“Guide to Uterine Cancer”

 

WHAT IS IT? It’s a cancerous tumor in your uterus, the pear-shaped organ also known as your womb. Most cases happen in the lining of the uterus (endometrium), but you can get tumors in the muscles there, too. Over 60,000 women in the U.S. get this type of cancer each year. If you’re past menopause, your chances are higher.

YOUR GENES: These can play a role in how likely you are to have uterine cancer. For example, Lynch syndrome is a genetic disorder that makes you more likely to get certain cancers. Women with it have much higher odds of getting uterine cancer. But having a problem gene doesn’t mean you’ll get it. It means you and your doctor should watch for signs so you can treat it early if you do. Most women who get uterine cancer don’t have a known genetic cause.

EARLY SIGNS: If you haven’t been through menopause and you have bleeding or spotting -- a red, pink, or white discharge -- between periods, see your doctor. The same is true if you’ve had menopause and have these symptoms any time. Bleeding can be a sign of uterine cancer, but it’s also a symptom of other medical problems. Bleeding after menopause isn’t normal, so it definitely needs to be checked out. Your doctor can help you find out what’s going on.

OTHER SYMPTOMS: Let your doctor know if you have:

• Pain in your pelvis (the area between your hips)
• Lost weight without trying
• Pain during sex
• A hard time peeing or it hurts to pee

It’s best if you find uterine cancer before it grows or spreads, so don’t put off your checkups or ignore symptoms.

HOW IT’S DIAGNOSED: You may have an ultrasound so your doctor can see inside your uterus. Your doctor may send a thin, lighted tube in through your vagina to get a closer look. But a biopsy is the best way to know if it’s cancer. Your doctor will take a small amount of tissue from the endometrium and look for cancer cells under a microscope.

HAS IT SPREAD? If you have uterine cancer, your doctor will start with one of the following to see if it has spread to nearby areas, like your cervix, or to your lymph nodes (tiny glands in your neck, armpits, groin, and other parts of your body):

• Ultrasound
• MRI scan, which uses magnets and radio waves to make detailed images of parts of your body
• CT scan, which takes X-rays from different angles and puts them together to make a more complete picture

SURGERY: Your doctor probably will recommend that your uterus be taken out. They may surgically remove your uterus through your vagina or abdomen. The procedure is called a hysterectomy. Your ovaries and fallopian tubes will probably be removed, too. If your cancer has spread, your doctor also may take out nearby lymph nodes. 

RADIATION: Your doctor may recommend this after surgery to kill any cancer cells that may still be there. It may also be an option if surgery isn’t a good idea for you. Your doctor may insert a cylinder containing radioactive material into your vagina or use a machine to aim high-energy rays at the harmful cells. New types of radiation treatment make a 3-dimensional beam that’s the exact shape of the tumor.

HORMONE THERAPY: Estrogen and other hormones in your body can make uterine cancer grow or spread faster. Drugs like progestins, tamoxifen, LHRH agonists, and aromatase inhibitors are used to block these hormones to slow the tumor’s growth. This can cause side effects that feel like menopause, including hot flashes, weight gain, or dryness in your vagina.

IMMUNOTHERAPY: These drugs help your own immune system find and attack cancer cells. To keep itself from fighting the body's normal cells, your immune system uses "checkpoints." These are parts of cells that need to be turned on or off to start the disease-fighting process. Drugs that target these checkpoints, called immune checkpoint inhibitors, may help treat some more serious types of endometrial cancer.

TARGETED THERAPY: Some newer drugs target changes that are seen in cancer cells. Several of them work by stopping new blood vessels from forming in tumors. This helps slow the spread of cancer.

CLINICAL TRIALS: You may be able to be part of a test for new and better drugs to treat uterine cancer. Ask your doctor if there are trials in your area and if one might be right for you.

YOUR SEX LIFE: Side effects of uterine cancer treatment can change your sex life. Vaginal dryness or mood changes from hormone therapy may make sex painful or reduce your desire. If you’ve had surgery to remove both your ovaries and uterus, you may have the same issues. But lubricants can help with dryness, and some women say their sex lives actually got better after surgery because they have less pain and other symptoms.

PREGNANCY: While most women who get uterine cancer are past menopause, younger women can get it, too. If you hope to have children, talk to your doctor about your options, such as storing eggs, before you begin treatment -- surgery, radiation, and hormones can affect your fertility. 

CAN YOU PREVENT IT? Get regular women’s health checkups so your doctor can spot any signs of cancer early. Your age, genes, and family history may raise your risk of uterine cancer. So can obesity. You can do some things to help prevent it, though, like staying at a healthy weight and getting plenty of exercise. Work closely with your doctor, who can help you control the risk factors that can be controlled. 

REVIEWED BY: Laura J. Martin, MD, WebMD, on February 18, 2020

REFERENCES:

Memorial Sloan Kettering Cancer Center: “Uterine (Endometrial) Cancer.”

American Cancer Society: “Endometrial Cancer,” "Immunotherapy for Endometrial Cancer," "Targeted Therapy for Endometrial Cancer."

