(PDF) STAGE IV BLOOD CANCERS: NOT INVINCIBLE !
5 Uterine Cancer Warning Signs Women Must Know
Early detection is crucial for this common cancer affecting thousands of women each year
In a quiet corner of a busy medical center, Sarah waits nervously for her test results. Just weeks earlier, she noticed unusual bleeding between her periods – something she nearly dismissed as stress-related. That single decision to call her doctor may have saved her life.
Uterine cancer remains one of the most prevalent yet underdiscussed health threats affecting individuals with female reproductive organs. Though rarely making headlines, this silent threat impacts approximately 28 out of every 100,000 people with a uterus in the United States annually.
The disease begins when cells in the uterus – the pear-shaped organ in the pelvis where a baby develops during pregnancy – start multiplying out of control. The most common form, endometrial cancer, originates in the inner lining of the uterus.
What makes this cancer particularly treatable? Early detection. Understanding the warning signs can mean the difference between a straightforward treatment path and a challenging battle. Here's what women need to know about recognizing, diagnosing, and confronting this disease.
The 5 critical warning signals your body might be sendingWhile uterine cancer can remain silent in its earliest stages, the body often sends distinct distress signals. Recognizing these five key symptoms could potentially save your life:
When these symptoms appear together or persist for more than two weeks, medical professionals recommend scheduling an appointment with a healthcare provider without delay.
Beyond the basics: Advanced warning signalsAs uterine cancer advances, additional symptoms might emerge that affect overall well-being and quality of life:
Unexplained weight loss often indicates that something significant is happening within the body. When cancer cells multiply, they consume energy that would otherwise nourish healthy tissues, potentially leading to unintentional weight loss.
Abdominal bloating that persists beyond normal fluctuations can indicate fluid buildup in the abdominal cavity as the disease progresses. Many women describe feeling constantly bloated regardless of what they eat.
Digestive disruptions including constipation, diarrhea, or changes in bowel habits might develop if the cancer spreads to nearby organs like the colon or rectum.
Fatigue that doesn't improve with rest often accompanies later-stage uterine cancer. This bone-deep exhaustion stems from the body's ongoing battle against abnormal cell growth.
Medical experts emphasize that these symptoms might indicate various health conditions beyond uterine cancer. However, the clustering of multiple symptoms warrants thorough investigation.
The diagnostic journey: What to expectFor women concerned about potential uterine cancer symptoms, understanding the diagnostic process helps alleviate some anxiety around medical appointments.
The journey typically begins with a comprehensive physical examination, including a pelvic exam. The healthcare provider will assess the size and shape of the uterus and check for any abnormalities in the reproductive organs.
Next comes the transvaginal ultrasound – a painless imaging procedure that uses sound waves to create detailed pictures of the uterus. This test measures the thickness of the endometrium (uterine lining) and identifies any unusual growths or masses.
If abnormalities appear during the ultrasound, the provider will likely recommend an endometrial biopsy. During this procedure, a thin tube is inserted through the cervix to collect a small tissue sample from the uterine lining. The sample undergoes laboratory examination to check for cancer cells.
Some cases require a more comprehensive tissue sample through a procedure called dilation and curettage (D&C). This outpatient surgery involves widening the cervix and gently scraping tissue from the uterine lining for analysis.
If cancer is confirmed, additional imaging tests like CT scans, MRIs, or PET scans help determine whether the disease has spread beyond the uterus.
Risk factors: Understanding your personal equationWhile uterine cancer can affect anyone with a uterus, certain factors increase susceptibility. Understanding these risk elements empowers individuals to advocate for appropriate screening and preventive measures.
Age plays a significant role, with most cases diagnosed in people over 50. The peak incidence occurs in the 60s and 70s, though younger individuals aren't immune.
Hormonal imbalances, particularly excess estrogen without adequate progesterone, create an environment where endometrial cells might grow abnormally. This imbalance occurs naturally during menopause but also appears in conditions like polycystic ovary syndrome (PCOS).
Obesity significantly increases risk because fat tissue produces extra estrogen. Individuals with higher body mass indexes face substantially elevated chances of developing the disease.
Never having been pregnant represents another risk factor, as pregnancy alters hormonal patterns in ways that appear protective against endometrial cancer.
