Uterine cancer?

Dear A little worried,

Cancer is always a worrisome topic, but finding answers to questions like these can help to put fears and concerns at ease, and perhaps can even help someone to catch the disease in its early stages. Kudos for taking the initiative to find out more!

The uterus, or womb, is a hollow, muscular reproductive organ in a woman's pelvic cavity. The most common type of uterine cancer affects the endometrium, the lining of the uterus. Endometrial cancer, commonly referred to as uterine cancer, accounts for 95 percent of malignancies of the uterus.

The most common symptom of endometrial cancer is unusual bleeding or spotting in the years leading up to or, particularly, after menopause. Some women, on the other hand, have a watery or white discharge with little or no trace of blood. For women still menstruating, increased menstrual flow and bleeding between periods may be the only symptoms. Other symptoms include pelvic pain, pain during intercourse/penetration or urination, and weight loss. Although many of these signs may be indications of other, less serious conditions or infections, it's important to talk about any symptoms with a health care provider. Most frequently, paying close attention to the signs and symptoms of endometrial cancer and mentioning that information to health care providers can help to catch the disease at an early stage, increasing the probability of a successful treatment. Endometrial cancer can reach an advanced stage without any signs or symptoms, although it's unlikely.

Endometrial cancer is the fourth most common cancer in American women, affecting about 55,000 women in the U.S. each year. If it's detected early, the five year survival rate (the percentage of women who live five years after diagnosis, not including those who die of other diseases) is high at 90 percent. This probability decreases if the cancer is detected in later stages.

While researchers do not know exactly what causes endometrial cancer, they believe that elevated estrogen levels may be a factor. Other risk factors, some of which are related to an increase in the body's exposure to estrogen, may include:

• Age — past menopause and between the ages of 60 and 70; 95 percent of endometrial cancer occurs in women over 40 years old
• Longer span of menstruation — women who started menstruating at an early age, i.e., before age twelve, then continuing to menstruate into their fifties
• Obesity
• Diabetes
• Hypertension
• Estrogen replacement therapy (ERT)
• Tamoxifen — an anti-estrogen used to treat breast cancer
• Having never been pregnant or given birth
• Pelvic radiation therapy
• High-fat diet
• History of breast or ovarian cancer
• Hereditary nonpolyposis colorectal cancer (HNPCC) — an inherited predisposition to colon cancer without the large number of polyps
• Race — white women are at higher risk (31 percent, according to one study) than black women

If you or someone you know is having abnormal periods or breakthrough bleeding, it makes sense to see a health care provider for an appointment and indicate the need to see someone sooner rather than later to have an exam and then a diagnosis. Whether or not it's uterine cancer or something else that needs attention, your well-being is worth the trip.