Endometrial cancer of the uterus: symptoms and signs
Hormonal disorders, diseases of the genital organs, malfunction of the endocrine system and metabolic processes increase the likelihood of tumors in the inner layer of the uterus lining its cavity. This pathology often develops in women of menopausal age (49-60 years), in the last decade, the disease occurs in women under 29 years old. Time to go to the doctor and save your life, you must know what is endometrial cancer symptoms and signs.
The symptoms of carcinoma of the endometrium
Cancer (carcinoma) of the uterine endometrium is recognized as the most common neoplastic disease of the genital organs and is second in frequency of diagnosis of oncological processes in women, second only to cancer of the breast. According to ICD uterine cancer refers to a category C54 – malignant neoplasm of body of uterus. This code is used by the oncologists when writing history.
Some time endometrial cancer does not manifest itself. The first signs of the pathological process appear when the tumor reaches a certain size, what disrupts the normal operations of the endometrium.
Uterine cancer has specific symptoms in the early stages of development, which makes it possible to diagnose it in a timely manner:
- Uterine bleeding that occurs after the beginning of menopause (found in 90% of cases postmenopausal women).
- Of bleeding in the intermenstrual period. They are not always a sign of a tumor, as it may indicate the violation of the cycle, and pathology of cervical and other gynecological diseases. The search for the causes of this phenomenon significantly increases the cancer detection.
- Serous and purulent discharge from the vagina, appearing in the decay (necrosis) of the tumor and the growth of pathogenic bacterial flora.
- Selection brown with an admixture of pus and mucus, which has an unpleasant odor and is not accompanied by pain sensations.
- Watery discharge, copious leucorrhoea.
- Lower abdominal pain with cramping or persistent, radiating to the lower back. Occur in the later stages of disease, when disturbed patency of the cervical canal, the metastasis of cancer cells and affects the nerve endings.
- Violation of urination and defecation as a result of tumor invasion into the bowel and urinary tract.
- Blood in the urine and the stool.
- Discomfort and pain during intimacy.
- Swelling of the internal genital organs, determined during palpation.
Pronounced signs of uterine cancer are confirmed in the result of laboratory tests and ultrasound.
Carcinoma of the endometrium characteristic General symptoms of neoplastic diseases:
- General weakness in the body;
- loss of appetite and resulting a fast weight loss (in later stages);
- pale skin.
Uterine cancer does not occur suddenly on the background of complete health. The development of a malignant tumor preceded by precancerous conditions (including endometrial hyperplasia with atypia). Early diagnosis and timely treatment of precancerous processes significantly reduce the risk of cancer and increase life expectancy.
Signs of cancer of the endometrium depending on its pathogenesis
In medicine the root causes of the development of endometrial carcinoma divided into three groups:
- Estrogen-dependent, characterized by the combination of increased production of estrogen by metabolic processes in the body (hypertension, diabetes, etc.). Meet 70% of patients. The emerging tumors are sensitive to Progestogens, grow slowly and metastasize, which provides a favorable prognosis of the disease.
Carcinoma of the endometrium, which develops as a result of estrogens, has the following accompanying signs:
- obesity, contributing to the conversion of androgens into estrogens in adipose tissue;
- malfunction of the adrenal cortex, the liver;
- uterine bleeding;
- delay menopause;
- hyperplastic changes in the endometrium.
High levels of estrogen in the blood contributes to a simultaneous formation of tumors in the mammary glands, ovaries and intestines.
- Estrogenozawisimae occur in 30% of patients with endometrial cancer. The tumor does not depend on the level of hormones in the blood and is the result of atrophy of the inner layer of the uterus. This form of the disease is characterized by:
- weak differentiation;
- autonomy development;
- insensitivity to the progestin;
- high ability to metastasize;
- uterine bleeding;
- profuse and prolonged menstruation.
Cancer treatment of this type is more difficult and has a less favorable prognosis.
- Endometrial cancer may have a genetic in nature of origin. Therefore, women carrying a genetic predisposition to this disease, should pay attention to their health and regularly visit a gynecologist.
