Womb cancer (uterine cancer) is a common cancer Most people who get womb cancer are over 50.
Womb cancer happens when cells in your womb (uterus) grow in an abnormal and uncontrolled way, forming a lump or tumour. Your womb is part of your reproductive system and is where a baby develops if you get pregnant.
There are two main types of womb cancer.
Womb cancer can sometimes spread to surrounding tissue or to other parts of your body. This is known as metastasis.
This topic focuses on endometrial cancer. Other types of womb cancer, such as uterine sarcoma, may be treated differently.
Doctors don’t know the exact cause of womb cancer yet. But some things make you more likely to develop it. These include having too much of the hormone oestrogen in your body (compared to your levels of progesterone).
You're also more likely to develop womb cancer if you:
The first sign of womb cancer is usually bleeding from your vagina, particularly if you’ve been through the menopause. If you haven't been through the menopause yet, you might have unusually heavy bleeding during your period or bleeding between periods.
Other, less common, symptoms of womb cancer include:
If you have any of these symptoms, contact your doctor.
Your doctor will ask about your symptoms and examine you – this might include examining inside your vagina. They’ll ask about your medical history too. If your doctor thinks your symptoms need further investigation, they’ll refer you to see a gynaecologist. This is a doctor who specialises in reproductive health.
You might need to have some more tests, which may include the following.
In this test, a radiographer (a health professional trained to perform imaging procedures) will put a small ultrasound probe into your vagina. Ultrasound uses sound waves to produce an image of the inside of your womb. This test will measure the thickness of your womb lining, which can help to diagnose womb cancer.
A biopsy is a small sample of tissue. This will be sent to a laboratory for testing to determine the type of cells and if these are cancerous. There are different ways to take a biopsy to help diagnose womb cancer.
You can usually have a biopsy or hysteroscopy as an out-patient – you don’t need to stay overnight in a hospital. And you won’t usually need to have a general anaesthetic but this may be an option if you need it.
Lynch syndrome increases your risk of getting certain types of cancer, including womb cancer and bowel cancer. If you’re diagnosed with endometrial cancer, your doctor will offer you a test for Lynch syndrome. This will involve them testing a sample of your tissue. If you do have Lynch syndrome, you may be offered treatment and monitoring to reduce the risk of getting another Lynch syndrome-associated cancer, or to help to diagnose one early. Your relatives may also be offered tests for Lynch syndrome.
If you have womb cancer, you may need to have more tests to find out how advanced it is. This process, known as staging, takes into account whether or not the cancer has spread and how big it is.
Your gynaecologist will usually arrange for you to have a scan, such as a magnetic resonance imaging (MRI) scan or a computer tomography (CT) scan, to stage your womb cancer before they do an operation to treat it.
If womb cancer is diagnosed early, treatment can work well.
The treatment you will be offered will depend on which type of womb cancer you have. It will also depend on how fast the cancer is growing, how far it has spread, and your age and general health. Your doctor will discuss what your treatment options are with you.
The main treatment for womb cancer is surgery, which aims to remove all traces of the cancer. This usually involves having a hysterectomy, which is an operation to remove your womb and cervix. If your cancer hasn't spread outside your womb, a hysterectomy often cures the cancer.
As well as removing your womb and cervix, your gynaecologist will usually remove both your fallopian tubes and ovaries too. This is known as a bilateral salpingo-oophorectomy, or a BSO for short. Your gynaecologist may also remove or check the lymph nodes (organs that are part of your immune system) around your womb. As well as removing any cancerous cells, checking your lymph nodes may help your gynaecologist to decide if you need other treatment.
You may be able to have keyhole surgery, which you usually recover from more quickly than open surgery. In keyhole surgery, your surgeon will do the operation through a number of small cuts rather than one large cut. Check with your gynaecologist if this is an option for you.
Non-surgical treatments include the following. These treatments won’t cure womb cancer on their own but they may be used alongside surgery. But sometimes you can have them alone to help control the symptoms of womb cancer.
After treatment for womb cancer, you’ll need to have regular check-ups with your doctor to see if the cancer has returned.
If the cancer has already spread and is advanced, a cure might not be possible. You can get support from specialist cancer doctors and nurses as well as treatment for any symptoms. This is called palliative care.
