What is the uterus?
The uterus is part of a woman’s reproductive system. It is a hollow, pear-shaped organ where a baby grows during pregnancy. The uterus is positioned in the pelvis between the bladder and the rectum.
What is uterine cancer?
Uterine cancer forms in the tissues of the uterus. Two types of uterine cancer are endometrial cancer, which starts in the cells lining the uterus, and uterine sarcoma, which is a rare cancer that begins in muscle or other tissues in the uterus.
Are there known risk factors for possibly getting uterine cancer?
The known risk factors for uterine cancer include:
Uterine cancer occurs most often in women over the age of 50.
- Endometrial hyperplasia
The risk of uterine cancer is higher if a woman has endometrial hyperplasia. Endometrial hyperplasia is a condition that occurs when the lining of the uterus, called the endometrium, grows too much.
- Hormone replacement therapy (HRT)
HRT is used to control the symptoms of menopause, to prevent osteoporosis, or thinning of the bones, and to reduce the risk of heart disease or stroke. Women who use estrogen without progesterone have an increased risk of uterine cancer.
- Obesity and related conditions
The body makes some of its estrogen in fatty tissue. For this reason, obese women are more likely than thin women to have higher levels of estrogen in their bodies. High levels of estrogen may be the reason that obese women have an increased risk of developing uterine cancer. The risk of this disease is also higher in women with diabetes or high blood pressure, conditions that are prevalent in many obese women.
Women taking the drug tamoxifen to prevent or treat breast cancer have an increased risk of uterine cancer. This risk appears to be related to the estrogen-like effect of this drug on the uterus. Providers follow women taking tamoxifen closely for possible signs or symptoms of uterine cancer.
Caucasian women are more likely than African-American women to get uterine cancer.
- Colorectal cancer
Women who have had an inherited form of colorectal cancer have a higher risk of developing uterine cancer than other women.
Other risk factors are related to how long a woman’s body is exposed to estrogen. Women who have no children, begin their periods at a very young age, or enter menopause late in life are exposed to estrogen longer and have a higher risk of developing uterine cancer.
What are the warning signs or symptoms of uterine cancer?
The most common symptom of uterine cancer is vaginal bleeding or discharge. The bleeding may start as a watery, blood-streaked flow that gradually contains more blood. Other symptoms of uterine cancer can include: difficult or painful urination, pain during intercourse, or pain in the pelvic area.
What tests are used to diagnose uterine cancer?
Providers use a variety of tests to determine if a woman has developed uterine cancer. Those tests include pelvic exams, transvaginal ultrasounds, and biopsies.
What are the treatment options for uterine cancer?
The majority of women with uterine cancer are treated with a hysterectomy, a surgery that removes the uterus either through the vagina or through an incision in the abdomen. In most cases, the surgeon will also remove both fallopian tubes and both ovaries. Some women may have radiation therapy in addition to their surgery. Radiation therapy can be administered before surgery in order to shrink the tumor, or after surgery to destroy any cancer cells that remain in the area. Providers may use hormonal therapy to treat uterine cancer. Chemotherapy is not as commonly used to treat uterine cancer as it is for other types of cancer, although it may be needed if the cancer has spread to distant parts of the body.
What is chemotherapy?
In chemotherapy, a single drug or a combination of drugs is used to treat cancer. These drugs are designed to destroy cancer cells; however, chemotherapy also damages healthy cells, causing a variety of side effects.
What is radiation therapy?
Radiation therapy involves the use of targeted, high-energy rays to kill cancer cells. It affects cancer cells only in the treated area.
What is adjuvant chemotherapy?
Adjuvant chemotherapy is used as an additional treatment in cases where the cancer is thought to be completely removed by a primary treatment, usually surgery, but statistically there is a chance of recurrence. Radiation and chemotherapy can be used as primary and/or adjuvant treatments depending on the condition, recommendation, and personal decision made by the patient.
What is biological therapy?
