Cancer of the uterus: the most common GYN cancer

When it comes to gynecological cancers, more attention is given to cervical cancer. That’s understandable. Cervical cancer, which is largely attributed to the human papilloma virus, or HPV, is one of the few preventable cancers. With the advent of Pap smears, an HPV vaccine and strong guidelines for screening, the incidence of cervical cancer has dropped significantly in the past 50 years. As advances are made in vaccinations that target a wider range of HPV, the incidence and death rates from this type of gynecological cancer should continue to decline.

Yet, quiet as it’s kept, uterine cancer is not only the most common gynecological cancer, but it is also the fourth most common cancer in women, trailing only breast, lung and colon cancers. The American Cancer Society estimates that in 2014 more than 53,000 new cases of uterine cancer were diagnosed and roughly 9,000 women succumbed to the disease.

Uterine cancer is also referred to as endometrial cancer. It gets its name from the endometrium, the inner lining of the upper part of the uterus. The cervix is the lower narrow part of the uterus. The endometrium is the site of 95 percent of all uterine cancers. The remaining 5 percent are called sarcomas, which grow in the muscle of the uterus.

Although it is more frequent in whites, the death rate from uterine cancer in blacks is roughly double that in whites and Latinas, according to the latest data from the National Cancer Institute.

The reason for this disparity is unclear. Lack of knowledge of symptoms and poor or delayed access to care are partially to blame. Yet the symptoms, particularly in older women, are distinct.

Spotting or bleeding, or an unusual discharge in postmenopausal women, should be evaluated by a gynecologist right away. For younger, pre-menopausal women, unusual bleeding, such as bleeding between periods or excessively heavy periods, should also be examined. These symptoms can occur with noncancerous conditions, such as uterine fibroids, but should still be checked out by a doctor. Other symptoms may include pelvic pain or pain during intercourse.

One of the most significant risk factors for uterine cancer is age. The median age of diagnosis is 62, but younger women are not exempt. Fran Drescher, the star of “The Nanny,” was diagnosed at the age of 42.

Hormones are another risk factor. Uterine cancer is often fueled by estrogen. Women with prolonged exposure to estrogen — those who started their periods early or stopped late, or those who have not had children — may have increased risk. In addition, it’s been found that taking estrogen alone (without progesterone) to treat the symptoms of menopause can lead to uterine cancer in some women.

Heredity plays a role as well. Uterine cancer tends to run in families, especially those with an inherited tendency to develop colon cancer. The risk of ovarian cancer is also increased in these women.

But the most controllable risk factor is obesity. That’s because fat tissue produces estrogen. Studies indicate that obese and overweight women have two to four times the risk of developing this disease than women of a normal weight, regardless of menopausal status. In addition, according to the American Cancer Society, uterine cancer can be up to four times more common in women who have diabetes. Obesity and diabetes are strongly linked.

The gold standard treatment for uterine cancer is hysterectomy, which can often be performed with less invasive techniques, such as laparoscopy or robotic surgery. Some cases may require chemotherapy, radiation or hormone therapy.

Currently, there is no screening test for uterine cancer. Pap smears can detect only cancers of the cervix.

The good news is that uterine cancer is often curable. The overall five-year survival rate is 81.5 percent, according to the National Cancer Institute. However, when detected and treated early, the five-year survival rate exceeds 95 percent.

Although most cases of uterine cancer cannot be prevented, there are some things that women can do to lower the risk of developing the disease. A healthy eating plan and regular physical activity and weight control are key to keeping uterine cancer at bay.