This is very different from cervical cancer. If the cancer is detected and treated early, the long-term prospects are good. In most cases, the uterus has to be removed. Bleeding irregularities or bleeding after the change are considered early signs of endometrial cancer. Other technical terms for uterine body cancer are corpus carcinoma and uterine carcinoma.
What is uterine cancer?
It is still unclear why the tissue of the uterine lining begins to grow uncontrollably in some women. What is certain, however, is that the female hormone estrogen plays a decisive role. Women whose bodies have to process a lot of oestrogen are therefore particularly at risk – for example due to an early onset and long-lasting period or due to long-term use of oestrogen preparations without a balancing progestogen. While oestrogen causes the lining of the uterus to grow during the menstrual cycle, progestogens ensure that it is shed again if no fertilized egg implants in the uterus. In the case of uterine cancer, however, this mucosal layer continues to grow. The cancer can then spread from the mucous membrane into the muscle layer of the uterus.
If the tumor is not detected in time, it can spread over time to the cervix or adjacent organs such as the ovaries or vagina. In the worst case, it can also form metastases in other organs of the body. The most important symptom of uterine cancer is vaginal bleeding after the menopause or, in younger women, bleeding between periods; this is an early symptom of the disease and must therefore be taken seriously.
Experts distinguish between two forms of uterine cancer:
- Type I carcinoma: The cancer is influenced by the hormone oestrogen. This type is responsible for around 80 percent of endometrial cancers.
- Type II carcinoma: The tumor develops independently of hormones.
Frequency and age
On average, 24 to 25 out of every 100,000 women in Switzerland develop cancer of the uterus in the course of their lives. Every year, around 900 women are diagnosed with uterine cancer in Switzerland. It is mostly older women who suffer from this disease. The average age of all affected women at diagnosis is 70. From the age of 74, the rate of new cases decreases again.
Uterine body cancer: causes and risk factors
Anyone who produces a lot of oestrogen in their body or takes the hormone in addition has an increased risk of uterine cancer. This may be due to an early onset and late cessation of menstruation or the intake of estrogens without the balancing hormone progestin. Pregnancies therefore reduce the risk of developing uterine cancer. Women before the menopause are less likely to be affected by uterine cancer. The risk of developing a tumor in the uterus increases up to the age of 74.
Other factors increase the risk of endometrial cancer:
Gynecological Tumor Center
At the USZ, numerous specialist departments have joined forces to form a Gynecological Tumor Center. The center is certified according to the guidelines of the German Cancer Society (DKG). A team of experts specializing in the medical treatment of uterine cancer works closely together here for the benefit of our patients. At DKG-certified centers, patients are treated according to strict quality criteria and, according to current studies, have a better chance of survival on average.
Symptoms: Bleeding indicates uterine cancer
Uterine cancer is often detected late. For a long time, those affected do not notice this disease. The lining of the uterus grows secretly without causing any discomfort. Often the first alarm signal is bleeding that resembles menstruation but only occurs after the menopause. In pre-menopausal women, bleeding between the normal menstrual periods can also be an indication. An unpleasant smelling discharge from the vagina, sometimes mixed with blood or pus, can also indicate a tumor. Another sign may be unwanted weight loss. If the tumor is already very large and has grown to the urinary bladder, chronic urinary tract infections can also be the result. However, most of these symptoms only develop at an advanced stage.
Second opinion for uterine cancer
When a cancer diagnosis is made, a second medical opinion is an important decision-making tool. The Comprehensive Cancer Center Zurich supports you with a professional expert opinion. They receive a thorough analysis of the situation as well as personal advice and quick answers to their questions.
Uterine cancer: diagnosis at the USZ
We will first ask you about your symptoms and carry out a normal palpation examination. With the help of an ultrasound through the vagina, we gain an initial insight into the uterus and can detect any abnormalities there. A hysteroscopy (endoscopy of the uterus) provides an even more precise picture: We insert an endoscope a few millimeters wide through the cervix into the uterus. In order to assess the uterine cavity, it must be dilated with a gas or a transparent liquid. We also perform a scraping during this examination. This allows us to obtain tissue that is examined for cancer. Diagnostic hysteroscopy can be performed on an outpatient basis. As a rule, a short anesthetic is required.
Depending on the stage of the cancer and its suspected spread, further imaging procedures may then be necessary: both magnetic resonance imaging (MRI) and computer tomography (CT) allow a closer look at various organs in the pelvic cavity. Positron emission tomography (PET) is used to detect any metastases in lymph nodes or organs.
Uterine cancer: prevention, early detection, prognosis
Taking the contraceptive pill over a longer period of time reduces the risk of developing endometrial cancer. Regular physical exercise and a normal weight can also protect against this type of cancer. Mothers of several children also have an advantage.
In any case, it makes sense to have regular check-ups with your gynecologist, because the earlier uterine cancer is detected, the better the chances of recovery. However, uterine cancer can often only be detected at an advanced stage during palpation.
If the cancer has already spread to other organs or even further afield, the likelihood of survival decreases considerably. Overall, uterine cancer is a dangerous disease: around 200 women die from it every year in Switzerland, many of them at an advanced age. However, mortality rates have fallen significantly in the last 40 years thanks to better diagnostic options. Newer treatment options can also lead to an improvement in the prognosis of the disease in more advanced stages.
Progression and prognosis of uterine cancer
The chances of recovery for women suffering from uterine cancer have improved significantly in recent years. Many women today have a long life ahead of them after having their uterus removed, especially if the cancer was detected early. For some, however, it is psychologically difficult to come to terms with the fact that they have lost their reproductive organs. The younger the affected women are, the greater the impact of this problem. However, there are now various offers of help. Many women also find the side effects of the treatments, such as problems during sexual intercourse, pain, nausea, exhaustion or bladder infections, stressful. We can alleviate some of these with further treatments. It is therefore important to always discuss any complaints with your doctor.
Self-help groups
The exchange with people who are affected by the same disease can be a great support in coping with the disease. Advice on finding a suitable self-help group is available from Selbsthilfe Zürich. Self-Help Zurich and the University Hospital Zurich are cooperation partners in the national project “Health literacy thanks to self-help-friendly hospitals”.
Uterine body cancer: treatment by surgery
The uterus almost always has to be removed (hysterectomy) in the case of uterine cancer. As those affected have usually already gone through the menopause, there is no obstacle to having children. During a hysterectomy, we usually remove not only the uterus but also the fallopian tubes and ovaries as well as surrounding tissue, such as adjacent lymph nodes. During the operation, we can see how far the cancer has spread. The subsequent treatment is then based on this. If the tumor has spread far and there is a risk of cancer cells spreading to other organs, further therapies are necessary, such as radiotherapy, chemotherapy or immunotherapy.
