Article: Raising Awareness (Uterine Cancer 101)

When it comes to cancer and the female body, breast cancer is what comes to mind for most – so much so that a lot of fundraising events are exclusively ‘women only’ (which I’m conflicted about for quite a few reasons, but let’s not get in to that). However, there are a few other cancers that specifically target the female anatomy and, among them, uterine cancer is the most commonly occurring cancer of the female reproductive system.

It’s also the fourth most common cancer diagnoses in women (coming behind breast, lung, and colon/rectum cancer respectively) making it a cancer well worth knowing about. In the UK alone, about 9,300 new cases of womb cancer are diagnosed per year. In the US 61,380 women are estimated to get a diagnosis per year.

And yet I personally didn’t even consider it too much, until the amazing influencer and sex education ambassador Ducky DooLittle found herself with a diagnosis and started raising awareness. Ducky is great, her writing style is very approachable and succinct, and, as someone who is beating cancer’s ass, she knows her shit and I highly recommend you check out her posts on the topic.

However, in my own efforts to raise awareness, consider this article a bit of a uterine cancer 101, as I go through some of the basic need-to-know aspects of this common reproductive cancer that, oddly, is infrequently discussed.

What Is Uterine Cancer?

All cancer is, in essence, an uncontrolled and invasive growth of mutated cells that just don’t want to play nice with the rest of the cells and whose main goal is to royally fuck up your day/life. But the location of these renegade cells can affect symptoms, treatment, and survival rates, so it’s worth looking at the specifics.

Uterine cancer (also known as womb cancer or endometrial cancer) is a form of cancer that affects the womb. The womb is described by Cancer Research UK as ‘the pear shaped muscular bag that holds a baby during pregnancy’, which is an accurate description but also a less-than-graceful description.

95% of uterine cancer cases begins with the endometrium – the lining of the womb – or, to be more specific, the glans of the endometrium, known as adeno, or the surface lining layers of the cells (the epithelium), known as carcinoma. Combined, these types of cancer are known as adenocarcinomas.

Very rare cases will occur in the muscle surrounding the womb, and this is known as uterine sarcoma. This acts in a different way to endometrial cancer and won’t be discussed here, but you can find more resources about it via the NHS and similar pages.

People aged 40-74 are most affected, specifically those who have been through the menopause, but younger incidents can occur (which is why I personally wish the UK screening services were more vigilant, but I digress).

Symptoms of Uterine Cancer

Knowing how common uterine cancer is, understanding the symptoms and when to go to a doctor is very important.

Fortunately, the most common symptom of uterine cancer is rather obvious – abnormal vaginal bleeding. Unfortunately, anyone who has a womb knows just how flippant periods and vaginal bleeding can be at times, so here are the specific symptoms to keep an eye out for.

Vaginal bleeding after menopause.

Bleeding that is unusually heavy or between your regular cycle.

Vaginal discharge that may be pink and watery or dark and have a strong, unpleasant smell.

In 90% of cases, uterine cancer will be detected because of heavy post-menopause bleeding, which makes the survival rates of uterine cancer quite optimistic (as it is often detected early) so never hesitate to go to your doctor if you flow is irregular, or if you’re bleeding post-menopause. To you it may seem like ‘a bother’ or ‘a waste of the doctor’s time’ but it’s not – it’s potentially life-saving.

Additional symptoms can also present themselves for uterine cancer and are as follows:

Low red blood cell levels (anaemia)

High platelet count (thrombocytosis).

High blood sugar level.

Pain in the back, legs, or pelvis.

Loss of appetite.

Tiredness.

Nausea.

Abdominal bruising.

Pain during sex.

Diagnosis will involve a physical examination of the pelvic area (which may involve an examination of the vulva and vagina) as well as a discussion about your symptoms. From there an ultrasound is commonly suggested to look at what’s going on.

People who have families with a history of certain cancers are genetically predisposed to womb cancer (Lynch syndrome/HNPCC families). In these cases doctors may choose to be proactive and suggest vaginal ultrasounds regularly from the age of 35 to 40 years onward. This is why it’s always important to disclose your family’s medical history if you know it.

What Comes Next?

If you’re diagnosed with uterine cancer then additional tests may be done to assess the extent of the cancer and whether it’s spread to other areas.