MD Anderson Cancer Center: “Uterine Cancer Facts.”

National Cancer Institute: “Uterine Cancer.”

Dana-Farber Cancer Institute: “Endometrial Cancer.”

HealthyWomen.org: “Sex After a Hysterectomy.”

Cedars-Sinai Hospital: “Uterine Cancer Genetic Risk.”

NHS Choices: “Sex after hysterectomy.”

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell #FeelFree2SignUpAndFollow

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.
 
"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.  

“A Visual Guide to Breast Cancer”

Breast Cancer Today: Breast cancer isn’t what it was 20 years ago. Survival rates are climbing, thanks to greater awareness, more early detection, and advances in treatment. For roughly 268,000 Americans who are diagnosed with breast cancer each year, there are plenty of reasons to be hopeful.

Breast Cancer Symptoms: Breast cancer often has no symptoms, but you may notice something you want the doctor to check. Keep an eye out for:

• A painless lump in the breast
• Changes in breast size or shape
• Swelling in the armpit
• Nipple changes or discharge

Breast pain can also be a symptom of cancer, but this isn’t common.

Signs of Inflammatory Breast Cancer: This rare, fast-growing type rarely causes a distinct lump. Instead, breast skin can become thick, red, and look pitted, like an orange peel. The area might also feel warm or tender and have small bumps that look like a rash.

Mammograms: The earlier you find the disease, the easier it is to treat. Mammograms, an X-ray of the breast, can show tumors before they get large enough to feel. The American Cancer Society says women ages 45-54 with an average risk level should get a yearly mammogram. Starting at age 55, mammograms can be performed every 2 years. Continue them as long as you’re in good health. The U.S. Preventive Services Task Force says until you’re 50 you should talk to your doctor about your need for testing. After that, get a mammogram every 2 years from ages 50 to 74. You don’t have to stop at 75; the group just doesn’t assess the pros and cons. You can work it out with your doctor.

Ultrasound and MRI: Your doctor may order an extra test that takes pictures of the inside of your body. A breast ultrasound can help find cysts, fluid-filled sacs that most often aren’t cancer. You might get an MRI along with a mammogram as part of your routine testing if you have a higher risk of breast cancer.

Self-Exams: For years, doctors told women to check their own breasts once a month. But studies suggest these exams play a very small role in finding cancer compared to other testing methods. The current thinking is that it’s more important to know your breasts and be aware of any changes, rather than checking them on a regular schedule. If you want to do a self-exam, go over the technique with your doctor.

What If You Find a Lump? First, don’t panic. Eighty percent of breast lumps aren’t cancerous. They often turn out to be harmless cysts or tissue changes related to your menstrual cycle. But let your doctor know right away if you find anything unusual in your breast. If it is cancer, the earlier it’s found, the better. And if it isn’t, testing can give you peace of mind.

Breast Biopsy: The only sure way to know a lump is cancer is to do a biopsy. This means removing a sample of the lump so it can be examined in the lab. Your doctor may be able to do this with a small needle. But you might need surgery to take part of or the entire lump for testing. The results will show whether it’s cancer, and if so, what type. There are several forms of breast cancer, and treatments are carefully matched to each type.

Hormone-Sensitive Breast Cancer: Some types of breast cancer are fueled by the hormone’s estrogen or progesterone. Your doctor will test for hormone receptors -- proteins that pick-up signals from the hormone that tell cells to grow. A biopsy can show if a tumor has receptors for estrogen (it’s ER-positive) and progesterone (it’s PR-positive). About 2 out of 3 breast cancers are hormone sensitive. There are several medications that keep the hormones from causing further cancer growth.

HER2-Positive Breast Cancer: In about 20% of patients, breast cancer cells have too much of a protein called HER2/neu. This type is known as HER2-positive, and it tends to spread faster than other forms. It’s important to know whether a tumor is HER2-positive, because there are special treatments for this type of cancer.

Breast Cancer Stages: If breast cancer is the diagnosis, the next step is to figure out how big the tumor is and how much of your body it affects. This process is called staging. Doctors use stages 0-IV to describe whether cancer is only in the breast, has moved into nearby lymph nodes, or has spread to other organs like the lungs. Knowing the stage and type of breast cancer will help your health care team create a treatment plan.

Survival Rates: The odds of beating breast cancer are strongly tied to how early you find it. The American Cancer Society says 99% of women with stage I breast cancer live at least 5 years, and many women in this group remain cancer-free for good. The more advanced the cancer, the lower this figure becomes. By Stage IV, the 5-year survival rate drops to 27%. But these rates will rise as more effective treatments are found.

Breast Cancer Surgery: There are many types of breast cancer surgery, from taking out the area around the lump (lumpectomy or breast-conserving surgery) to removing the entire breast (mastectomy.) Talk about the pros and cons of each with your doctor to decide what’s right for you.

Radiation Therapy: This treatment kills cancer cells with high-energy rays. It may be used after breast cancer surgery to wipe out any cancer cells that remain near the tumor site. It might be paired with chemotherapy to treat cancer that has spread to other body parts. Side effects include fatigue and swelling or a sunburn-like feeling where you were treated.

