Detecting and Treating Endometrial Cancer
How to Detect Uterine Cancer
Uterine cancer, also called endometrial cancer, is a form of cancer that starts in the uterus. It is most common among postmenopausal women, but can also affect premenopausal women as well. You should contact your gynecologist as soon as possible if you recognize the symptoms of uterine cancer because treatment is most effective if you catch the disease early. Your gynecologist will then do an ultrasound of the uterus to look for signs of uterine cancer. If they see any suspicious areas, they will also take tissue samples from your uterus to confirm their diagnosis.
Pay attention to abnormal vaginal bleeding or discharge.Vaginal bleeding after menopause is a common symptom of uterine cancer. Bleeding or spotting between periods may also be a sign of uterine cancer for premenopausal women. Additionally, watery discharge that seems abnormal, even if you cannot see blood in it, may also be a symptom of uterine cancer.
- If you have abnormal vaginal bleeding or discharge you should make an appointment to be seen by your doctor. These can be symptoms of a variety of health issues, not just uterine cancer, but whatever the cause it is important to get it checked out.
Notice pain during urination or sexual intercourse.Experiencing pain during urination is another common symptom of uterine cancer. Additionally, if sexual intercourse is painful for you, this can also be a sign that you have uterine cancer.
- Pain during urination or sex are symptoms of a variety of health issues, including urinary tract infections and some sexually transmitted diseases. Just because you are experiencing 1 or both of these symptoms, that does not mean that you have uterine cancer. However, you should consult with your doctor about medical treatment.
Be on the lookout for weight loss you can't explain.Losing weight without making an effort to do so is another symptom of uterine cancer. For example, if you lose 5 to 10 pounds over the course of 1 to 2 months, that could be a sign that you have uterine cancer.
- Weight loss in and of itself does not mean that you have uterine cancer. It is a secondary symptom that should only signal uterine cancer to you when combined with other symptoms.
- Whatever the cause, unexplained weight loss is an issue that you should consult a doctor about.
Contact your doctor if you notice symptoms.If you are experiencing any of the symptoms of uterine cancer, you should make an appointment to be seen by a doctor. However, if you have multiple symptoms or any of your symptoms are severe or painful, you should get medical care immediately. Call your doctor's office, tell the office staff about your symptoms, and then discuss whether you can be seen immediately.
- You can see your primary care physician for this type of health issue. However, if you have a gynecologist, you can also make an appointment directly with them.
- The doctor will ask you how often and for how long you have been experiencing the symptoms, so keep track of them once you first notice them.
- The doctor will also do a physical exam and ask you questions about your medical history in order to make a preliminary diagnosis.
Getting an Ultrasound
Have a pelvic ultrasound done.A pelvic ultrasound is used to take a picture of your ovaries, Fallopian tubes, and uterus. This is used to help determine the possible diagnosis and see if further testing is needed. Your doctor will first place ultrasound gel on your pelvic region. Then they will move the ultrasound wand around the skin on your lower abdomen to examine your ovaries, Fallopian tubes, and uterus for tumors and polyps.
- Because the bladder needs to be full to get a good picture, your doctor may ask you to drink a lot of fluids before the exam.
- The ultrasound may be done by your doctor or an ultrasound technician, depending on if there is an ultrasound machine available in your doctor's office.
See if your doctor recommends a transvaginal ultrasound (TVUS).A TVUS is commonly used to examine the uterus, especially if external ultrasounds are inconclusive. Your doctor will gently insert the ultrasound wand into your vagina to take pictures of your uterus. They will then examine the pictures of your uterus for tumors or an abnormally thick lining, which can also be a sign of uterine cancer.
- To have the procedure done, you will be asked to lay down on the exam table. Then you will put your knees up and your feet into the table stirrups, if there are some attached to the exam table. Once you are in position, the doctor will insert the ultrasound wand a few inches into your vagina.
- Getting a transvaginal ultrasound can be uncomfortable but it shouldn't be particularly painful. If you are experiencing pain during the procedure, tell your doctor so they can find a way to examine you that is less painful.
Have a saline infusion sonogram done if other imaging is inconclusive.A saline infusion sonogram is typically used if the other ultrasound tests do not detect a tumor. Your doctor will put a small tube into your vagina that they will use to insert saline into your uterus. The saline will enable your doctor to get a clearer picture of your uterine lining when they do an ultrasound.
