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Uterine Cancer Overview
Uterine cancer or endometrial cancer usually develops in the inner lining of the uterus. Most of the time, the malignancy develops after menopause, but there are a few cases when the cancer is seen before the menopausal stage.
Uterus is part of the reproductive system of a woman, and it is where the baby grows in time of pregnancy. The uterus has two main structures, the myometrium and the endometrium. The myometrium is the outer wall and is mainly made up of muscles while the endometrium is the inner wall where the fetus attaches itself.
The factors that increase the risk of the woman to develop uterine cancer includes endometrial hyperplasia, older age usually 50 years and above, excess estrogen production, and the use of tamoxifen, a drug used in the treatment of breast cancer.
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Relationship of Uterine Cancer and Endometrial Thickness
Endometrial thickness or endometrial hyperplasia is a common precursor to uterine cancer. It is a term used to describe the abnormal cell growth in the endometrium. Endometrial thickness is a minor condition that is easily treated. The condition, however, can lead to cell changes and become cancerous.
Hyperplasia develops when estrogen production dominates and there is a deficit in the amount of progesterone in the uterus. There are two types of hyperplasia, simple and atypia. In simple hyperplasia, there is thickening in the lining of the uterus, but the structure of the endometrium isnot changed. Simple hyperplasia is nonmalignant hence there is a little risk to develop uterine cancer. On the other hand, hyperplasia with atypia occurs when the cells in the endometrium change abnormally. Hyperplasia is not generally synonymous with cancer, but it has increased chances of becoming one.
It is in its precancerous stage when the hyperplasia extends through the myometrium. If untreated, endometrial hyperplasia will irritate the cells of the uterus and eventually the cell will change its state. If the thickness of the endometrium is <5mm, there is only a slim chance that uterine cancer will develop. However, if the thickness is >5mm, there is about 93% of developing cancer. Women at menopausal stage are at increased risk of developing uterine cancer compared to women in their reproductive years.
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Uterine cancer presents good prognosis if diagnosed early and interventions are done to reduce metastasis. Modalities of treatment include:
- Hysterectomy is the surgical procedure done to remove the uterus, fallopian tubes, ovaries, cervix, surrounding tissue and lymph glands. It is the primary mode of management for uterine cancer
- Radiation therapy and chemotherapy are frequently administered together with surgery, or alone in treating uterine cancer.
- Hormone therapy is also helpful, since cancer of the uterus is sensitive to the presence of certain hormones.