or other organs further away. 

TREATMENTS FOR CANCER OF THE UTERUS

The treatment of uterine cancer It depends on the type of cancer and its stage at the time of diagnosis.

The treatments of endometrial cancer they can include surgery, radiation therapy, and chemotherapy.

SURGERY

When uterine cancers are diagnosed in the early stages, surgery is generally the most common treatment and often, depending on the stage, radiation therapy is added to complete the treatment.

Surgical treatment may include removal of the uterus (hysterectomy), fallopian tubes, and ovaries.

La hysterectomy o Surgical removal of the uterus can be done by laparoscopic surgery or by robot-assisted laparoscopic surgery, Surgical technique minimally invasive and a safe therapeutic option provided it is carried out by highly specialized medical professionals with adequate experience.

Laparoscopic surgery

La laparoscopic surgery it's a technique minimally invasive surgery, which allows the patient to intervene by making small incisions (without having to open the abdomen), does not cause pain and the scars are very small and almost imperceptible.

It is a safe therapeutic option as long as it is carried out by highly specialized medical professionals with adequate experience.

• Small painless incisions are made very close to the belly button.
• Gas is introduced (through the incisions) to bulge the abdomen and give the surgeon room and visibility.
• Surgical instruments (forceps, scalpel and other very small devices) are introduced.
• A tube with a small camera (the laparoscope) is placed through the incision.
  • The camera improves the visualization of the operative field and thanks to this the surgeon is much more precise
• The camera, controlled by a second surgeon, allows it to be viewed and viewed on a screen placed in the operating room.
• When the procedure is over, the incisions are closed with simple stitches.

It is common for the patient to be discharged and can return home the same day that the intervention is performed. The postoperative period is less painful, requires less medication, the risk of infection is reduced, and the patient's recovery is much faster.

Robotic surgery

La robotic surgery in gynecology and obstetrics is laparoscopic surgery minimally invasive assisted by a robot, a surgery especially suitable to carry out highly complex surgical proceduressuch as endometrial cancer treatment when it includes lymphadenectomy (removal of lymph nodes) or sentinel node.

Both conventional laparoscopic surgery and robotic surgery, in which the robot accurately replicates the movements of the surgeon, are safe therapeutic options, but they must be performed by highly specialized medical professionals, with experience and certificates for the use of the surgical robot.

The use of the robot provides the surgeon with greater safety to treat anatomical areas of difficult access, facilitates an enlarged and clear view of the interior of the patient, ensures stable and tremor-free handling of surgical instruments (forceps, scissors, etc.) and enables maximum precision of the surgeon's hand movements.

All gynecological laparoscopic surgeries They can be carried out both by conventional surgery and by robotic surgery, but the robotic system can be especially indicated as a support for the performance of more complex surgical interventions in which it is essential to ensure maximum safety and precision.

• Endometrial Cancer Treatment
• Cervical Cancer Treatment
• Ovarian Cancer Treatment
• Hysterectomy (surgery to remove the uterus)

RADIOTHERAPY

Radiation therapy involves using high intensity radiation to destroy cancer cells.

CHEMOTHERAPY

La Chemotherapy consists of using drugs to destroy and reduce or make cancer cells disappear.

MONITORING AND CONTROLS

Once the treatmentPeriodic gynecological follow-up and check-ups should be carried out every 3-4 months during the first 2 years, to verify that the disease does not reappear and to control the side effects of treatment.

• First 2 years: gynecological check-ups every 3-4 months.

After the first 2 years, the reviews and controls must be carried out every 6 months up to 5 years and, since then, the reviews must be done annually.

• Between 2 and 5 years: gynecological check-ups every 6 months.
• From 5 years old: annual gynecological controls.

In the revisions, a complete physical examination, diagnostic hysteroscopy, imaging tests and, if suspected, tissue biopsy are performed