Biological therapy is a type of cancer treatment that works with the body’s immune system. It can help fight cancer or help control side effects from other cancer treatments like chemotherapy.
What are benign uterine diseases?
There are several common benign uterine diseases — benign means non-cancerous, not invading surrounding tissue — which usually do not grow rapidly and do not spread to other organs. Benign conditions are often mild and not life-threatening.
Some common benign uterine diseases include:
What is the treatment for fibroids?
- Uterine fibroids are among the most common tumors in women. These benign growths of the uterus often appear during childbearing years.
- Uterine polyps consist of areas in the uterus where the lining, or endometrium, becomes overgrown and forms a mass referred to as a polyp.
- Endometrial hyperplasia is a condition when the lining of the uterus, called the endometrium, grows too thick. Near the onset of menopause, women who are experiencing irregular menstrual cycles because they no longer ovulate monthly, are more likely to experience this benign condition.
- Endometriosis is a condition where the tissue that normally lines the uterus grows in other areas of the body. This may cause pain, irregular bleeding, and infertility.
- Uterine prolapse describes the condition where the uterus has dropped from its position within the pelvis into the vagina. Normally, the uterus is held in place by the muscles and ligaments that make up the pelvic floor. Uterine prolapse results when pelvic floor muscles and ligaments weaken, providing inadequate support for the uterus. The uterus then descends into the vaginal canal.
Treatment options for fibroids include:
What is endometriosis?
- Watchful waiting
Because fibroids are not cancerous and rarely interfere with pregnancy, a watchful waiting approach may be the best treatment. Fibroids usually grow slowly and often shrink after the onset of menopause, when hormone levels drop.
A hysterectomy is the only proven permanent solution for uterine fibroids. Of course, hysterectomy is major surgery that renders a woman incapable of bearing children. If the hysterectomy includes removal of the ovaries, it causes the immediate onset of menopause. Because fibroids are so often benign and do not commonly cause any pain or discomfort, treating them with a hysterectomy is usually not required.
A fibroidectomy involves the removal of masses from the uterus using one of several procedures, including:
- Hysteroscopic Myomectomy: used for fibroids that are just under the lining of the uterus and that protrude into the uterine cavity. There is no need for a surgical incision. The provider inserts a flexible scope called a hysteroscope into the uterus through the vagina and cervix and removes the fibroids using special surgical tools fitted to the scope.
- Laparoscopic Myomectomy: may be used if the fibroid is on the outside of the uterus. Small incisions are made, allowing the provider to insert two probes into the abdominal cavity in order to remove the fibroids. The first probe contains a tiny camera, while the second probe is fitted with surgical instruments inside. This procedure is performed while the patient is under general anesthesia.
- Abdominal Myomectomy: During this procedure, an incision is made in the abdomen to access the uterus, and another incision is made in the uterus to remove the tumor. Once the fibroids are removed, the uterine wall is repaired.
- Uterine Artery Embolization (UAE)
This approach blocks the arteries that supply blood to the fibroids, causing them to shrink. It is a minimally-invasive procedure, which means that it requires only a tiny incision, and is usually performed while the patient is conscious but sedated.
Medications for uterine fibroids target hormones that regulate your menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure.
Endometriosis is a condition where the tissue that normally lines the uterus grows in other areas of the body. This may cause pain, irregular bleeding, and infertility. The symptoms of endometriosis can range from mild to severe, and do not necessarily indicate the severity of the condition. The most common areas for the uterine tissue to grow include the pelvic area, outside of the uterus, on the ovaries, bowel, rectum, bladder, and the lining of the pelvis.
What is the cervix?
The cervix is part of a woman’s reproductive system and is the lower, narrow part of the uterus that connects the uterus to the vagina.
What is cervical cancer?
Cervical cancer is usually a slow growing malignancy that begins in the lining of the cervix. Normal cervical cells can gradually develop pre-cancerous changes that turn into cancer.
