Uterine Cancer

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Uterine cancer means that you have a cancerous tumor inside the uterus. The symptoms are often noticed early. Then you can get treatment that removes the disease. Cervical cancer is rare before the age of 40.

Cervical cancer is a different disease than cervical cancer.

What is uterine cancer?

Uterine cancer occurs in the mucous membrane on the inside of the uterus. More than 1,400 people a year get the disease. Most have passed the menopause. Most can receive treatment that removes the disease. Cervical cancer is the same as cervical cancer.

Uterine cancer begins in the mucosa

The mucous membrane of the uterus builds up when the hormone estrogen affects cells so that they divide and new cells are formed.

Uterine cancer can occur in the mucosa if something goes wrong in the cell division. First, the cancer tumor only grows in the mucosa. After a while, it can begin to grow through the mucous membrane and further into the uterine muscle wall.

The cancer cells can spread

There are  lymph vessels  and  blood vessels  in the uterine wall. The cancer cells can spread through them to the lymph nodes in the pelvis and stomach. There, the cancer cells can form metastases, which are the same as daughter tumors. The cancer cells can also spread to the ovaries, vagina and lungs.

Where does cancer occur?

The body consists of many billions of cells. The cells divide to form new cells so that the body can function. Sometimes it gets wrong when a cell divides. Usually, it does nothing or the cell can stop the error from spreading to more cells at the next cell division. But sometimes it doesn’t work. Then more and more altered cells can be formed for each cell division. Eventually, cancer cells can form and become a cancerous tumor. The cancer cells divide uncontrollably and do not die when they should. You can read more in the article What is Cancer?

Symptoms of uterine cancer

The symptoms of uterine cancer can be bleeding or floods that are somehow different:

  • You get bleeding even though you have stopped having menstruation.
  • You get altered movements when you are in menopause or after you stop having menstruation.
  • You get changed menstruation before you get into menopause or when you are in menopause. For example, changing menstruation may mean that you bleed more than you usually do or that the period lasts longer.

Pain is uncommon but can be a symptom if you have previously received treatment for, for example, the appearance or cell changes in the cervix . Then it can hurt because it is too crowded for the bleeding caused by the cancer to come out. It can hurt as in menses .

The symptoms may have causes other than cancer. Occasional bleeding during the first year after the last period is often due to the fact that the ovaries still produce a certain amount of hormones.

When and where should I seek care?

Contact a health care provider or gynecologist if you have any other bleeding or flooding that may indicate uterine cancer.

If it is a weekend, you can wait until it is everyday.

You can contact many receptions by logging in .

Investigations and investigations

You are called to a gynecological examination .

You are offered an examination according to a standardized course of care if the doctor suspects you may have uterine cancer. Standardized care is a way of organizing the investigation so that it goes as quickly as possible. Among other things, there are times set for the examinations you may need.

The doctor who writes the referral tells you why you should be investigated according to a standardized course of care, what it means and when you can be told if you have cancer or not.

It is often quick to get calls for examinations in a standardized course of care. It is good if you are clear about how the staff most safely reach you so that you do not miss any time.

Tissue tests show if there is cancer

A tissue test can show if you have uterine cancer. Often, the tissue sample can be taken during the gynecological examination. The doctor inserts a thin tube through the vagina, cervix and into the uterus. Mucosal cells are sucked out through the tube. It may hurt a little but sampling goes fast.

The tissue sample can also be taken during a gynecological scraping . Scraping is done in a hospital.

The tissue sample is sent to a laboratory where it is examined under a microscope.

More research if you have cancer

More research is needed to find out more about the disease if you have cancer. The studies can show how large the cancer tumor is and whether it has spread.

The lungs are usually x-rayed or the entire chest and abdomen are examined with computer tomography or with a magnetic camera to see if the cancer has spread.

Treatment for uterine cancer

A group of gynecologic cancer specialists suggest the treatment they deem to be best for you based on the studies that have been done. Then you and the doctor talk about it.

The most common treatment is surgery. After surgery, you may need radiotherapy and sometimes even chemotherapy.

