Q. My cousin was recently diagnosed with uterine cancer.
She is only 45 years old and has been living a healthy lifestyle all her life. There are not many symptoms except that she has some irregular bleeding now and then, which she thought was due to her hormonal fluctuation.
I am worried as I also get some bleeding now and then.
What are the other things I should look out for and what ways are there to prevent getting uterine cancer?
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A. Uterine cancer is the fourth- most-common cancer in Singapore among women and it occurs in the uterus or womb.
The uterus comprises of two layers - the uterine lining and the muscle layer.
The uterine lining is also known as the endometrium and is made up of many blood vessels and go through phases of increasing thickness before being shed as monthly menses.
The most common type of uterine cancer are those arising from the endometrium known as carcinoma, whereas those arising from the muscle are known as sarcoma. The latter is rare.
Endometrial cancer can affect women of any age, although 70 per cent of the time it occurs after the age of 50 years.
Factors associated with endometrial cancer include obesity, diabetes and hypertension.
Unopposed oestrogen stimulation, for example, oestrogen-only pills, is a strong risk factor.
One can reduce the risk of getting uterine cancer by maintaining a healthy body weight and good control of diabetes - if one has diabetes.
The most common symptom of endometrial cancer is abnormal vaginal bleeding, ranging from a watery and blood-streaked flow to a flow that contains more blood.
Vaginal bleeding during or after menopause is often a sign of a problem and the patient should seek medical help early.
Most uterine cancer is detected at an early stage and the five-year survival rate is as high as 95 per cent when treated appropriately. However, the survival rate drops to less than 20 per cent if a patient's cancer is detected at a late stage.
Some of the tests that are commonly used to diagnose uterine cancer include endometrial biopsy to get a sample of cells from inside the womb for laboratory analysis.
Dilation and curettage is a procedure in which tissue is scraped from the lining of the womb and examined for cancer cells.
Transvaginal ultrasound, where an ultrasound probe is placed inside the vagina, helps to look for abnormalities in the uterine lining.
Other imaging tests that could be used are magnetic resonance imaging and computed tomography scans.
The treatment options available for uterine cancer vary according to the stage of the cancer when detected.
Surgery is the most common treatment for endometrial cancer. This is either the surgical removal of the uterus alone or, more likely, the surgical removal of the uterus, fallopian tubes and ovaries.
Other treatments that might be used are radiotherapy, chemotherapy or hormonal therapy.
Dr Sue Lo
Director and senior medical oncologist at The Harley Street Heart & Cancer Centre