These tests might include blood tests, an MRI scan, a CT scan, or a PET-CT scan.

All of these will be done by medical professionals in a safe and reassuring atmosphere and you will be kept informed throughout the process.

A distinction will also be made between the type of uterine cancer you have. There are two types of endometrial cancer.

Type 1 endometrial cancer is the most common, is slow-acting, and is generally linked to excess oestrogen in the body. It’s thankfully slow spreading and typically won’t have spread to other parts of the body.

Type 2 endometrial cancer is not linked to excess oestrogen and is faster growing and more likely to spread.

Uterine cancer also comes in different stages, which relates to how far the cancer has progressed. The stage of your cancer will determine its treatment.

Treatment For Uterine Cancer

Stage 1 cancer is the easiest to treat and, with early diagnosis, will likely be what you’ll be fighting against. Stage 1A cancer will have seen the cancer potentially grow into the muscle wall, but no more than halfway, whereas 1B will have seen that growth go past the halfway threshold.

The main treatment for stage 1 uterine cancer is surgery to remove the womb and cervix (known as a hysterectomy), and will typically include removal of the fallopian tubes and ovaries too. Lymph nodes in your pelvis may also be removed, to stop them trying to be like the ‘bad boy’ cells in the womb and playing copycat.

In cases where surgery isn’t an option radiotherapy might be used as an alternative, but this is extremely uncommon.

95% of people with stage 1 uterine cancer survive for 5 years or more after treatment.

Stage 2 uterine cancer is a bit peskier. This is when the cancer has grown in the cervix. But the same still applies – surgery is the best option. Radiotherapy may also be suggested after surgery to prevent the cancer from coming back, given that it had spread. At stage 2 chemotherapy may also be suggested to you.

75% of people survive stage 2 uterine cancer.

Stage 3 uterine cancer will have spread outside the womb, but is still in the pelvis. This becomes known as advanced womb cancer and has 3 different categories depending on where it’s spread (relating to the ovaries, fallopian tubes, vaginal tissues, and nearby lymph nodes).

Stage 3 uterine cancer involves a hysterectomy, the removal of your ovaries and fallopian tubes, and potentially the top of your vagina and some surrounding tissue. Radiotherapy and chemotherapy is then offered in the aftermath.

I can’t sugar coat how grim this sounds, but I can assure you that your medical support team will have your back 100% and will keep you full informed throughout the entire process.

Survival rates are 40%.

Stage 4 uterine cancer is the most aggressive, but also very uncommon. This is where the cancer may have grown in to the bowel, bladder, lymph nodes further away in the body or even the lungs, liver, bones, or brain.

At this point treatment is as diverse as those various different cancers themselves and you will need to talk to your medical team to discuss treatment options in a comprehensive manner.

The survival rate is 15%.

Just please be assured that most uterine cancer is detected very early, and even more so if you’re informed about the symptoms and proactive with your body. Never be afraid to get yourself checked out for any medical or bodily concern. You deserve peace of mind when it comes to your health.

Living Through (and After) Treatment

To quote Deadpool, cancer is a shitshow and we all know that the fight against it isn’t going to be easy. Add to that the fact that having your womb (or any part of you) removed will come with a psychological and emotional element and that uphill climb begins looking pretty steep.

However, there are many support measures in place for those suffering with cancer, and cancer specific charities do exist and will be able to provide you with the information and support you need alongside your medical team.

If you feel capable of feeling vocal about your cancer experiences it will also help to open up and to have a strong support network in place. In all aspects of life, finding your tribe just makes everything easier, and when your battling cancer help is going to be vital some days. Seeking support is never a weakness: It’s a strategy for long-term success.

Trust in your doctors and take the process one day at a time and you prospects are generally going to be optimistic.

After treatment you may even choose to become a cancer ambassador yourself, and help fellow sufferers, or survivors. Returning to normality is also an option too, with provisions made for expected side-effects, such as diminished sex drive, discussed and dealt with as they emerge.

Life doesn’t end at a cancer diagnosis and you are strong enough to overcome yours, should you be faced with it. And, for those who use this resource to get screened and get the all clear, I hope this article gave you peace of mind and an increased vigilance when it comes to your health.

Together we overcome.