The uterus, or womb, is a small, pear-shaped organ located in the pelvis, consisting of the cervix, or neck of the uterus, and the corpus or main body of the uterus. The uterus is the organ in which the fertilized egg attaches itself and develops during pregnancy.
The two common forms of uterine cancer are cervical (from the neck of the uterus) and endometrial (from the lining of the corpus or body of the uterus). The cells covering the cervix usually go through mild to severe changes called dysplasia before becoming cancer. Similarly tissue lining the corpus goes through mild to severe changes called hyperplasia before becoming cancer.
These pre-cancerous conditions do not necessarily lead to cancer. It is important, however, that any woman with such a condition be treated and then examined by a physician at regular intervals.
The earliest stage of uterine cancer is called carcinoma in situ (Cancer confined to its original site). If not detected and treated properly, cancer cells penetrate into deeper layers of the uterus, then spread to neighboring organs such as the vagina, bladder or rectum and eventually metastasize to other parts of the body.
At higher risk of cervical cancer are women who have unusual bleeding or vaginal discharge between periods, had frequent sex before age of 20 or sex with many partners, and women with poor genital hygiene. The highest incidence occurs in women aged 40-49.
Most cases of endometrial cancer are diagnosed in women between the age of 50 and 64. It rarely occurs in women under 40. At higher risk are women who, during or after menopause, have unusual bleeding or discharge have estrogen therapy during or after menopause, had a late menopause (after 55); have diabetes, high blood pressure and an overweight problem.
Signs And Symptoms
The earliest warning signs of cervical cancer are irregular bleeding or vaginal discharge charge. Warning signs of endometrial cancer include bleeding between menstrual periods, excessive bleeding during periods, and bleeding after menopause.
Any of these signs should be reported promptly to a physician.
Cancer Of The Cervix
The Pap test is highly accurate in detecting cervical cancer at an early stage. It can also show cell changes that could develop into cancer.
The Pap test takes but a few minutes, is painless, and can be done in the physician's office. It is the examination under a microscope of cells normally shed from the body of the uterus and from the cervix, These cells collect in the vaginal fluid and can be collected, along with cells taken from the surface of the cervix, on a cotton swab or stick.
If the cell samples reveal any abnormality, additional diagnostic techniques may include:
1. Colposcopy-the visual examination of the vagina and cervix with a magnifying instrument called the colposcope to check tissue for abnormality.
2. Biopsy- the surgical removal, for microscopic examination, of a piece of tissue from a suspected area. This is the only way to positively determine if cancer cells are present.
3. Conization-a surgical procedure to remove a cone-shaped specimen of tissue from the cervical canal. This provides a larger tissue sample than is removed for a biopsy.
Cancer Of The Endometrium
The Pap test is only about 40 percent effective in detecting endometrial cancer. More effective diagnostic techniques are:
Dilation and Curettage (D and C)- Removal of tissue samples from the body of the uterus, by a scraping technique while the patient is anesthetized. It is done in the hospital and the tissue samples can be studied microscopically for cell changes characteristic of cancer.
Aspiration Curettage-This provides samples of tissue from the walls of the body of the uterus, through suction with a small instrument inserted through the cervix. The procedure is painless and can be performed in a physician's office. The tissue samples are then studied under the microscope for abnormal cell changes.