Uterine cancer is also known as endometrial cancer. It is a cancer which begins in the lining of the uterus. The uterus is the part of a woman's body where the fetus develops. Uterine cancer is one of those rare cancers in India, which can be diagnosed in its early stages. This is because excessive vaginal bleeding occurs, thus making it a very serious and an apparent symptom. It is also one of the few forms of cancer which can be cured as removing the uterus is often more than enough to cure the patient of uterine cancer.

Here are the causes, diagnosis and treatment of uterine cancer:

Causes

The exact cause of uterine cancer is not yet known, however, there is a theory on what causes uterine cancer. Hormones in a woman's body have been thought to increase the chances of getting uterine cancer. This is because it has long been thought that having high levels of estrogen is the cause of uterine cancer. Increased estrogen thickens the endometrium and thus, increases the likelihood of uterine cancer.

Diagnosis

There are several tests used to diagnose whether you have uterine cancer including:

1. Pelvic exam: This is an examination in which the vagina, bladder, rectum and uterus are scanned for lumps. If they are found, it might be due to uterine cancer.
2. Pap test: A pap test is a special test designed to scan for uterine cancer.
3. Transvaginal ultrasound: A transvaginal ultrasound uses high-intensity sound waves so that pictures of the uterus can be taken.
4. Biopsy: During a biopsy, the doctor will remove tissue from the endometrium and it will then be analyzed for cancerous growths.

Treatment

1. Surgery: This is the most common treatment as it removes the entire uterus and prevents the spreading of the cancer.
2. Chemotherapy: Chemotherapy involves giving drugs which kill cancerous cells. They are given through either an intravenous line or even in pill form.
3. Hormone therapy: This is a therapy in which either progesterone levels are increased or estrogen levels are decreased.
4. Radiation therapy: In this treatment, high energy laser beams are used to destroy cancerous cells.

Uterine Cancer - Causes, Diagnosis and Treatment

Definition

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.

Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue. Fibroid location, size and number influence signs and symptoms:

TYPES

 	Submucosal fibroids: Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are more likely to cause prolonged, heavy menstrual bleeding and are sometimes a problem for women attempting pregnancy.
 	Subserosal fibroids: Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing a pressure sensation, or on your spinal nerves, causing backache.
 	Intramural fibroids: Some fibroids grow within the muscular uterine wall (intramural fibroids). If large enough, they can distort the shape of the uterus and cause prolonged, heavy periods, as well as pain and pressure.

Symptoms

In women who have symptoms, the most common symptoms of uterine fibroids include:

 	Heavy menstrual bleeding
 	Prolonged menstrual periods - seven days or more of menstrual bleeding
 	Pelvic pressure or pain
 	Frequent urination
 	Difficulty emptying your bladder
 	Constipation
 	Backache or leg pains

 	Abnormal menstrual bleeding, such as:
o	Heavier, prolonged periods that can cause anemia
o	Painful periods.
o	Spotting before or after periods.
o	Bleeding between periods.

 	Pelvic pain and pressure, such as:
o	Pain in the,abdomen pelvis, or low back.
o	Pain during sexual intercourse.
o	bloating and feelings of abdominal pressure.

 	Urinary problems, such as:
o Frequent urination
o	Leakage of urine (urinary incontinence).
o	kidney blockage following ureter blockage (rare).

 	Other symptoms, such as:
o	Difficulty or pain with bowel movements.
o	infertility. Sometimes, fibroids make it difficult to become pregnant.
o	Problems with pregnancy, such as placental abruption and premature labor.
o	miscarriage.

Tests and diagnosis

Ultrasound
Magnetic resonance imaging
Hysterosonography
Hysterosalpingography
Hysteroscopy

Uterine Fibroids - All You Should Know!

Uterine polyps are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign), although some can be cancerous or can eventually turn into cancer (precancerous polyps).

Uterine polyps range in size from a few millimeters - no larger than a sesame seed - to several centimeters - golf-ball-size or larger. They attach to the uterine wall by a large base or a thin stalk.

You can have one or many uterine polyps. They usually stay contained within your uterus, but occasionally, they slip down through the opening of the uterus (cervix) into your vagina. Uterine polyps most commonly occur in women who are going through or have completed menopause, although younger women can get them, too.