- Once the saline is inserted into your uterus, the doctor will use the transvaginal ultrasound wand to inspect the lining of your uterus for abnormalities.
Having Tissue Sampling Done
Have an endometrial biopsy done.An endometrial biopsy is the most commonly used tissue sampling procedure used to detect uterine cancer. If your doctor sees an abnormality during imaging tests, they will likely suggest having a biopsy done. During the biopsy, your doctor will insert a flexible, thin tube into your vagina, through your cervix, and into your uterus.
- The tube uses suction to remove a very small amount of endometrium tissue from your uterus.
- You may experience slight discomfort, similar to menstrual cramps, during this procedure. Because of this, take a non-steroidal anti-inflammatory drug, like ibuprofen, before the procedure to reduce any discomfort.
- Once the sample is collected, your doctor will have it examined by a pathologist.
Discuss the need for a hysteroscopy tissue sampling procedure.A hysteroscopy is an outpatient procedure performed in a surgical suite or special procedure room that involves you doctor placing a tiny telescope up into your uterus. The telescope will allow your doctor to pinpoint any abnormalities, such as a tumor or polyp. It also allows them to take a tissue sampling from the tumor or polyp for examination by a pathologist, as opposed to the more generalized sample of an endometrial biopsy.
- If your doctor needs to get a clearer view of what is going on in your uterus, they may suggest this procedure. It allows them to look close up at abnormalities and collect a tissue sample at the same time.
- Your doctor will use local anesthesia, pain medication, or general anesthesia to eliminate any pain during this procedure.
Have a D&C procedure done if other tests are inconclusive.A D&C (dilation and curettage) is a surgical procedure that is more invasive than a hysteroscopy. During this procedure, your cervix is dilated and a spoon-shaped instrument, referred to as a curette, is used to scrape tissue from the inside of your uterus. A pathologist will then examine the tissue to see if cancer is present.
- To perform this procedure, the doctor will give you either local or general anesthesia.
- A D&C is an outpatient procedure that is done at a local clinic or hospital. However, following the procedure, you may need to stay in the clinic or hospital for a few hours before being released. During that time the medical staff will make sure you are recovering correctly from the procedure and the anesthesia.
Following Up With Your Doctor
Discuss the results with your doctor.As your doctor proceeds through their diagnostic tests, they should discuss their findings with you. For example, once your doctor has time to look at any imaging that has been done, they should talk to you about what they see. Then, if a biopsy is necessary, they should let you what the results are as soon as possible.
- If your doctor doesn't see anything suspicious during their initial examination or imaging, they should tell you that right away.
- If the doctor sees anything suspicious during imaging, they should tell you that as well. However, remember that a confirmation of uterine cancer will only come after a biopsy is done. Tumors and polyps are often non-cancerous and not hazardous to your health.
Have a conversation about possible treatments.Once you have a diagnosis of uterine cancer, your doctor may know what the first step of treatment should be or they may refer you to a specialist that can give you more specialized care. Whatever doctor ends up taking charge of your care, you should have a clear conversation with them about what the treatment plan is and when it will begin.
- At any point along the way, feel free to ask any questions that you have. This can include simply asking why certain treatments have been suggested or asking the doctor about alternative treatment options that might be available.
- If you are someone that hopes to carry a child, it is important to tell your doctor about this desire before treatment starts. Many cases of uterine cancer are treated with hysterectomies, so your doctor needs to know that you want to keep your reproductive organs if at all possible before formulating a plan.
- It is also a good idea to do your own research about possible treatment options for your condition. Discuss anything you find with your doctor so that together you can assess whether they would be helpful for you.
Follow your treatment plan.Your treatment options can vary based on where the cancer is located and what stage it is at. However, most people with uterine cancer have some combination of surgery, radiation, hormone therapy, and chemotherapy. Once you and your doctor have agreed on how to proceed, start treatment right away. Delaying treatment will only increase the risk of the cancer growing and spreading.
- Your treatment plan may change as your treatment progresses. Discuss how your treatment is progressing with your doctor and be open to changing the plan if your doctor thinks it's necessary.
Video: Uterine Cancer Symptoms & Treatment at MD Anderson
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