Stage of development and symptoms of endometrial cancer
Pathological changes of the uterus have symptoms at each stage of progression:
|The stage of progression of precancerous lesions and endometrial cancer||Occurring in the body changes||Symptoms|
|The first stage||Functional impairment (increased production of estrogen, lack of ovulation, cystic masses in the ovaries, etc.).||At this stage, the cancer starts yet, but there are risk factors for its occurrence. To diagnose an underlying medical condition is possible when conducting a pelvic examination, ultrasound and laboratory examinations.|
|The second stage||The development of morphological changes with the background character (hyperplasia and endometrial polyps).||Arise uterine bleeding, abdominal pain, disturbance of the cycle.|
|The third stage||The formation of preneoplastic morphological changes (atypical endometrial hyperplasia that develops in the basal, functional or both layers).||Deteriorating General condition of the woman, having frequent bleeding, anemia.|
|The fourth stage||The formation of malignant neoplasms (carcinoma in situ, carcinoma with minimal invasion into the layers of the uterus, severe types of cancer of the uterine body).||The first manifestations of cancer.|
The prognosis of the disease depends on the reaction of women when the signs of precancer and cancer and early intervention specialists.
Actually endometrial cancer in its development goes through four stages:
Stage of cervical cancer at FIGO Feature Forecast (five-year survival) Pre-invasive carcinoma (in situ)
95 – 98%
I The tumor does not extend beyond the body of the uterus
86 – 98%
II The tumor goes to the cervix
III Cancer spreads to the ovaries, fallopian tubes, vagina.
IV The tumor goes to the bladder and rectum. Marked distant metastases.
There are the following histological types of uterine cancer:
- clear cell;
- glandular-squamous cell;
Adenocarcinoma is vysokomehanizirovannoe tumor. The prognosis of this disease is quite favourable. When nizkoeffektivnyj and undifferentiated tumors five-year survival is much lower. This classification takes into account practicing oncologists in determining prognosis and designing the regimens. The structure of tumors is determined by histological examination.
Ways of metastasis of cervical cancer:
- lymphogenic (lymph nodes of the pelvis and distant);
- hematogenous (through the blood vessels to the liver, lungs, bones);
- implantation (lesion the myometrium, and peritoneum perimetry).
What to do if signs of endometrial cancer?
Inadequate treatment of endometrial cancer (including the presence of risk factors) at the initial stage and ignoring its symptoms lead to metastasis of tumor cells in various organs, recurrence of pathology after complete cure and death.
Most susceptible to the symptoms of endometrial cancer women:
- menopausal age;
- having a genetic predisposition;
- suffering from diseases of the endocrine system, Central nervous system and obesity;
- subject to the hormonal fluctuations;
- with functional disorders of the pelvic organs (endometrial hyperplasia, lack of ovulation, irregular menstrual cycles, cystic masses in the ovaries etc.);
- using hormonal drugs, including for contraception;
- some benign tumors of the uterus;
- do not have children.
If signs of the cancer process you need immediately to address to the gynecologist, to pass the necessary laboratory and clinical examination and to obtain recommendations on treatment and prevention of carcinoma of the endometrium.
The diagnostic circuit includes:
- gynecological examination;
- a blood test for tumor markers: SCCA, CA-125, CEA, CA 27 – 29.
- Ultrasound of the pelvic organs;
- hysteroscopy endoscopic examination of the uterus;
- biopsy and histological examination.
Upon confirmation of the diagnosis developed treatment. The choice of method of treatment will depend on the degree of progression of the disease:
- surgical treatment (removal of the uterus, together with cervix, appendages – according to indications);
- radiation treatment;
- hormonal therapy.
Women at risk must:
- to monitor body weight, maintain a healthy lifestyle at a young age;
- in a timely manner to treat infectious and inflammatory processes in the genital organs;
- to monitor the duration of the menstrual cycle and the nature of the discharge;
- use preparations containing hormones, under medical supervision and in the specified dosage;
- regularly visit an endocrinologist if there are hormonal irregularities;
- every six months to visit the gynecologist to be tested for Cytology and undergo ultrasound examination of small pelvis organs;
- to plan pregnancy and child birth.
Patients previously cured of cancer, to be tested by experts 3 – 4 times a year.