Chemotherapy: This treatment uses drugs to kill cancer cells anywhere in the body. They’re often given by IV, but they can be taken by mouth or a shot. You might have it before surgery to shrink a large tumor or after to lower the odds of your cancer coming back. In women with advanced breast cancer, chemo can help control the cancer’s growth. Side effects may include hair loss, nausea, fatigue, and a higher risk of infection.

Hormone Therapy: This is for women with ER-positive or PR-positive breast cancer. These cancers grow faster in response to the hormone’s estrogen or progesterone. Hormone therapy can block this effect. It might be used after surgery to help keep the cancer from coming back. Doctors sometimes give it to women with high risk factors to reduce the chances of getting breast cancer.

Targeted Treatments: These newer drugs pinpoint specific things inside cancer cells. For example, women with HER2-positive breast cancer have too much of a protein called HER2. Targeted therapies can stop this protein from making cancer cells grow. These drugs are often used along with chemo because they tend to have milder side effects.

Immunotherapy: This turns your body’s own disease-fighting powers against cancer. Drugs called immune checkpoint inhibitors target certain proteins on immune system cells. They make it harder for cancer cells to evade attacks. Immunotherapy is sometimes used to treat advanced cancer.

Life After Diagnosis: There’s no doubt that cancer is a life-changing experience. The treatments can wear you out. You may have trouble managing daily chores, work, or social outings. This can make you feel isolated. It’s crucial to reach out to friends and family for support. They may be able to go with you to treatments, help out with chores, or just remind you that you aren't alone. Many people choose to join a support group, either near them or online.

Breast Reconstruction: Many women who have a breast removed choose to get reconstructive surgery. This replaces the skin, nipple, and breast tissue that are lost during a mastectomy. It can be done with a breast implant or with tissue from somewhere else in your body, like your tummy. Some women start the process right after their mastectomy. But you can also get it months or years later.

Breast Forms: Instead of reconstruction, you can be fitted for a breast form. This is a breast-shaped prosthesis that fits inside your bra. Wearing one allows you to have a balanced look when you’re dressed. Like the surgery, breast forms are often covered by insurance.

Breast Cancer: Why Me? The most obvious risk factor for breast cancer is being a woman. Men get the disease, too, but it’s about 100 times more common in women. Other things that make it more likely include being over age 55 or having a close relative who had the disease. Still, up to 80% of women with breast cancer have no family history of the illness.

Breast Cancer Genes: Some women have a high risk of breast cancer because they got changes, or mutations, in certain genes at birth. The genes most often involved in breast cancer are known as BRCA1 and BRCA2. Women with mutations in these genes have a higher chance of getting breast cancer at some point in life than those who don’t. Other genes may be linked to breast cancer risk as well.

Reducing Your Risks for Breast Cancer: Women who breast-feed their children for the recommended length of time (6 months exclusively and up to 2 years or beyond partially) can reduce their risk of breast cancer by 25%. You can also reduce your risk by maintaining a low BMI and by getting exercise. You should also cut back on the amount of alcohol you drink. Birth control pills and some forms of hormone therapy after menopause can boost the odds. But the risk seems to go back to normal after you stop these medications. Good lifestyle choices can help survivors, too. Research says physical activity can lower the chances your cancer will return. And it's a proven mood-booster, too.

Breast Cancer Research: Doctors continue to search for treatments that work better and are easier to undergo. Funding for this research comes from many sources, including advocacy groups throughout the country. Many of the 3.1 million breast cancer survivors and their families choose to participate in walk-a-thons and other fundraising events. This links each individual fight against cancer into a common effort for progress.

Reviewed by: Laura J. Martin, MD on September 08, 2019

Sources:

American Cancer Society: “After the Tests: Staging," “American Cancer Society Guidelines for the Early Detection of Cancer,” “Breast awareness and self-exam," "Breast Cancer Facts & Figures 2013-2014," “Breast cancer risk factors you cannot change," "Breast cancer survival rates by stage," “Breast Cancer Symptoms: What You Need to Know," “Breast Reconstruction After Mastectomy," “How Is Breast Cancer Treated?" "How Is Breast Cancer Found?” “How Many Women Get Breast Cancer?” "Lifestyle Changes to Consider During and After Treatment," “Moving On After Treatment," "What Causes Breast Cancer?” “What’s New in Breast Cancer Research," "Survival Rates for Breast Cancer."

BreastCancer.org: “Symptoms of Breast Cancer.”

Breastcancer.org: “Understanding Hormone Receptors and What They Do.”

Inflammatory Breast Cancer Research Foundation: “Symptoms.”

Dr. Susan Love Research Foundation: “Breast Cancer Detection.”

Mayo Clinic: “Breast lump: Early evaluation is essential.”

U.S. Preventive Services Task Force: “Breast Cancer Screening.”

National Cancer Institute: "Cancer Stat Facts: Female Breast Cancer," “Immunotherapy to Treat Cancer.”

Breast Cancer: Basic and Clinical Research (New Zealand): “Breast Cancer Immunotherapy: An Update.”

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.