Uterine cancer, commonly known as uterine cancer, actually refers to endometrial cancer, also known as uterine cancer, which occurs in the endometrial epithelium and is mostly adenocarcinoma. It is a common cancer in the female reproductive system, and its incidence rate is only second to cervical cancer, ranking fourth among the most common cancers among women. It is more common in women aged 50-60 and often occurs after menopause. In recent years, the incidence rate is on the rise worldwide. It can spread to many parts of the body: from the uterus downwards to the cervix, from the fallopian tubes upwards to the ovaries; It can also infiltrate into the surrounding tissues of the uterus; Or it can be transferred to a location far away from the uterus through the lymphatic system and blood circulation.
Women who marry early, give birth early, have multiple births, have not given birth, are infertile, have early menarche, have delayed menopause, and experience sexual dysfunction have a higher incidence of the disease. At present, it is also believed that cholesterol in smegma can be converted into carcinogens through bacterial action. It is also an important cause of cervical cancer. The possible causes of uterine cancer include:
1. Genetic factors
Undoubtedly, any cancer has a certain degree of heritability, and endometrial cancer is no exception. According to clinical statistics, about 20% of endometrial cancer patients have a family history, and their family history is twice as high as cervical cancer.
2. Age
The vast majority of patients with endometrial cancer are diagnosed before the age of menopause, with only 15% of women diagnosed with endometrial cancer before the age of 50 and only 5% of women diagnosed before the age of 40.
3. Sexually transmitted disease infection
Sexually transmitted disease infection usually represents a complex sexual life, and the probability of developing uterine cancer is relatively high.
4. Cervical inflammation
If there is long-term damage, skin rupture, erosion, or inflammation of the cervix, it may transform into early-stage uterine cancer cells.
5. Smoking
Smoking increases the risk of developing type II endometrial cancer: firstly, smoking reduces the body's immune system and accelerates the development of uterine cancer cells; secondly, smoking itself produces substances that may lead to the development of uterine cancer cells.
6. Improper sexual activity
Women who have two or more male partners have a significantly increased risk of developing uterine cancer.
7. Endometrial hyperplasia
Endometrial hyperplasia has a certain tendency towards cancer and is therefore classified as a precancerous lesion. Its hyperplasia is divided into simple, complex, and atypical types. The incidence of simple hyperplasia developing into endometrial cancer is about 1%; Complex hyperplasia accounts for about 3%; The development of endometrial cancer from atypical hyperplasia is about 30%.
8. Long term stimulation of the endometrium by estrogen
Both endogenous and exogenous estrogen, under the long-term action of estrogen without progesterone antagonism, are associated with the development of type I endometrial cancer. The extensive use of selective estrogen receptor modulators plays a role as estrogen receptor agonists in endometrial tissue to varying degrees. Although tamoxifen reduced the risk of breast cancer and its recurrence, it increased the risk of endometrial cancer. Some scholars believe that progesterone can alter the stability of cervical epithelial cells, leading to abnormal changes and potentially causing the development of uterine cancer cells.
The main symptoms of uterine cancer
(1) Uterine bleeding: Irregular vaginal bleeding before and after menopause is the main symptom of uterine cancer, often with small to moderate amounts of bleeding, rarely with large amounts of bleeding. Bleeding can occur at any time, except for those undergoing sex hormone therapy. If postmenopausal women undergoing hormone replacement therapy experience vaginal bleeding similar to menstruation, it indicates the possibility of uterine cancer. Not only are younger or near menopausal patients prone to mistaking menstrual irregularities and not seeking medical attention in a timely manner, but even doctors are often negligent. Therefore, if there is any abnormal vaginal bleeding or excessive bleeding, it is necessary to seek medical treatment as soon as possible. There are also individuals with delayed menstrual cycles, but their symptoms are irregular. Postmenopausal patients often present with persistent or intermittent vaginal bleeding. Patients with uterine cancer generally do not experience contact bleeding. Late bleeding may be mixed with minced meat like tissue.
（2） Vaginal discharge: As adenocarcinoma grows in the uterine cavity and has a lower chance of infection compared to cervical cancer, there may only be a small amount of bloody discharge in the early stages. However, in the later stages of infection and necrosis, a large amount of foul smelling pus like fluid may be discharged. Sometimes the discharge may contain small fragments of cancer tissue. If there is pus accumulation in the uterine cavity, it can cause fever, abdominal pain, and an increase in white blood cells. The general situation also deteriorates rapidly.
（3） Pain: Due to the accumulation of cancer and its bleeding and drainage, it stimulates irregular contractions of the uterus and causes paroxysmal pain, accounting for about 10% to 46%. This symptom mostly occurs in the late stage. If cancer tissue penetrates the serosa or erodes the parametrial connective tissue, bladder, rectum, and compresses other tissues, it can also cause pain, which often presents as stubborn and progressive aggravation; And it mostly radiates from the lumbar sacral region, lower abdomen to the thighs and knees.
（4） Other: Late stage patients may feel the enlarged uterus or adjacent tissues and organs in the lower abdomen, which can cause swelling and pain in the lower limb on that side, or compress the ureter and cause hydronephrosis or renal atrophy on that side; Or there may be systemic exhaustion symptoms such as anemia, emaciation, fever, and cachexia.