Uterine cancer

Uterine cancer - Acute

Definition  

A group of uterine malignancies including, most commonly, endometrial cancer, which primarily affects postmenopausal women, and 3 rarer, distinct uterine sarcomas: carcinosarcomas arising in the endometrium, leiomyosarcomas arising from myometrial muscle, and sarcomas arising in the endometrial stroma

 

Medical History  

* At risk - finding

* Estrogen excess

* Tamoxifen use

* Obesity

* Finding related to menstrual cycle

* Hereditary nonpolyposis colon cancer

* Polycystic ovary syndrome

* Parity finding

* Contraception status

* Dietary finding

* Exercise history finding

* Smoking

* Alcohol Abuse

 

Findings  

* Vaginal bleeding

* Dyspareunia

* Dysuria

* Pain in pelvis

* Vaginal discharge

 

Tests  

 

Suspected endometrial cancer  

* Endometrial biopsy: Histological information obtained from the endometrial biopsy is generally sufficient for proceeding with definitive treatment .

 

Suspected uterine cancer  

* Transvaginal ultrasound: Transvaginal ultrasound as a first step, followed by biopsy, is the most cost-effective approach in populations with a low prevalence of endometrial carcinoma .

 

Suspected uterine cancer  

* Echogynography: Sonohysterography may permit improved imaging of the fallopian tubes and the uterine cavity, but there may be a risk of peritoneal contamination by malignant cells .

 

Suspected uterine cancer  

* CA 125 measurement

 

Differential Diagnosis  

* Uterine leiomyoma - Chronic

* Polyp of corpus uteri

* Pregnancy problem

* Victim of child molestation

* Anovulation

* Female genital tract infection

* Disease of liver

* Pituitary adenoma

* Prolactinoma - Chronic

* Polycystic ovary syndrome - Chronic

* Disorder of thyroid gland

* Hormonal Contraceptive

* Anticoagulant

* Antipsychotic

* Estrogen/Progestin Combination

* Endometriosis - Chronic

* Dysplasia of cervix

* Endometrial hyperplasia

* Cervical cancer - Chronic

 

Treatment  

 

Drug Therapy  

 

Uterine cancer  

 

CISPLATIN

 

CARBOPLATIN

 

DOXORUBICIN HYDROCHLORIDE  

 

IFOSFAMIDE

 

MEGESTROL ACETATE

 

MEDROXYPROGESTERONE ACETATE  

 

TAMOXIFEN CITRATE  

 

Procedural Therapy  

 

Uterine cancer  

* Operation on uterus: Surgery remains the primary and most important therapeutic intervention for uterine cancer.

 

Uterine cancer  

* Radiation therapy: Radiation therapy is used as adjuvant therapy as well as primary therapy in patients with uterine cancer who are poor surgical candidates .