Some receive radiotherapy or hormone therapy instead of surgery.

Almost all are operated

Most often, the entire uterus is removed. The fallopian tubes and ovaries are also removed because the cancer can spread there. Sometimes lymph nodes in the stomach are also removed.

You are anesthetized before surgery. 

The most common thing is to have surgery for puncture surgery, also called laparoscopy . Then narrow instruments are inserted through small holes in the abdomen. There, the organs are released so that they can be removed through the vagina.

Sometimes the surgeon needs to open his stomach.

After the surgery

It is common to be able to leave the hospital one to two days after the peephole operation. Some need to stay longer.

Serious complications are unusual. Some may have an infection in the wound or urinary tract infection. You are given blood thinners which reduce the risk of blood clots.

Contact the clinic where you were operated on if you get a fever, difficulty peeing or if it hurts in a new way the first few weeks after the surgery.

Consequences of the operation

You can no longer get pregnant if the uterus is removed. You enter the menopause if both ovaries have been removed and you have not already passed the menopause. You may get menopausal symptoms even if you have already passed menopause, but the appendages usually go over quickly.

Stop smoking or take a break

It is good if you who smoke quit it before the operation. The wounds heal better, the risk of infection decreases and you recover faster after the surgery. The best thing is if you completely quit smoking, otherwise make a stop before and after the operation. Talk to your doctor if you need help and support to quit smoking .

Different types of radiation therapy

You may receive radiotherapy after surgery if there is a risk that cancer cells may have spread outside the uterus.

You may also receive radiation therapy instead of being operated on if, for example, you have any other illness that makes it unsuitable for surgery.

There are external radiation therapy and internal radiation therapy.

External radiation therapy

External radiation treatment means that the radiation comes from a device outside the body. It is common to receive treatment every weekday for five weeks.

You just need to be in the hospital at every treatment opportunity. A treatment session takes a few minutes. The first visit may be a little longer.

Internal radiation therapy

Internal radiation treatment means that the radiation is delivered from within the body. 
You get to try out a capsule that looks like a wand. It is loaded with substances that radiate. The doctor inserts the capsule into the vagina and removes it after a few minutes. Then the treatment is done.

Treatment is usually done once a week for three weeks. You can leave the hospital immediately after each treatment.

Radiation therapy can cause problems that usually go away

Some suffer from problems while the treatment is in progress. You can get very tired, feel sick, have diarrhea or sweat when you are kissing. The problems usually go on for a while after the treatment is finished, but sometimes the problems persist.

In the text Radiation treatment you can read more about the problems and what can be done for them.

Cytostatic slows cell division

Sometimes cytostatics can be a complement to surgery and radiation therapy. Cytostatic drugs are given to you as a drop in the blood during a visit to the hospital.

The treatment takes a few hours. Afterwards, you can leave the hospital.

It is common for the treatment to be repeated four or six times. Between each course it usually takes three weeks.

Side effects of cytostatic drugs can often be alleviated

Cytostatics can make you feel ill, but there are good drugs that can relieve. 
It is common to become tired and sensitive to infections. Some cytostatic drugs can cause you to lose your hair. It will come back after the treatment. You can try out a wig before treatment begins, if you wish.

Treatment with hormones

Treatment with yellow body hormone can slow down and reduce both the cancerous tumor and the presence of metastases.

You can receive hormone therapy as the only treatment if, for example, you have any other illness that makes it inappropriate for surgery or radiotherapy. You will receive the treatment as tablets.

Check after treatment

You need to be in control when the treatment is complete. The checks are to find out if the disease is coming back and to help you with any side effects you may have received from the treatment.

The check always involves a gynecological examination . Sometimes more examinations are needed, such as a chest x-ray or computed tomography .

The risk of the disease recurring is greatest during the first years after treatment is completed. Therefore, it is common with checks every six months for the first three years after treatment, and then once a year for two years. But it can vary how many control visits are needed. 

If the disease comes back

There are several options for treatment if the disease recurs. The treatment depends on how you are feeling and where in the body the cancer is coming back.