Symptoms

Signs and symptoms of uterine polyps include:

Irregular menstrual bleeding - for example, having frequent, unpredictable periods of variable length and heaviness
Bleeding between menstrual periods
Excessively heavy menstrual periods
Vaginal bleeding after menopause
Infertility
Some women have only light bleeding or spotting; others are symptom-free.
When to see a doctor
Seek medical care if you have:

Vaginal bleeding after menopause
Bleeding between menstrual periods
Irregular menstrual bleeding
Causes

Hormonal factors appear to play a role. Uterine polyps are estrogen-sensitive, meaning they grow in response to circulating estrogen.

Risk factors

Risk factors for developing uterine polyps include:
Being perimenopausal or postmenopausal
Having high blood pressure (hypertension)
Being obese
Taking tamoxifen, a drug therapy for breast cancer
Complications

Uterine polyps might be associated with infertility. If you have uterine polyps and you're unable to have children, removal of the polyps might allow you to become pregnant, but the data are inconclusive.

Uterine Polyps - Symptoms, Causes & Complications Related To It! 

It is very common for women to have heavy and painful periods or have a feeling of fullness in the lower abdomen. Although, it may not sound very alarming these could be the symptoms of uterine fibroids. These are the most common types of benign tumours found in women. The fibroids are basically some tissues and muscle cells that grow within the uterus, outside the uterus, or along the wall of the uterus. The fibroids are usually benign and asymptomatic and do not require any treatment unless they cause problems. 

Know the causes 

Though the exact cause of fibroid formation is not known, it is believed that the female hormones estrogen and progesterone have a role to play in their formation. Fibroids are formed only when a woman is producing these hormones and they are not seen in women in non-reproductive age i.e. before starting of menses or after stoppage of menses (menopause). If fibroids are persisting even after menopause or especially if increasing in size then it is an alarming sign. Such a fibroid needs to be taken care of immediately. 

What are the symptoms? 

Fibroids often remain quiet for long periods of time. They cause nonspecific symptoms in the pelvis and abdomen including: 

Fullness in the abdomen 
Low back pain 
Irregular menstruation 
Cramping with menstruation 
Painful sex 
Increased urgency to urinate 
Anemia, leading to tiredness and weakness 
Infertility Diagnosing the fibroids 
When these symptoms are recurrent, it is good to confirm the diagnosis. This can happen with a pelvic exam followed by ultrasound scanning to confirm the size and location of the fibroids. A blood test also may be done to confirm anemia, which is common due to heavy periods.

Treatment Options 

Management of fibroids can range from doing nothing to periodic monitoring to surgical removal. 

If pain and heavy bleeding are the only symptoms, then pain killers like ibuprofen should suffice for symptomatic relief. Anemia, if severe, may require iron supplementation. 
Embolization is an option which shrinks the fibroid, at the same time preserving the uterus. The blood flow to the fibroid is cut off, thereby preventing its further growth. It takes about 1 to 3 hours and requires some bed rest after the procedure. There could be some pelvic pain and vaginal bleeding, which will gradually subside. The fibroids may grow back, but the benefits of keeping the uterus are definitely there. This is suitable in case of single fibroid with specific blood supply. 
The next surgical option is myomectomy, where the portion of the uterus which contains the fibroid alone is removed. This is done in women who still wish to get pregnant and in women who would like to retain the uterus. This can also be achieved laparoscopically( key hole surgery). In such cases, fibroids are cut into small pieces and then removed from the body. This procedure should be done by a doctor specialised in advanced gynecological endoscopy as all this cutting should be done in a bag to avoid any spillage of cells inside the abdominal cavity. This procedure is known as Laparoscopic Myomectomy with In-bag Moecellation. 
In women who have crossed their pregnancy phase, hysterectomy or complete removal of the uterus is advised. In these women, the bleeding and pain may not have subsided even after years of treatment with hormones. The growing fibroids could be pressing on the adjacent organs, causing pressure. This is the only definitive treatment and should be done in women have completed their family and don t desire to be pregnant. 
Myomectomy and hysterectomy may be done laparoscopically or with an open method depending on the overall health, the size and location of the fibroids in the uterus.

Uterine Fibroid - How Removing Them Will Help You?

It is perfectly normal for women to experience the periodic monthly bleeding cycle. However, if a woman experiences uterine bleeding which is abnormal and dysfunctional, it could be a symptom of infection. Other causes of abnormal uterine bleeding include hormonal imbalance, infection in cervix and cancer of the uterus. Many women can also experience abnormal uterine bleeding during first trimester of pregnancy.

