Uterine cancer affects the endometrium that is the inner lining of the uterus. It, therefore, is spread only among women. As far as uterine cancer is a serious disease taking numerous lives, this paper aims at discussing the condition, specifically its diagnosis, histology, pathophysiology, treatment, prognosis, and management.
A gynecologist diagnoses a woman with this type of cancer after she experiences certain symptoms. These could include spotting or bleeding in the vagina, having menses in between the real season or after menopause. Other times, experiencing non-bloody discharge in the vagina could also be a symptom of uterine cancer. However, in 93% of cases, abnormal vaginal bleeding is usually a proof of a person having cancer (Colombo & Preti, 2011). Other symptoms could include uncontrollable loss of weight, the presence of a tumor in the uterus, and sharp pain in the pelvis region.
Once at the gynecologist’s office, the doctor can use several ways to diagnose whether the patient has uterine cancer. The first method is checking by an ultrasound device. It takes photographs of body parts using sound waves generated by a transducer. A computer then translates them into pictures. There are two types of ultrasounds. In the first one, the doctor places a probe on top of the abdomen area of the skin. When using the other one, the probe is inserted into the vagina (American Cancer Society, 2015). It detects the presence of a tumor in the uterus.
Another process of diagnosis is sampling the endometrial tissues. It is done by putting a narrow pipe inside the womb. It then sucks it to take samples. Afterwards, the surgeon tests the tissue to find any abnormities. Hysteroscopy is another method where the gynecologist inserts a tiny telescope through the cervix into the womb. It should be full of salty water. The doctor then views the surface to check for any tumors. Dilation and curettage is another method of sampling. Here, the cervix’s opening is made big, and medical equipment is used to remove some tissue from inside the uterus. The tissues are then observed using a microscope to detect the presence of cancer. The third method of diagnosis implies the use of position emission tomography. In this case, the patient is given radioactive glucose, and a scanner is then used to detect the presence of cancer. Cancer cells compared to normal cells use a high rate of glucose. The scanner will, therefore, show radioactivity concentrating in the cancer cells. The last approach to diagnosing cancer is a complete blood count. It measures all the different types of blood cells in the body. A depreciating rate of red blood cells could signify the presence of uterine cancer. It is because cancer causes bleeding that leads to the reduction of red blood cells (ACS, 2015).
Cancer of the uterus is a heterogeneous condition. Pathology and molecules have helped scientists discover the two forms of cancer. The first one is adenocarcinomas. It causes more than 855 types of uterine cancer. The second form is the serous carcinomas. It is a very high- level form of uterine cancer. Adenocarcinomas are usually unstable in a microsatellite manner (Colombo & Preti, 2011). Serous carcinomas are stable. The histological study of adenocarcinomas cancer reveals tiny and vast abnormal nuclei with cells in a column shape. However, serous endometrial carcinoma appears to have teh majority of nuclei and papillary structures. The cells are rounded and spread outside the uterus without reaching the myometrium. Another part of serous carcinoma called clear cell carcinoma contains an eponymous cytoplasm that is clear. It is also distinct with clearly visible membranes.
Serous carcinoma cells mutate in the chromosomal areas causing malignancies. This occurs spontaneously in post-menopausal women. Such tumors spread at the early stages of cancer resulting in a very high level of mortality (Zanotti, 2010). Adenocarcinomas cells cause bleeding during the first stages of cancer. However, if detected early, this type of cancer is curable. Clear cell carcinomas do not react towards receptors of estrogen and progesterone. These cells also rarely respond to immunes in the body (Colombo & Preti, 2011).
Treatment of uterine cancer includes operations, chemotherapy, radiotherapy, a mixture of the two, and a hormone therapy. Surgery is usually a preferred treatment. However, there are issues that determine the best cure for a cancer patient. These can include the age of the patient, whether or not she has children or wants to have children in future, and many other factors.
A uterine cancer patient can undergo several surgeries. The first one is a hysterectomy. It is done to remove the two organs, that are, the cervix and the uterus. Here, an abdominal incision is made. However, this surgery is not recommended for a patient planning to have children in the future. The second operation is the bilateral salpingo-oophorectomy. It removes all ovaries and fallopian tubes. The process leads the patient to menopause. Lymph node surgery is another kind of treating uterine cancer. Here, the lymph nodes are removed from the aorta and pelvis and checked on the presence of cancer cells.
Washing the pelvis of the patient is another way of treating uterine cancer. The surgeon uses salt water. He then tests the fluid in the laboratory to find out whether it contains cancer cells (ACS, 2015). In another type of surgery, also known as debunking of the tumor, the doctor tries to remove the tumor. This method supplements chemotherapy in treating uterine cancer. Apart from surgery, radiotherapy is also used in treatment. Here, radiation in form of x-rays is used to get rid of cancer cells through internal radiotherapy. The doctor then inserts material containing radioactive substance inside the tumor. Secondly, this can be implemented through an external version where a machine focusing radiation beams concentrates on the tumor. This treatment takes a month.
Chemotherapy is also used to treat uterine cancer. Drugs such as Paclitaxel, Cisplatin, and Doxorubicin among others are administered to help in fighting cancer. They can either be injected into the veins or taken orally. Combination treatment using radiotherapy and chemotherapy can also be used. Research has shown that this combination has at one time resulted in a 37% reduction of the death risk. Hormone therapy is also used in the treatment of uterine cancer. Drugs containing hormones or ones that are useful in blocking hormones are used to get rid of cancer cells in the body. An example is Progestin, which contains progesterone.
The overall survival period for uterine cancer in the USA is 5 years at the rate of 84% (Colombo & Preti, 2011). It could be because of numerous cases of early diagnosis which can lead to a survival rate of over 5 years at 95%. The 1-year survival rate is witnessed in 92% of cases. Endometrial tumors have a 5-year survival rate at 84%, while clear cell have a survival rate of 62%. Papillary carcinomas, on the other hand, have a 53% survival rate. Periods and rates of survival are usually used by gynecologists or oncologists to get a patient’s prognosis (ACS, 2015). These rates are based on the past diagnosis of persons who had uterine cancer. If there are any improvements in treatments used before, this may lead to favorable results in terms of ratings.
It is estimated that re-emergence of uterine malignancies occurs within the first years of treatment. Therefore, the patient needs to be examined after every four months for three years. It is to be continued for five years after treatment (Colombo & Preti, 2011). Patients with the high-level cancers like carcinosarcomas should visit the hospital periodically for the first two years and annually afterwards (ACS, 2011). Another way of managing the cancer is maintaining a good health. The patient should strive to have the required healthy weight. She should adopt an active lifestyle which means having a strict exercise regimen. She should follow this to the letter. In case the patient takes alcohol, it is advised to stop the habit. However, she can decide to limit the amount she takes. Having nutrition knowledge is essential to a cancer patient. She should therefore follow a healthy diet. It should consist of mostly vegetables and fruits. Her lifestyle has to correspond to her diet.
Although undergoing treatment may make a patient lose taste in food, she should strive to eat as it is essential for her to have energy to undergo strenuous treatments like radiotherapy. Research has also shown that exercising helps patients attain both physical and emotional well-being. They can then be able to cope with the cancer. It is recommended that cancer patients join a support group in their neighborhoods. This help acts as a pillar for the patients. Support groups are known to provide them with comfort and strength. They could be in the form of peer-counseling, church support groups, friends, family interventions, online-support groups, and one-on-one therapy with a professional. The patients should, however, join only when they are comfortable and feel they are ready to open up to other people.
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Uterine cancer is one of the highest killing cancers among women. However, with the early diagnosis, a proper treatment, and the right determination, a person can overcome the disease.