Often you can get cytostatics, but you may get to try other varieties than when you first had the disease. You may be re-operated if there is a possibility that all cancer can be removed. You can also get treatment with yellow body hormone.

If you don’t get rid of the cancer

Sometimes it is not possible to get rid of the disease. Then there is treatment that can still allow you to live a good life long with the disease. There are treatments that can slow down the disease and that can relieve symptoms for a long time, sometimes for many years. Such treatment is called palliative care .

How is life affected by uterine cancer?

It varies from person to person how the disease and treatments affect life. Most feel good after the treatment and have no or only minor problems.

How big the changes will be for you depends on what treatment you need, if you have other illnesses and how you feel otherwise. It can also vary from one period to another. 

Here are some things you can experience after treatment for uterine cancer.

Some feel missing

The uterus is needed for you to be pregnant. It can also be an important part of who you are – whether you have already given birth or cannot or do not intend to. It may be the cause if you feel sadness and missing after treatment for uterine cancer.

Fatigue can have different causes

Some may feel very tired. The fatigue remains even when you rest and sleep.

Fatigue can have one or more causes, for example:

  • The disease can affect the body in different ways so that you get tired.
  • You get in too little energy.
  • The treatment can be tiring in various ways.
  • Concern or depression.

Tell the health care provider if you are very tired. Make sure you and any close relatives know more about the fatigue and what it is due to. It can also help and increase the understanding of the surroundings.

Physical activity can make you feel less tired. Touch yourself in a way that suits you .

Several short rest breaks are usually better than a single, longer rest break.

Medicines can also help with fatigue.

Urinary incontinence and bowel incontinence

Radiation treatment can cause incontinence. That means it’s hard to keep up. You may have urinary incontinence or bowel incontinence.

A physiotherapist can help you train your muscles so that you can pinch if needed. There are drugs that relieve the hassle. There are also different types of incontinence protection. The district nurse can arrange free incontinence care.

The appetite and intestines can be affected by radiation therapy

The recovery depends a lot on getting the nutrition you need. Sometimes it is difficult.

The disease and treatments can affect the desire to eat. The taste experience can be affected. You may also get constipation or diarrhea.

Tell your doctor or contact nurse who can make sure you meet a dietician. The dietitian can help you with tips on food and strategies for eating and getting organized on the intestines.

Lymphedema can be treated

You may get lymphedema if the lymph nodes have been removed or if you have received radiotherapy.

Lymphedema means that lymph fluid is collected so that you get the trouble of swelling. You can get swelling in the abdomen or legs.

Tell your doctor or contact nurse if you get swelling or a feeling of weight so you can get treatment as soon as possible. This reduces the risk of the problems becoming difficult.

Sexuality and closeness

It is possible to have a good sex life and cohabitation after uterine cancer, but it may take time.

The illness and treatments can make you think differently about yourself and your body. Some lose their desire for feeling anxious or depressed.

It can be difficult to talk about the changed situation. You can get help, for example by a psychotherapist or a sexologist.

You can get help whether you have a partner or not. If you have a partner, the help can be about talking support so you can talk to each other or discover new ways of being together.

menopausal

You come into the menopause if the ovaries have also been removed and you still had menstruation. Then you can get ridges, or the trouble of getting your vagina dry and burning. There are different kinds of drugs that can help.

What is the cause of uterine cancer?

It is not possible to say exactly why someone gets uterine cancer, but the hormones estrogen and yellow body hormone are often important. Yellow body hormone is the same as progesterone.

Estrogen and yellow body hormone control the menstrual cycle by affecting the lining of the uterus in different ways. Estrogen builds up the mucous membrane. Yellow body hormone interrupts the build-up.

The risk of uterine cancer increases if estrogen can work without being balanced by yellow body hormone. This can happen for a variety of reasons, which you can read about here.

Your weight affects the risk

The greatest risk of uterine cancer is obesity . This is because estrogen is produced in the body fat, except in the ovaries. The more obesity you have, the more estrogen is formed.

The risk increases the older you are

The ovaries stop producing the estrogen and yellow body hormones when you have had your last period. But the body continues to form a certain amount of estrogen in the body fat.