A personal or family history of certain cancers – including breast, ovarian, or colorectal cancers – elevates risk, particularly in families with Lynch syndrome, a hereditary condition that increases cancer susceptibility.
Previous pelvic radiation therapy, diabetes, and certain medications like tamoxifen (used to treat breast cancer) round out the list of common risk factors.
Prevention strategies that make a differenceWhile no guaranteed prevention method exists, several strategies may reduce risk:
Maintaining a healthy weight through balanced nutrition and regular physical activity helps regulate hormone levels and reduce excess estrogen production.
Using hormonal birth control methods like combination birth control pills, which contain both estrogen and progesterone, may offer protective benefits for some individuals.
Managing chronic health conditions like diabetes and high blood pressure helps reduce overall cancer risk through improved metabolic health.
For those at extremely high risk due to genetic factors, healthcare providers might recommend preventive surgery (prophylactic hysterectomy) after childbearing years are complete.
Regular gynecological check-ups remain crucial for early detection, particularly for those with known risk factors. These appointments provide opportunities to discuss any unusual symptoms before they progress.
When to ring the alarmMedical experts agree on one critical point: abnormal vaginal bleeding should never be ignored. This symptom, particularly bleeding after menopause, warrants immediate medical evaluation.
Even for premenopausal individuals, bleeding between periods, increasingly heavy periods, or periods lasting longer than usual deserve professional attention. While these symptoms often relate to benign conditions, ruling out cancer provides essential peace of mind.
Women experiencing persistent pelvic pain, unusual discharge, or any combination of the symptoms mentioned should schedule appointments with their healthcare providers rather than waiting for symptoms to worsen.
Those with multiple risk factors benefit from discussing appropriate screening schedules with their doctors, potentially including regular transvaginal ultrasounds to monitor endometrial thickness.
The good news about uterine cancer lies in its treatability when caught early. With prompt detection and appropriate care, many individuals overcome this disease and return to full, active lives. The key lies in listening to your body, recognizing its warning signals, and seeking timely medical attention when something seems amiss.
Are Endometrial Cancer And Uterine Cancer The Same?
Inside your pelvis is an organ that plays an important role in your period, ability to get pregnant, and carry a pregnancy. As with other parts of your body, sometimes cancer cells can grow there.
The uterus is a hollow, lightbulb- or pear-shaped organ between your rectum and bladder. It's made up of three parts: the fundus, the body, and the cervix, which connects the uterus to the vagina.
It has three tissue layers. The inner lining is endometrium. If you're pregnant, the lining, or endometrium, grows thicker. This is where the fertilized egg implants and where your baby grows until delivery. If you don't become pregnant, the uterus sheds the endometrial lining when you have your period.
The thick center layer of the uterus is the myometrium, which is made of smooth muscle cells. The outer layer is called the perimetrium or serosa and is made of thin epithelial cells.
Cancers that form in the uterus can affect any of the different layers.
Is endometrial cancer the same as uterine cancer?
"When you think about cancer, it's described based on location," explains Faith Ohuoba, MD, an OB/GYN at Memorial Hermann Health System in Houston. "Endometrial cancer is cancer of the endometrium, which is the lining of the uterus. Uterine cancer is any cancer of the uterus, which is going to be defined by the lining and everything else, like the muscle or connective tissue. So while endometrial cancer is a type of uterine cancer, there are other types of uterine cancer that are not the endometrial type."
There are two types of uterine cancer:
Endometrial carcinoma (cancer)
This form is the most common, making up 95% of cases. It happens in the inner lining of your uterus (endometrium).
There are two types of endometrial cancer:
Type I endometrial cancer. People with endometrial cancer are most likely to have this type, called endometrioid adenocarcinoma. It usually forms from the lining of your uterus, and doctors link it to high levels of estrogen. These cancers tend to grow slowly and are less likely to spread.
Type II endometrial cancer. This form is not related to estrogen levels. It grows faster and has a higher chance of spreading. This group includes more aggressive cancers like uterine serous carcinoma and clear cell carcinoma.
Uterine sarcoma
This rare type forms in the muscle wall of your uterus (myometrium).
Uterine cancer symptoms
Uterine cancer symptoms can be similar to those of other reproductive health conditions. Possible signs include:
If you have unusual pain or irregular vaginal bleeding, see a doctor for an accurate diagnosis and the right treatment.