The following are considered to be abnormal or dysfunctional uterine bleeding:

A menstrual cycles occurs between 21 to 35 days, anything shorter or longer than this is abnormal
No period for 3 6 months (amenorrhea) is abnormal
Spotting or bleeding between periods
Spotting or bleeding after intercourse
Bleeding that is heavier or lasts longer than usual
Spotting or bleeding after menopause
What can cause such a situation?

Some of the common causes leading to abnormal bleeding are as follows:

Miscarriage
Ectopic pregnancy
Pregnancy
Cervical or uterine infections
Fibroids
Hormonal imbalances
Problems with blood clotting
Polyps
Polycystic ovarian
Endometrial hyperplasia
Cancer of the reproductive tract
How to Diagnose it?

Most women tend to ignore abnormal bleeding, taking it as something to do with age or hormones. A detailed physical examination and history is done to understand menstrual cycle patterns and family history. In addition, the following would be used.

Ultrasound: The pelvic organs are examined through sound waves to locate the problem area
Hysteroscopy: Through a thin device that is inserted into the vagina, the doctor takes a look at the inside of the organs and identify the cause for the bleeding
Endometrial biopsy: The uterine lining tissue is removed and examined under microscope to look for tissue changes that could be causing the bleeding
How Best to Treat It?

This would depend on the reason for the abnormal bleeding. However, in most cases, combinations of the following are useful in treatment.

Hormone replacement can be done depending on the age and gynecological history, the type and the dose of the hormone would be decided upon. These could be in the form of tablets, vaginal creams, injections, or through an intrauterine device
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are useful in reducing bleeding and controlling cramps during excessive menstrual bleeding.
Antibiotics may be useful if there is infection of the pelvic organs.
Polyps, cysts, cancers, and other growths can be removed via hysteroscopy and sent for biopsy to confirm they are not cancerous.
Endometrial ablation where the endometrial tissue is treated with heat can be used to control bleeding permanently.
Hysterectomy would be done if other forms of treatment have failed. This could depend on their gynecologic history and other considerations as she cannot get pregnant after this.
Do not ignore if you see a change in the pattern of your uterine bleeding. It definitely calls for medical attention and if identified early, can be managed in much simpler ways. 

Abnormal Uterine Bleeding - How Best to Diagnose It?

In case you have a diseased uterus, which makes you infertile, you can undergo a procedure known as uterus transplant or uterine transplant to get pregnant. In the process of sexual reproduction, a diseased uterus does not allow embryonic implantation. This factor is referred to as uterine factor infertility or UFI. As a result, you will not be able to get pregnant.

Who requires a uterus transplant?
This procedure involves women who have UFI and women who had their uterus removed by hysterectomy. Women who have a damaged uterus on account of an injury or infection, which does not function anymore, can also undergo a uterus transplant procedure. Women from the age of 21 to 45 are eligible for this procedure. Many women are born without having a uterus. This condition is called Mayer-Rokitansky-K ster-Hauser syndrome.

Procedure
Uterus transplantation begins with undertaking a uterus retrieval surgery on the uterus donor. The uterus, which is recovered has to be stored and transported to the location of the patient undergoing the transplant. An ischemic tolerance may last over 24 hours. Three major surgeries have to be carried out with the recipient. Firstly, a transplantation surgery is required in which the donor s uterus gets transplanted. In case pregnancy develops, a caesarean section surgery has to be performed. The patient is given immune suppressive therapy. After childbirth, a hysterectomy is done in order to terminate the immune suppressive therapy.

Will the women be able to get pregnant after having sex?
Women receiving a uterus transplant will not be capable of becoming pregnant without undergoing fertility treatments. The transplanted uterus is not connected with the fallopian tubes, which is the location of the normal fertilisation process. The women will require to carry out IVF or in vitro fertilisation to become pregnant after a uterus transplant. IVF is a process in which the eggs are removed from the ovaries and get fertilised in a laboratory. Then, they are implanted in the uterus. After undergoing the uterus transplant procedure, a woman has to wait for a period of one year. The uterus requires time for healing and after recovery, the embryo may be implanted for pregnancy. After giving birth successfully, a woman will be able to keep the transplanted uterus.

She has the option to get pregnant again. However, after giving birth twice, a hysterectomy must be carried out for the removal of the uterus. This is done so that the woman can stop using the immune suppressant drugs, which are associated with major risks. Uterus transplant is a relatively new technology. In October 2014, the first healthy baby was born to a woman who had undergone a uterus transplant. This surgery is kind of experimental in nature and is usually the last option for getting pregnant. 

Diseased Uterus - Can it be Replaced?

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