Every year around 11,000 women in Germany are newly diagnosed with cervical cancer. Most of those affected are older than 60 years. If the so-called endometrial carcinoma is detected early, the chances of recovery are good. What symptoms are possible and how is the treatment carried out?
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quick overview
Definition: Endometrial carcinoma (cancer of the lining of the uterus) is a malignant tumour. It is not to be confused with cervical cancer (cervical carcinoma).
Risk Factors: long-term use of estrogen preparations, obesity, old age, diseases such as diabetes or breast cancer
Diagnosis: Tissue sample (biopsy) as part of a uterine scraping, vaginal ultrasound, imaging procedures
Therapy: surgical removal of the uterus (hysterectomy), radiotherapy, chemotherapy, hormone therapy
Article content at a glance:
The most common types of cancer in Germany
What is uterine cancer?
Uterine cancer is a malignant disease in which the mucous membrane cells inside the uterus degenerate. It should not be confused with what is known as cervical cancer, which develops in the neck of the womb (cervix) and is therefore also known as cervical carcinoma.
Unlike cervical carcinoma, the early stages of which are usually detected before the age of 40, uterine cancer mainly occurs after the age of 60. The mean age at diagnosis is 68 years. With around 11,000 new cases per year, uterine cancer is the most common cancer of the internal female genital organs.
Other names for uterine cancer are:
- uterine body cancer
- endometrial cancer
- Endometrial carcinoma (endometrium = mucous membrane of the uterus)
- Uterine carcinoma (uterus = uterus)
- corpus carcinoma
Symptoms and warning signs of cervical cancer
Initially, uterine cancer does not cause any specific symptoms. Unusual bleeding, especially after the menopause, can be the first indication of cancer and should be clarified quickly in any case. However, women before menopause should also have unusually heavy and irregular bleeding examined by a doctor.
Advanced stage symptom:
- blood in the urine or stool
- inexplicable abdominal pain
- bloody or flesh-colored, often foul-smelling vaginal discharge
- irregular urination or bowel movements
- unusual weight loss
Irregular urge to urinate or bowel movements can also indicate other (harmless) diseases. However, if you have one or more of these signs, you should see a doctor.
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Uterine cancer: causes and risk factors
The exact causes of malignant tumors of the uterine body have not yet been finally clarified. It is certain that hormonal factors play an important role, in particular a long-lasting influence of the female sex hormone estrogen. For this reason, early puberty as well as late menopause (menopause) mean a statistically higher risk of developing uterine cancer.
Women are affected more often than average:
over 50 years
overweight (estrogens are formed in the fat cells)
who have no children
who have only taken estrogen-containing medication (without progestin) for a long time as part of the treatment of menopausal symptoms
who have breast or colon cancer
who suffer from long-term bleeding disorders
who have close relatives with cervical cancer
who suffer from diabetes mellitus or high blood pressure
Studies indicate that progestogen-containing combination preparations of the birth control pill can slightly reduce the risk of disease.
Diagnosis: examinations for suspected uterine cancer
Unlike cervical cancer, there is no early detection test (pap smear) for uterine cancer. However, routine palpation of the uterus as part of the gynecological check-up can provide important initial indications of endometrial carcinoma.
If uterine cancer is suspected, the doctor usually performs a vaginal ultrasound examination. Frequently, a scraping (abrasio) of the uterus is then performed. Tissue removed from the lining of the uterus is then examined in the laboratory for cancer cells.
If an endometrial carcinoma is present, further procedures can be used:
This will clarify the size of the tumor and its possible spread to neighboring organs.
How can uterine cancer be treated?
The treatment depends on the stage of the endometrial cancer and the patient’s state of health. Four different options are possible:
Surgery: The treatment of choice is surgical removal of the tumor. This usually involves removing the entire uterus, fallopian tubes and ovaries (hysterectomy) and the adjacent lymph nodes. If the tumor has already spread to neighboring organs, parts of the intestine or bladder may also have to be removed.
Radiotherapy: If the disease is already more advanced, radiation therapy can follow to fight any remaining cancer cells.
Chemotherapy: At certain stages, chemotherapy can be an alternative or supplement to radiation therapy. This is where cytostatics come into play. These are drugs that kill cancer cells.
endocrine therapy: If secondary tumors (metastases) have already formed in other organs, hormone therapy is an option. High doses of progestin are administered. The hormone is the antagonist of estrogen. It inhibits the growth of tumors originating from the lining of the womb.
uterine cancer and the desire to have children
After a hysterectomy or radiation to the uterus and ovaries, it is no longer possible for women to become pregnant. However, for women who want to have children, treatment can sometimes be adjusted in the early stages so that they remain fertile.
Uterine cancer: life expectancy and chances of recovery
Uterine cancer is usually detected in the early stages when the cancer is still limited to the lining of the uterus. In this phase, the chances of recovery are good. If the cancer cells are only slightly aggressive and the tumor has not grown through more than half of the uterine wall, the survival rate after 5 years is 95 percent. However, the chances of recovery decrease significantly the later the carcinoma is discovered. The median 5-year survival rate for all stages is 65 percent.
Once treatment is complete, follow-up care begins. This includes regular check-ups to check if the tumor has come back.
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