Are there known risk factors for possibly developing cervical cancer?
There are certain risk factors that increase the likelihood of developing cervical cancer. Those risk factors include:
- Human Papilloma Viruses, or HPV
HPV infection is the primary risk factor for squamous cell cervical cancer. HPV is the most common sexually transmitted disease and is associated with the development of cervical dysplasia and cervical cancer.
- Failure to Have Regular Pap Tests
Cervical cancer is detected more often in women who have not had regular Pap tests. The Pap test helps providers to find and treat precancerous cells in order to prevent cancer.
- Weakened Immune System
Women with HIV, the virus that causes AIDS, or who take medications that suppress the immune system, have a higher-than-average risk of developing cervical cancer.
Cancer of the cervix occurs most often in women over the age of 40.
- Sexual History
The risk of developing cervical cancer increases with the number of sexual partners and the risk of those partners.
- Smoking Cigarettes
Women with an HPV infection who smoke cigarettes have a higher risk of cervical cancer than women with HPV infection who do not smoke.
- Extended Use of Birth Control Pills
Using birth control pills for five or more years may increase the risk of cervical cancer among women with HPV infection.
- Having Many Children
Studies suggest that giving birth to many children may increase the risk of cervical cancer among women with HPV infection.
- Diethylstilbestrol, or DES
DES may increase the risk of a rare form of cervical cancer and certain other cancers of the reproductive system in women exposed to this drug before birth. Although DES is no longer given to pregnant women, it was prescribed to some pregnant women in the United States between about 1940 and 1971.
If you think that you may be at risk for cervical cancer, share this concern with your provider.
What are the warning signs or symptoms of cervical cancer?
Precancerous changes and the early stages of cervical cancer often do not cause pain or other symptoms. As cervical cancer progresses some symptoms can become apparent. Those symptoms include:
- Abnormal vaginal bleeding
- Bleeding that occurs between regular menstrual periods
- Bleeding after sexual intercourse, douching, or a pelvic exam
- Menstrual periods that last longer and are heavier than usual
- Bleeding after menopause
- Increased vaginal discharge
- Malodorous vaginal discharge
- Pelvic pain
- Pain during sexual intercourse
Keep in mind that infections or other health problems can also cause these symptoms, so experiencing one or more of these symptoms does not mean that you have cervical cancer.
What tests are used to diagnose cervical cancer?
There are a variety of tests that can be used to help diagnose cervical cancer. One of the most commonly used tests is a Pap test, sometimes called a Pap smear. Your provider may also suggest a biopsy, in which cells are surgically removed from your cervix for testing. Depending on the findings and your medical history your provider will recommend additional tests as necessary. If cancer is present, your provider may suggest one or more imaging tests, such as magnetic resonance imaging, or MRI, an ultrasound, a CT scan, or a chest X-ray. These tests can help determine if your cancer has spread to other parts of your body.
What are the treatment options for cervical cancer?
If you are diagnosed with cervical cancer, there are several treatment options available to you. Treatment generally begins within a few weeks of diagnosis, after you’ve had time to review your treatment choices, get a second opinion, and learn more about your condition.
Treatment of the early stages of cervical cancer focuses on the surgical removal of the cancer cells and tends to be more aggressive than the treatments for cervical dysplasia. Another commonly used treatment is radiation therapy. There are two main types of radiation therapy used to treat cervical cancer, external and internal. Chemotherapy may also be used in the treatment of cervical cancer. There are a variety of cancer-fighting drugs that can be administered through an IV to destroy cancer cells.
What are the ovaries?
The ovaries are part of a woman’s reproductive system. They are located in the pelvis. Each ovary is similar in size and shape to an almond. The ovaries produce eggs, called ova, and also make female hormones.
What is ovarian cancer?
Ovarian cancer is a cancer that develops in a woman’s ovaries, the female reproductive organs that produce eggs. There are three main types of ovarian cancers: ovarian epithelial carcinomas, malignant germ cell tumors, and stromal cell carcinomas.
