Uterine cancer usually occurs in older women who have already entered or passed menopause.The most common of the uterine cancers is an endometrial carcinoma. This arises in the inner lining of the uterus known as the endometrium.
Being aware of the common signs and symptoms of endometrial cancer can make a woman more alert to the changes taking place in her body. Early detection and diagnosis of uterine cancer detection plays an integral part in the successful treatment of these malignant tumors. Women at risk should also consider routine screening. Read more on risks of uterine cancer.
The key feature that menopausal or post-menopausal women need to be aware of is abnormal vaginal bleeding. This includes any type of vaginal bleed, which should not be present since a women is in menopause or has passed it and therefore complete cessation of menstruation is expected in this stage of life. However, it is also important to not that uterine cancer can occur in younger women of fertile age although it is rare.
Signs and Symptoms of Uterine Cancer
Abnormal Uterine Bleeding
This is the most common presentation of uterine cancer. This may manifest as :
- Postmenopausal bleeding or spotting.
- Bleeding in between periods (intermenstrual bleeding).
- Prolonged, heavy, or frequent periods, especially after the age of 40.
- Thin white or blood tinged vaginal discharge after menopause.
- Bleeding after intercourse (post-coital bleeding).
It is extremely important to remember that any vaginal bleeding after menopause is definitely not normal and should be investigated immediately, even though all postmenopausal bleeding may not be a sign of cancer.
- Lower abdominal or pelvic pain.
- Pain during or after intercourse.
- Pain while passing urine.
Other Signs and Symptoms
- Feeling a mass or lump in the lower abdomen or pelvis.
- Unintentional weight loss, especially if it is continuous.
Complications of Uterine Cancer
As a rule, the earlier the cancer is detected and treatment started, the lower the chance of complications. The patient’s health status prior to commencing treatment is also a consideration in the development of complications.
Due to Direct Spread to Neighboring Tissues
Cancer cells can invade and damage nearby tissues and organs, such as the bladder in front, the rectum behind, or the vagina lower down, resulting in
- Urinary obstruction.
- Bowel obstruction.
- Bleeding from the vagina, bladder or rectum.
It can spread to the deeper layers of connective tissue around the uterus and the pelvic lymph nodes.
Due to Metastasis
Complications of uterine cancer can also develop due to spread of the cancer (metastasis) to distant tissues and organs. This may occur when the cancer cells detachfrom the uterine tumor and reach other organs either through the lymph vessels or through blood vessels to reach the lungs, liver, brain, or bones. Once at these sites these cells replicate to form new tumors.
These tumors have the same kind of abnormal cells as the primary tumor. For instance, cancer that has metastasized to the lungs from the uterus will contain uterine cancer cells and are known as metastatic uterine cancer. The cancer can grow and metastasize rapidly if treatment is not commenced at an early stage. The most common sites for metastasis of endometrial cancer are the vagina, lungs and abdominal cavity, leading to complications such as :
- Ascites – fluid collection in the abdomen.
- Dyspnea – difficulty breathing.
- Persistent cough.
As a Result of Treatment
Complications following :
- Surgical removal of the uterus (hysterectomy), along with removal of the cervix, fallopian tubes and ovaries may produce various complications such as early menopause and prevent premenopausal women from having children.
- There are various other complications of surgery in general and the psychological effects of a hysterectomy on younger women also needs to be considered.
- Thromboembolism is a possible and potentially serious post-operative complication.
- Lymphadenectomy or removal of the pelvic lymph nodes can cause lymphedema.
- Radiation Therapy
- Some of the symptoms associated with radiotherapy include nausea, diarrhea, fatigue, vaginal discharge, pain while passing urine, and temporary loss of pubic hair.
- Radiotherapy may lead to early menopause in women who have not reached menopause.
- Chemotherapy may cause nausea, vomiting, tiredness, hair loss, and increased susceptibility to infections.
- Hormone therapy with progesterone may lead to nausea, weight gain, cramps.