"When a woman has abnormal bleeding, it needs to be investigated," Ohuoba says. "Look at abnormal bleeding in terms of flow. How often are you getting your cycle, and for how many days? If any of those factors are off, go get checked out." She also advises seeing your doctor for heavy periods and clotting.
Endometrial cancer symptoms
Endometrial cancer has similar symptoms as that of the uterus. They may include:
A hormone imbalance is the main risk factor for both uterine and endometrial cancers. Having more estrogen than progesterone raises your chances, which can happen if you have certain conditions, including:
Taking estrogen without progesterone (called unopposed estrogen) also raises your odds of getting endometrial or uterine cancer.
Other risk factors for endometrial and uterine cancer are based on your age, lifestyle, menstrual and reproductive history, and other things. They include:
Older age. As you get older, your chances of forming uterine cancer rise. Most cases happen after age 50 or after menopause.
No pregnancies. You're more likely to get one of these conditions than someone who's had one or more pregnancies.
Longer menstruation. The more years you're exposed to estrogen through menstruation, the higher your chances of uterine cancer. So, if you started your period before age 12 and menopause after age 50, you're at a higher risk.
A high-fat diet. Doctors have linked several cancers to a diet high in animal fat, including uterine cancer. Plus, fatty, high-calorie foods may also cause obesity.
Family history. If you have Lynch syndrome or hereditary nonpolyposis colorectal cancer (HNPCC), your chances of endometrial cancer go up.
Race. Although endometrial cancer is more common in White women or people assigned female at birth, those who are Black are almost twice as likely to lose their lives to the disease. And doctors often diagnose this group with rarer, more aggressive forms of endometrial cancer.
Medical treatment. Certain medical treatments also raise your risk of uterine cancer, such as radiation therapy to your pelvis, estrogen replacement therapy (ERT), and the breast cancer drug tamoxifen.
Treatment for endometrial and other types of uterine cancer involves surgery, strong cancer-killing medicines, and support to soothe pain and other symptoms.
Surgery
The first step in your treatment plan for uterine cancer will likely be surgery. A surgeon will remove your uterus and cervix, a procedure called a hysterectomy. There are four types:
Total abdominal hysterectomy. The surgeon makes a cut in your belly area to remove your uterus.
Vaginal hysterectomy. The surgeon removes your uterus through your vagina.
Radical hysterectomy. If cancer has spread to the cervix, the surgeon removes the uterus, nearby tissues, and the upper part of your vagina.
Minimally invasive hysterectomy. This is when a surgeon makes several small cuts to remove your uterus.
To find out if the cancer has spread, your doctor will also remove lymph nodes with a procedure called lymph node dissection (lymphadenectomy).
They may also remove your ovaries and fallopian tubes (called a bilateral salpingo-oophorectomy, or BSO) to be sure all of the cancer is gone. This surgery will trigger menopause. If you were assigned female at birth, are younger than 45, and haven't yet gone through menopause, talk to your doctor about keeping your ovaries.
Other treatments
Other uterine and endometrial cancer treatments include:
Radiation therapy. This treatment uses powerful energy. You could have it before surgery to shrink the tumor or as a substitute for surgery. You can get radiation therapy externally from a machine that sends it to your body, or from a device your doctor places inside your vagina (brachytherapy).
Chemotherapy. You may take cancer-killing drugs through an IV or as a pill before surgery to shrink the tumor or after to lower the chance of the cancer returning.
Hormone therapy. Hormone-lowering medicines kill cancer cells that depend on hormones to thrive. Your doctor may suggest hormone therapy if you have advanced endometrial cancer that has spread to other parts of your body.
Targeted therapy. This involves medicines that home in on certain chemicals in cancer cells. This treatment is for those with advanced endometrial cancer, and you may have it along with chemotherapy.
Immunotherapy. You take medicine to help your immune system destroy cancer cells. Doctors use this treatment for advanced endometrial cancer or when other treatments aren't working.
Palliative care. This is health care to help ease pain and other symptoms. Trained experts will support you and your family to enhance your quality of life. You may have palliative care along with other treatments like surgery, chemo, and radiation therapy.
Cancer survival rates depend on whether the cancer has spread and how far, your age, general health, treatment response, and other things.
