Uterine or endometrial cancer
"It is possible to reduce the risk by avoiding hormone replacement therapy with estrogen alone, maintaining a healthy weight, daily physical exercise and a thorough control by your gynecologist in case of family history, risk factors, taking tamoxifen or any genital bleeding".
DR. JOSÉ ÁNGEL MÍNGUEZ
CODIRECTOR. GYNAECOLOGY AND OBSTETRICS DEPARTMENT
What is uterine cancer?
Uterine cancer is a type of tumour that occurs when cells grow uncontrollably in the uterus. This type of cancer is often located inside the uterus and therefore has a good chance of being cured. Prevention is not possible in most cases, but reducing risk factors reduces the likelihood of developing this disease.
There are two types of uterine cancer, the most common being endometrial cancer. The endometrium is a mucous membrane that lines the inside of the uterus. The other type of uterine cancer is uterine sarcoma, which is less common and develops in the muscular tissues of the uterus.
At the Clínica Universidad de Navarra Cancer Centre we have a Gynaecological Cancer Department, whose aim is to offer our patients individualised care.
To do this, we have a group of highly specialised professionals: medical oncologists, gynaecological oncologists, radiation oncologists, pathologists, radiologists, nuclear medicine doctors, geneticists and specialised nurses.
This multidisciplinary approach allows us to personalise the treatment of each patient in a consensual manner, seeking excellence and innovation.
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What are the symptoms of uterine cancer?
Vaginal bleeding
It is the most common symptom, especially in postmenopausal women, and occurs outside of regular menstrual periods. It may be light or heavy, and its presence should be evaluated immediately.
Abnormal vaginal discharge
Characterised by a brownish, thick or foul-smelling discharge associated with abnormal changes in uterine tissue. Although not always indicative of cancer, it requires medical attention if persistent.
Pain or bleeding during sexual intercourse
Pain or bleeding after intercourse may be due to injury to the uterus or inflammation of the tissue. It is a warning symptom that should not be ignored, especially if it occurs with other signs.
Pelvic pain
Persistent pain in the lower abdomen, even mild, may indicate advanced changes in the uterus. This symptom usually appears in later stages of the disease.
Do you have any of these symptoms?
If you suspect that you have any of the above symptoms,
you should consult a medical specialist for a diagnosis.
What are the causes of uterine cancer?
The exact causes of uterine cancer are not known. The risk increases if there are chronically high oestrogen levels and the woman is past menopause.
Predisposing factors include obesity, a history of infertility or lack of pregnancy, late menopause (over 52 years of age), polycystic ovary syndrome, ovarian tumours that produce oestrogen, or use of oestrogen-containing hormones (e.g. hormone replacement therapy without added progesterone).
The most common hereditary syndromes associated with endometrial cancer are Lynch syndrome, Cowden syndrome and hereditary breast and ovarian cancer associated with BRCA1/2 mutations.
If there is a history of uterine cancer in a family, it is advisable to consult a specialist in Clinical Genetics to carry out the necessary tests and find out if there is a hereditary component.
Risk factors for uterine cancer
- Late menopause (over 52 years)
- Nulliparity (not having had children)
- Diabetes, hypertension, fat intake, oestrogen-only hormone replacement therapy, chronic anovulation (polycystic ovary or other causes).
- Taking frequently administered tamoxifen as part of breast cancer treatment.
- Inherited conditions: carriers of the gene for hereditary non-polyposis-linked colorectal cancer (Lynch type II).
- Personal history of breast or ovarian cancer.
- Endometrial hyperplasia.
- Some ovarian oestrogen-producing ovarian tumours.
How is uterine cancer diagnosed?
Molecular diagnosis of uterine cancer provides a more accurate prognosis and the appropriate treatment for each patient.
First, a complete clinical history is taken and a gynaecological examination is performed. Blood tests with tumour markers are requested. A transvaginal ultrasound scan is usually performed to assess the characteristics and thickness of the endometrium, and if the endometrium is thickened or suspicious, cancer is ruled out by biopsy, sometimes by hysteroscopy.
If the endometrium is thickened or suspicious, cancer is ruled out by biopsy, sometimes by hysteroscopy. Once cancer is confirmed, complementary tests (CT, MRI, PET-CT) are performed to determine the extent and plan the most appropriate treatment.
Treatment of uterine cancer
The usual treatment for uterine cancer is surgical. Depending on the size, location and stage of the tumor, the specialist will recommend one or another type of surgery, being necessary, in some cases, to completely remove the uterus by means of a hysterectomy and the appendages (tubes and ovaries). Also, depending on some prognostic factors (depth of invasion of the uterine wall and degree of differentiation) it is also necessary to remove the pelvic nodes and, in some cases, the aortic nodes.
In some cases in which there are adverse prognostic factors (lymph nodes with tumor, some histological types, etc.) that increase the risk of local and/or distant recurrence, it is recommended to administer radiotherapy and/or chemotherapy after surgery.
We have the latest technology in the administration of brachytherapy as well as proton treatment for endometrial cancer.
In advanced cases due to extension of the disease through the abdomen, chemotherapy should be administered after surgery that resembles that of ovarian cancer. Hormone therapy is frequently used in this type of tumor when it is disseminated.
The specialist will also consider the administration of radiotherapy after surgery to reduce the local and regional incidence of the tumor.
In patients of reproductive age and with the desire to have children, when the tumor is located in the uterine cavity and there is no suspicion that it infiltrates the uterine wall or is disseminated, treatment with hormone therapy can be given.
Proton therapy for cancer
Proton therapy is the most precise external radiotherapy modality, providing better distribution of radiation dose and therefore less irradiation of healthy tissues.
The Proton Therapy Unit of the Cancer Center Clínica Universidad de Navarra in its Madrid headquarters is the most advanced in Europe and the first in a Cancer Center, with all its healthcare, academic and research support.
Where do we treat it?
IN NAVARRA AND MADRID
The Gynecologic Cancer Area
of the Cancer Center Clínica Universidad de Navarra
The Gynecologic Cancer Area is a multidisciplinary unit focused on the treatment and research of tumors of the female genital tract.
We have professionals of recognized national and international prestige, considered opinion leaders in their field, who over the years have formed a team that places the patient at the center of its activity.
What diseases do we treat?
- Ovarian cancer
- Uterine or endometrial cancer
- Uterine cervical cancer
- Vaginal tumors
- Vulvar tumors
- Gestational trophoblastic disease
Why at the Clinica?
- High surgical specialization.
- Focused on the patient.
- State-of-the-art diagnostic and therapeutic technology.
- Research and clinical trials to offer the most innovative treatments.
Our team of uterine cancer experts