Your cervix is the neck of your womb, where your womb opens into your vagina. Although your cervix is part of your womb, cervical cancer is very different to womb cancer.
Cervical cancer often starts in the cells on the surface of your cervix, whereas womb cancer usually starts in the lining of your womb.
Womb cancer and cervical cancer have different causes too. Almost all cervical cancer is caused by the human papilloma virus (HPV), but doctors don’t yet know exactly what causes womb cancer.
Symptoms of womb and cervical cancer can be similar. Bleeding between periods is the most common symptom of both. You’ll have tests to find out if you have cancer and what type.
Clear cell cancer is a rare type of endometrial cancer. Endometrial cancer starts in the endometrium (lining) of your womb.
Endometrial cancers are sometimes divided into two groups – type 1 and type 2. Most are type 1, which means they’re linked to having too much of the hormone oestrogen in your body. Cancers that belong to the type 2 group are different because they aren’t linked to high levels of oestrogen. An example is clear cell cancer, which is a very aggressive type of womb cancer. It’s not very common – only one or two people in a 100 who get womb cancer have clear cell cancer.
Clear cell cancer is usually treated with a mixture of surgery, chemotherapy and radiotherapy.
Some treatments for womb cancer have side-effects that may affect your sex life. If you have radiotherapy to your pelvis, your vagina may become narrower and less stretchy, which can make sex uncomfortable and sometimes painful. Your vagina may also become drier and the skin inside more delicate. These symptoms can last a long time, but there are ways to ease them and, with time, you should find that your sex life gets better.
To prevent narrowing, you can use a dilator regularly to gently stretch your vagina and make it more supple. Dilators are plastic or metal tubes that come in different sizes. You can start using a dilator between two and eight weeks after you finish radiotherapy. You might need to carry on using it for two years or more, even if you have regular sex.
Vaginal dryness can make sex uncomfortable. Your doctor can prescribe you a cream or gel to put into your vagina, which should help.
Having cancer can have an enormous impact on every area of your life, including your relationships with the people close to you. You may need time to come to terms with everything that has happened to you. Try to talk to your partner so they know how you’re feeling. If aggressive type of womb cancer. It’s not very common – only one or two people in a 100 who get womb cancer have clear cell cancer.
Clear cell cancer is usually treated with a mixture of surgery, chemotherapy [AS1] and radiotherapy[AS2] .
Will treatment for womb cancer affect my sex life?
Some treatments for womb cancer have side-effects that may affect your sex life. If you have radiotherapy to your pelvis, your vagina may become narrower and less stretchy, which can make sex uncomfortable and sometimes painful. Your vagina may also become drier and the skin inside more delicate. These symptoms can last a long time, but there are ways to ease them and, with time, you should find that your sex life gets better.
To prevent narrowing, you can use a dilator regularly to gently stretch your vagina and make it more supple. Dilators are plastic or metal tubes that come in different sizes. You can start using a dilator between two and eight weeks after you finish radiotherapy. You might need to carry on using it for two years or more, even if you have regular sex.
Vaginal dryness can make sex uncomfortable. Your doctor can prescribe you a cream or gel to put into your vagina, which should help.
Having cancer can have an enormous impact on every area of your life, including your relationships with the people close to you. You may need time to come to terms with everything that has happened to you. Try to talk to your partner so they know how you’re feeling. If you need more help, your doctor can put you in touch with a sex therapist.
People are often cured after treatment for womb cancer, but, as with any cancer, it's always possible it will return. That’s why it's important to have check-ups with your doctor.
If you’re well, you’ll need fewer check-ups as time goes on. If womb cancer is going to come back, it usually does so within two years of having treatment. So, you’ll usually have check-ups every three to six months for the first two years, then every year.
Womb cancer is often found early because people notice the symptom of unusual bleeding. Because of this, treatment is often a success. At least seven out of 10 people diagnosed with endometrial womb cancer will live for 10 years or more after their diagnosis.
Whether or not your cancer comes back after your treatment will depend on what kind of cancer you had. It also depends on where it was, if it had spread, and what stage it was when you were diagnosed. If your cancer spread out of the lining of your womb or into your lymph nodes, the chances of it returning are higher. This is compared with cancer that stayed in the lining of your womb.
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