The uterus is the hollow muscular organ where a pregnancy can develop in women. As in other organs, cancer may also develop, which can compromise reproductive ability.
It is important before any type of cancer to offer the patient the possibility of preserving her fertility by vitrifying her eggs in case she wants to be a mother in the future, although in the case of uterine cancer it is possible that the woman cannot carry a child.
There is a great rejection of treatment by surgery because of the desire to have children, but conservative treatments present the risk of incompletely treating the cancer.
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The most common symptoms of uterine cancer are the following:
- Abnormal vaginal bleeding
- Frequent urination
- Difficulty or pain when urinating
- Pain during sexual intercourse
- Pain in the pelvic area
- Weight Loss
Abnormal vaginal bleeding is a very common and early onset symptom of uterine cancer. They are common with other diseases or conditions, so if you have any of them it is important to go to the doctor to determine the cause.
Types and risk factors
Depending on its location, there are two types of uterine cancer:
- Endometrial cancer is the most common type. It affects the endometrium, the inner lining of the uterus that changes in thickness with each menstrual cycle to allow implantation of the embryo.
- Uterine Sarcoma: A rare form in which cancer affects the muscle of the uterus and the tissue that supports it.
When we talk about uterine cancer, we generally refer to endometrial cancer because it has the highest incidence.
The risk of endometrial cancer can be increased by obesity, high blood pressure, diabetes mellitus and taking estrogen (without progesterone). In the case of uterine sarcoma, the risk may be increased by radiation therapy to the pelvis.
In addition, tamoxifen treatment of breast cancer may increase the risk of both endometrial cancer and uterine sarcoma.
A pelvic exam is needed to safely diagnose this type of cancer. It involves feeling the size, shape, and position of the uterus and ovaries by inserting one or two fingers into the vagina while pressing the lower abdomen with the other hand.
The uterus and ovaries are also checked by transvaginal ultrasound for tumors and abnormalities.
In order to analyse the cells of the uterus, dilation and curettage are necessary to remove tissue samples from the inner lining of the uterus and analyse them. These cells may also be tested by endometrial biopsy.
Treatment and fertility
The treatment will depend on the type of uterine cancer the patient presents and the prognosis according to the size and type of tumor. In general, it can be said that sarcoma of the uterus is more difficult to cure than endometrial cancer.
Surgery is the most common treatment for both types of uterine cancer to prevent the cancer from continuing to grow and spread to other tissues and organs. Surgeries are performed to remove the ovaries and tubes (bilateral salpingo-oophorectomy) and/or the uterus (hysterectomy).
Other treatments include radiation therapy, chemotherapy, hormone therapy, and immunotherapy.
If the treatment choice is surgery, which would be the most normal, it may be necessary to access surrogacy to access maternity.
If one of the other types of treatment is used instead of surgery, the woman may become pregnant in the future, even if radiation and chemotherapy have a negative effect on fertility.
It is important to offer these patients the possibility of preserving their fertility before starting treatment, as the quality and quantity of the eggs will be severely affected.
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