Uterine and endometrial cancer typically have high survival rates, especially when doctors diagnose them early and they haven't spread to other parts of your body. Doctors usually diagnose these cancers early on because people spot unusual bleeding. Here's a closer look at the numbers:
Uterine/endometrial cancer prognosis
The five-year survival rate for localized cancers of the uterus and endometrium is 95%. This means that this percentage of women diagnosed with the disease is alive five years later. If the cancer has spread from the uterus to nearby structures or lymph nodes (regional), the five-year survival rate drops slightly to 70%. And when it spreads to distant parts of the body, such as your lungs or bones (distant), the survival rate falls to 19%. The overall survival rate is 81%.
These statistics are different for Black women. For this group, the overall five-year survival rate is much lower, at 62%. They're more likely to face disparities of care: They often have less access to quality care, so they get their diagnosis at a later stage, when it's harder to treat. They are also more likely to have the more aggressive types of the disease that spread more quickly.
It's important to note that these numbers only refer to the cancer stage at first diagnosis. They may be different if it grows, spreads, or returns after treatment.
With these types of cancers, early diagnosis is key to effective treatment. "Don't be afraid to talk to your OB/GYN," Ohuoba says. "If you have abnormal bleeding, advocate for imaging studies to see what's going on. And understand the possibility of [needing a] biopsy. Patients get scared or refuse, but just know when dealing with gynecological cancers, especially of the uterus, biopsies and imaging are some of the things that you should make sure to have."
Endometrial cancer is a form of uterine cancer. Uterine cancer refers to any cancer in the uterus, including both the lining (endometrium) and other tissues, like muscle. Endometrial cancer affects only the lining of the uterus and is the most common type, making up 95% of cases.
Symptoms for both cancers are unusual vaginal bleeding, especially after menopause, and pelvic pain.
Risk factors include obesity, hormonal imbalances, a high-fat diet, family history, race, and certain medical treatments. Your doctor may suggest surgery, radiation, chemotherapy, hormone therapy, or immunotherapy, depending on the cancer's stage and spread. When diagnosed early, both cancers have high survival rates.
What is the difference between the endometrium and the uterus?
The uterus is the hollow, pear-shaped organ where a baby grows, while the endometrium is the inner lining of your uterus.
What is the difference between endometrial cancer and uterine sarcoma?
Endometrial cancer forms in the inner lining of your uterus (endometrium), while uterine sarcoma is a rare form of cancer that develops in the muscle wall of your uterus (myometrium). Both are types of uterine cancer.
Factors Influencing Sentinel Node Mapping Failure In Endometrial Cancer
Photo Credit: kjpargeter
The following is a summary of "Predictors for sentinel lymph node mapping failure using indocyanine green injection in apparent early stages of endometrial cancer: A single-center prospective study," published in the April 2025 issue of International Journal of Gynecology & Obstetrics by Bretová et al.
Researchers conducted a retrospective study to analyze predictive factors for sentinel lymph node (SLN) mapping failure in apparent early-stage endometrial cancer using intracervical indocyanine green (ICG) injection.
They analyzed data from June 2019 to August 2023, including all individuals with apparent early-stage (FIGO [International Federation of Gynecology & Obstetrics] 2009 stage I or II) endometrial cancer scheduled for sentinel node biopsy were consecutively included. A 4–6 mL ICG injection was administered superficially and deeply into the cervical tissue at the 3- and 9 o'clock positions. Clinical, surgical, and histopathological data were collected. Univariable and multivariable regression analyses were performed.
The results showed that 225 individuals met the eligibility criteria. In univariable analysis, body mass index (BMI; P = 0.036), FIGO 2009 stage (P = 0.019), and myoma (P = 0.017) were significant predictors of SLN mapping failure. However, multivariable logistic regression analysis identified only myoma (P = 0.031) as a statistically significant factor. For bilateral mapping failure, BMI (P = 0.021) and FIGO 2009 stage (P = 0.046) were significant in univariable analysis. Multivariable analysis further identified BMI (P = 0.007) and age (P = 0.004) as independent predictors of bilateral failure.
Investigators concluded that higher BMI and age had been statistically significant independent factors for bilateral sentinel node mapping failure in early-stage endometrial cancer.
Source: obgyn.Onlinelibrary.Wiley.Com/doi/10.1002/ijgo.70123
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