Meaning is important

You are exposed to more estrogen the more times you have had menstruation. So the risk of cancer increases if you start getting menstruation early and stop having menstruation late.

The risk of uterine cancer can increase if there is a long time between the times you have menstruation, such as in polycystic ovarian syndrome, PCOS. Then you have no ovulation and only a little yellow body hormone.

Some treatment for menopausal disorders

Treatment with estrogen without the addition of artificial yellow body hormone increases the risk of uterine cancer if you have a uterus. Artificial yellow body hormone is also called gestagenic hormone.

The disease is rarely hereditary

Less than five percent of all cervical cancers are hereditary. Hereditary cervical cancer may be due to a change in some genes called the Lynch genes. The change also increases the risk of colon cancer and rectal cancer.

You can get a referral  to a cancer genetic clinic if you have close genetic relatives who have had colon, rectal or uterine cancer and who became ill before the age of 50. At the reception, an investigation is done that can show if you also have the gene change.

You can remove the uterus even though it is healthy if you have a hereditary risk of cancer. You are carefully investigated and meet with both a specialist physician and a psychologist before making a decision about surgery that may prevent you from getting uterine cancer.

How can I reduce the risk of uterine cancer?

Avoiding overweight is the most important thing you can do to reduce the risk of uterine cancer. Eat good food and stir .

Pregnancy protects against uterine cancer. This is because you have more yellow body hormone in your body if you are pregnant. The risk of cancer decreases the more times you have been pregnant.

Birth control pills, birth control pills, or birth control patches also protect against uterine cancer. The protection remains for several years after you have stopped using oral contraceptives, oral contraceptives or patches.

Treatment for menopausal disorders reduces the risk if estrogen is combined with the progestin, which is an artificial yellow body hormone.

Treatment to get your period started reduces the risk of uterine cancer if you have polycystic ovarian syndrome, PCOS and are of childbearing age.

Be involved and influence your care

You have the right to be involved in your care as far as possible. The healthcare staff should tell you what treatment options are available. They should make sure you understand what the different options mean, what side effects are available and where you can get treatment. This way you can help decide on your treatment.

Ask questions if you don’t understand. You can also ask for information printed so that you can read it peacefully.

You have the right to receive interpreting assistance if you have a hearing impairment.

Make a care plan

You can make a care plan together with the contact nurse, the doctor and other staff. The care plan should contain information that is important to you, such as contact information and how to get the rehabilitation you need.

You can get a new medical assessment

You may get a  new medical assessment  from another doctor if you have a life-threatening or particularly serious illness. Obtaining another doctor’s assessment can help you, for example, if you are unsure of which treatment or treatment is best for you. 

Getting a cancer message

You can respond in many ways to a cancer message. It is common to need a lot of time to talk to your doctor and other healthcare professionals about what the message means.

If possible, please let a relative accompany you. The related person can act as a support and help to remember what has been said.

In many hospitals, there are special nurses called contact nurses who should be especially accessible to the sick person and to the relatives. The contact nurse can provide support and also help with various practical things.

You can get support in several places

Talk to the contact nurse or the hospital’s curator if you feel anxious or have questions.

You can also contact for example Cancer Counseling or Cancer Foundation. Favorable is a patient organization where you can get in touch with one or more people who have their own experiences of gynecological cancer. Uterine cancer is a gynecological cancer disease.

It is common for it to feel easier once treatment has begun and you know what is going to happen.

Children need to know

Children have the right to receive information and support based on their own needs if a relative is ill. You can get help with what you have to say, if you want to and can tell the child yourself.

Often it is good to make children as involved as possible, regardless of age. But you may need to customize the information and not have to tell everything. It may be good to start with the child’s own questions.

Being related

It can feel difficult to be close to someone who is sick. It is common to want to support while you have a strong concern and feel bad.

If you have people close to you, they can be a support. Often it will be easier for them to help you if you tell them how it feels. You can also talk to the contact nurse if you are close and need supportive calls.

You can get relief if you help take care of or support the sick person. You can also get support, for example in the form of calls or help with practical things.

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