I would like to know what is the first stage of uterus cancer and if the bleeding is from the lining of the uterus?

The reproductive system of a woman consists of the uterus which is the organ in which the fetus takes shape and grows. The uterus has two layers or linings; the myometrium or outer layer and the endometrium or inner layer. When tumors of cancer cells grow in the inner lining of the uterus, it is called endometrial or uterine cancer. Lymph nodes and blood vessels are present in high quantities in the uterus.  These lymph nodes regulate the flow of lymphatic fluids all over the body, and as such are vulnerable to rapidly spreading tumors and infections. When the functioning of the body cells in the uterus is hampered, uterine cancer can develop. The cancer may occur in one cell of the body and multiply to the other cell, thereby resulting in a tumor.

cancer of the uterus is classified into three stages, based on the way the cancer cells appear under a microscope. In stage one of uterine cancer the cancer cells are restricted to the uterus. There are three sub stages within this stage. In the first sub stage the cancer only affects the endometrium or the inner lining of the uterus. In the second and third sub stages, the cancer spreads to the muscular tissues of the uterus.

Abnormal vaginal bleeding is the most common sign of uterine cancer. It may initially be a watery discharge with specks of blood in it, and then gradually progress to larger quantities of blood.  Uterine cancer most commonly develops in women above the age of 50 years. Obese women are more susceptible to cancer of the uterus as fat build up in the body tissue results in increased estrogen production by the body. Estrogen affects the cells in the uterus lining. Estrogen levels may also increase due to intake of birth control pills or due to hormone replacement medications. Women who are unable to bear children due to infertility are at a higher risk of developing uterine cancer as estrogen levels are not affected due to hormonal changes during pregnancy. Pregnancy causes the estrogen level to reduce, thereby allowing the inner lining of the uterus to be at rest.

Treatment of uterine cancer depends on factors such as the stage the cancer is in, the location of the cancer, age of the patient and general overall health of the patient. The course of treatment may involve surgery, chemotherapy, radiation and hormone therapy.

answered by G M

The lining of the uterus is referred to as the endometrium. When cancerous cells or malignant tumors develop from the endometrium, medical experts term it as endometrial cancer and the condition can also be called uterine cancer. Though, cancer of the uterus may also develop from the other tissues of the uterus. Endometrial cancer is believed to be common among women after the age of 45 and is known to occur after a few years of menopause. There are several stages in the development of cancer of the uterus. When the malignancy has not spread outside the wall of the uterus to any other organ of the body or outside the uterus and is limited to the uterus only, then this is considered as the first stage of uterus cancer. Again this stage is further sub-divided. In the condition when the cancer has affected only the innermost tissue or cells of the uterus then this condition is considered as one of the earliest stages of uterine cancer. When this condition progresses, then the cancer gradually spreads to the muscular tissue of the uterus and thus increases the cavity of the uterus. Though uterine cancers usually occur after menopause they can also occur as menopause begins.

Besides age, other risk factors for this condition include obesity, diabetes, high blood pressure, late menopause, early menstruation, hormonal treatment, high levels of estrogen in the body, family history of breast or ovarian cancer and infertility and women who have never become pregnant. Symptoms to note are vaginal bleeding after the onset of menopause or abnormal and irregular bleeding during menopause. A doctor should be consulted immediately in such cases.  

In case of uterine cancer, after menopause, abnormal vaginal bleeding is caused by the cancer cells in the uterus which become weak and break off. Bleeding occurs irregularly whenever these cells break off. Hence if these abnormal cells are detected at an early stage then they can be treated.

In its early stage, this condition does not cause any pain or nausea or vomiting or such similar symptoms. Besides, such abnormal or irregular bleeding may last for a few days only. Therefore a doctor’s visit is a must even if the bleeding stops thereafter. This condition should not be considered as a part of menopause. Moreover, symptoms like painful or difficulty in urination, vaginal discharge, pain in lower abdomen or pain during sex should also not be ignored and should call for medical examination. If treated in early stages, this disease is highly curable.

answered by M W

The uterus is the pelvic organ that holds the pregnancy and that bleeds each menstrual period. The uterus is divided into three parts. The great bulk of the uterus is composed of smooth muscle and forms a thick uterine wall. The inside of the uterus is lined with a glandular epithelium which is supported by the endometrial stroma. Together, the glandular lining and the endometrial stroma are referred to as the endometrium of the uterus. Cancer of the uterus begins in the lining of the uterus (endometrium) and is more precisely termed endometrial cancer (carcinoma).

Risk factors for endometrial cancer include the following:

• early menarche (the start of menstrual periods), menopause after age 52, or both
• menstrual problems (such as excessive bleeding, spotting between menstrual periods, or long intervals without periods)
• woman
• never had children
• tumors that produce estrogen
• use of drug tamoxifen
• Family history of cancer of the breast, ovaries, large intestine (colon), or lining of the uterus.
• obesity
• high blood pressure
• diabetes

Symptoms and Diagnosis of Uterine Cancer:

Abnormal bleeding from the vagina is the most common early symptom. Abnormal bleeding includes bleeding after menopause or between menstrual periods and periods that are irregular, heavy, or longer than normal Diagnosis is confirmed by endometrial biopsy, hysteroscopy Prognosis and TreatmentIf endometrial cancer is detected early, nearly 90% of women who have it survive at least 5 years, and most are cured. The prognosis is better for women whose cancer has not spread beyond the uterus. If the cancer grows relatively slowly, the prognosis is also better. Hysterectomy means surgical removal of the uterus, is the main treatment for women who have endometrial cancer. If the cancer has not spread beyond the uterus, removal of the uterus plus removal of the fallopian tubes and ovaries (salpingo-oophorectomy) almost always cures the cancer. Nearby lymph nodes are usually removed at the same time STAGING OF UTERINE CANCER Cancers of the uterus are staged by surgical exploration with removal of the uterus, tubes and ovaries. In addition, an assessment of the pelvic and aortic lymph nodes is done.

SURGICAL STAGES OF CANCER OF THE UTERUS

Stage I Cancer limited to the lining of the uterus:

• IA No invasion into the uterine wall
• IB Invasion into less than one half of the uterine wall
• IC Invasion into more than one half the uterine wall

Stage II Extends into the cervix:

• IIA Extends only superficially along the endocervix
• IIB Extends deep into the cervix

Stage III Cancer has spread beyond the uterus:

• IIIA Cancer involves the tubes or ovaries
• IIIB Spread to the vagina
• IIIC Spread to the pelvic or aortic lymph node

Stage IV Distant metastases:

• IVA Is inside the bladder or rectum
• IVB Throughout the abdomen or other distant sites

answered by Dr