Reproductive Cancers

Types of Uterine Cancer

There are two types of uterine cancer: endometrial and sarcoma. Endometrial cancer, beginning in the lining of the uterus, is the most common type. It usually occurs after menopause in women whose risk factors include family history, obesity, hypertension, diabetes, and exposure to high levels of estrogen, especially without the balancing effects of progesterone, and exposure to radiation therapy in the pelvic area. The most common symptom is abnormal vaginal bleeding. Diagnosis is made by transvaginal ultrasound and endometrial biopsy. If treated early, and the cancer has not spread beyond the uterus, the survival rate is high. Uterine sarcoma, beginning in the connective or other tissue of the uterus, occurs in only about 5 percent of uterine cancers. Symptoms are similar to that for endometrial cancer, and risk factors include exposure to radiation therapy and the use of tamoxifen to treat breast cancer. Treatment for both is similar and includes hysterectomy, or removal of the uterus—the most common treatment—followed by radiation, chemotherapy, or hormone therapy if the cancer has metastasized.

Cervical cancer begins in the lower part of the uterus that extends into the vagina. It is the fifth most common cancer in women worldwide and the first and second most common in middle-income and developing countries. This slow-growing cancer has few symptoms in earlier stages and is, therefore, usually diagnosed in middle age. Later-stage symptoms include abnormal bleeding and discharge, low back pain, and pain during intercourse and urination. While the predominant risk factor is the very common sexually transmitted human papillomaviruses (HPV), which is highly preventable with the use of condoms, most women with HPV do not get cervical or other reproductive cancers.

The synthetic estrogen diethylstilbestrol (DES), used on pregnant women primarily from the late 1930s to the early 1970s—and “dumped” for profit by pharmaceutical companies into third-world nations for use by pregnant women after it was banned in developed countries—also is known to cause cervical and vaginal cancer. This is particularly true in young girls and younger women. Regular PAP tests and pelvic examination used to detect precancerous changes make cervical cancer highly preventable and, when found early, extremely treatable. Treatment involves removal of the cancerous tissue, which may be accompanied by chemotherapy or radiation. Recently, health agencies have recommended that girls between the ages of 9 and 26 get the HPV vaccine to reduce their risk of cervical, vulvar, and vaginal cancers.

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