Are there known risk factors for possibly developing ovarian cancer?
The risks for developing ovarian cancer can be linked to several factors. Those factors include:
- A family history of cancer
Women who have a mother, daughter, or sister with ovarian cancer have an increased risk of the disease. Also, women with a family history of cancer of the breast, uterus, colon, or rectum may also have an increased risk of ovarian cancer.
If you have a strong family history of ovarian or breast cancer, you may want to ask your provider to refer you to a genetic counselor. The counselor may suggest genetic testing for you and the women in your family. Genetic tests can sometimes show the presence of specific gene changes that increase the risk of ovarian cancer. Certain genes, known as BRCA1 and BRCA2, may be linked to both ovarian and breast cancer.
- A personal history of cancer
Women who have had cancer of the breast, uterus, colon, or rectum have a higher risk of ovarian cancer.
Most women diagnosed with ovarian cancer are over the age of 55. However, while epithelial ovarian cancers are more common at older ages, germ cell cancers are more common among young women.
- Having never been pregnant
Older women who have never been pregnant have an increased risk of ovarian cancer. The more children a woman has and the earlier in life that she gives birth, the lower her risk of ovarian cancer.
- Hormone therapy to treat menopause
Some studies have suggested that women who take estrogen, without also taking progesterone, for ten or more years, may have an increased risk of ovarian cancer
It’s important to remember that having a risk factor does not mean that you will develop ovarian cancer. Most women who have risk factors do not get the disease.
What are the warning signs or symptoms of ovarian cancer?
Unfortunately, early ovarian cancer may not cause obvious symptoms. The early symptoms that you may experience are often subtle, and can be confused with symptoms of other benign conditions. As the cancer grows the symptoms may become more pronounced. These symptoms may include:
- Pressure or pain in the abdomen, pelvis, back, or legs
- A swollen or bloated abdomen
- Nausea, indigestion, gas, constipation, or diarrhea
- Constant fatigue
Less common symptoms may include:
What tests are used to diagnose ovarian cancer?
- Shortness of breath
- Feeling the need to urinate often
- Unusual vaginal bleeding, including heavy periods, or bleeding after menopause
If you have a symptom that suggests ovarian cancer, your provider will conduct a physical exam and a variety of tests. You will also be asked about your personal and family medical history. Blood tests may be taken to check for any irregularities, including the presence of something called CA-125. CA-125 is a substance that can be found on the surface of ovarian cancer cells. Your provider may conduct an ultrasound to determine if an ovarian tumor is present. Ovarian cancers have certain features on ultrasound that distinguish it from benign, non-cancerous ovarian masses. Other tests may include a CT scan, a chest X-ray, a barium enema, or a colonoscopy.
What are the treatment options for ovarian cancer?
If you are diagnosed with ovarian cancer, your provider will probably refer you to a medical oncologist who specializes in the treatment of cancer. You may also be referred to a surgeon. Your treatment may include surgery to remove some combination of organs and tissue. Chemotherapy is another treatment option for women with ovarian cancer. Chemotherapy uses special drugs to destroy cancer cells.
What are benign ovarian diseases?
There are several common benign ovarian diseases — benign meaning non-cancerous, not invading surrounding tissue — which usually do not grow rapidly and do not spread to other organs. Benign conditions are often mild and not life-threatening.
Some common benign uterine diseases include:
- Ovarian cysts are quite common in women during their childbearing years. Most ovarian cysts are small, do not cause symptoms, and go away on their own.
- An ovarian tumor is a growth on an ovary. Unlike a fluid-filled cyst, a tumor is solid.
- Polycystic ovarian syndrome is characterized by ovaries that are two to five times larger than normal ovaries. Polycystic ovaries usually have a white, thick, tough outer covering. Women are usually diagnosed with this condition when they are in their 20s or 30s.