Uterine cancer is the most common cancer occurring in a woman’s reproductive system. There are 2 major types of uterine cancer.
Endometrial adenocarcinoma makes up more than 80% of uterine cancers and develops from cells in the endometrium (hence commonly known as endometrial cancer). Endometrioid carcinoma is a common type of endometrial adenocarcinoma, whilst less common types of uterine cancers include serous, clear cell, and carcinosarcoma.
Sarcoma accounts for about 2% to 4% of uterine cancers and develops from the uterine supporting tissues or the uterine muscle.

 

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Uterine Cancer Treatment In Malaysia

 

Genetics and family history

A higher risk for uterine cancers can be inherited and happens about 5% of the time. Lynch syndrome is most commonly associated with inherited uterine cancer and is also associated with colon, kidney, bladder, and ovarian cancers. Lynch syndrome is associated with DNA mismatch repair defect.

People affected by Lynch syndrome can receive increased screening for Lynch-associated cancers. Affected family members may consider preventive surgery for uterine and ovarian cancer.

 

Symptoms and Signs

  • Unusual vaginal bleeding, spotting, or discharge. For premenopausal women, this includes menorrhagia, which is an abnormally heavy or prolonged bleeding
  • Abnormal results from a Pap Smear Test.
  • Pain in the pelvic area

 

Diagnosis

In addition to a physical examination, the following tests may be used to diagnose uterine cancer.

Pap Smear is done during pelvic examination to look for abnormal glandular cells, which are caused by uterine cancer.

Endometrial biopsy allows removal of a small amount of tissue for examination under a microscope. This allows a definite diagnosis to be made.

Dilation and curettage is often done in combination with a hysteroscopy so the doctor can view the lining of the uterus during the procedure. After endometrial tissue has been removed, during a biopsy or D&C, the sample is checked for cancer cells.

Computed tomography (CT) scan allows a detailed, 3-dimensional image to exclude any abnormalities or tumors.

Magnetic resonance imaging (MRI) uses magnetic fields to produce detailed images of the body.

 

FIGO stages for uterine cancer

Doctors assign the stage of endometrial cancer using the FIGO system.

 
Stage 1 Uterine Cancer

The cancer is found only in the uterus or womb, and it has not spread to other parts of the body.

 

  • Stage 1a:The cancer is found only in the endometrium or less than one-half of the myometrium.
  • Stage 1b:The tumor has spread to one-half or more of the myometrium.

 

 
Stage 2 Uterine Cancer

The tumor has spread from the uterus to the cervix.

 
Stage 3 Uterine Cancer

The cancer has spread beyond the uterus, but limited to the pelvis.

 

  • Stage 3a:The cancer has spread to the serosa of the uterus and/or the tissue of the fallopian tubes and ovaries but not to other parts of the body.
  • Stage 3b:The tumor has spread to the vagina.
  • Stage 3c1:The cancer has spread to the regional pelvic lymph nodes.
  • Stage 3c2:The cancer has spread to the para-aortic lymph nodes.

 

Stage 4 Uterine Cancer

The cancer has metastasized to the rectum, bladder, and/or distant organs.

 

UTERINE CANCER TREATMENT OPTIONS

Talk to our uterine cancer oncologists at Onco Life Centre about your treatment options. The main treatments for uterine cancer are surgery, radiation therapy, chemotherapy, immunotherapy, targeted therapy and hormone therapy. Often the best approach uses 2 or more of these treatment methods. It is important that you understand the goal of your treatment. If a cure is not possible, treatment is aimed at relieving symptoms such as pain.

 

Surgery for uterine cancer

Hysterectomy can be simple (removal of the uterus and cervix) or radical (removal of the uterus, cervix, the upper part of the vagina, and nearby tissue). For patients who have been through menopause, the surgeon will typically also perform a bilateral salpingo-oophorectomy, which is the removal of both fallopian tubes and ovaries. Read More ...

Lymph node removal at the vicinity of the tumor will determine if the cancer has spread beyond the uterus.

Radiation therapy for uterine cancer

Some women with uterine cancer need radiation therapy after surgery to destroy any remaining cancer cells. Read More ...

Systemic therapies

The types of systemic therapies used for uterine cancer include Chemotherapy, Hormonal therapy, Targeted therapy and Immunotherapy.

Chemotherapy for uterine cancer is aimed at destroying cancer remaining after surgery or aimed at shrinking the cancer and slowing down the tumor's growth if it recurs after initial therapy.

Advances in chemotherapy during the last 10 years include the development of new drugs for the prevention and treatment of side effects.

Hormone therapy for uterine cancer is used to slow the growth of grade 1 or 2 tumors uterine adenocarcinomas. The use of aromatase inhibitors will reduce the amount of the hormone estrogen in a woman's body by stopping tissues other than the ovaries from producing it.

Targeted therapy for uterine cancer targets the cancer’s specific genes, proteins, or the tissue environment to block cancer cell growth and spread while limiting damage to healthy cells.

  • Anti-angiogenesis therapy is focused on stopping the process of making new blood vessels and “starving” the tumor. It can be used along with immunotherapy to treat some advanced endometrial cancers, typically after at least one other drug treatment has been tried.
  • Mammalian target of rapamycin (mTOR) inhibitors. In endometrial cancer, mutations in mTOR pathway allow women with advanced or recurrent uterine cancer to be treated with a drug that blocks this pathway.
Please click here to learn more about Targeted Therapy

 

Immunotherapy for uterine cancer is designed to boost the body's natural defenses to fight the cancer. Immunotherapy is approved by the US-FDA for uterine cancers with DNA mismatch repair defect or high microsatellite instability. PD-1 normally helps keep T cells from attacking other cells in the body (including some cancer cells). By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.

Please click here to learn more about Immunotherapy

 

 

 

Risk Factors

The following factors may raise a woman’s risk of developing uterine cancer:

Age
The average age at diagnosis is 60. Uterine cancer is not common in women younger than 45.
Obesity
Fatty tissue in obese women produces additional estrogen, which can increase the risk of uterine cancer. About 70% of uterine cancer cases are linked to obesity.
Genetics
It is recommended that all women under the age of 60 with endometrial cancer should have their tumor tested for Lynch syndrome, even if they have no family history of colon cancer or other cancers. The presence of Lynch syndrome has important implications for women and their family members.
Other Cancers
Women who have had breast cancer, colon cancer, or ovarian cancer have an increased risk of uterine cancer.
Radiation therapy
Women who have had previous radiation therapy for another cancer in the pelvis have an increased risk of uterine cancer.
Estrogen
Extended exposure to estrogen related to early menarche, late menopause or hormone replacement therapy may increase uterine cancer risk.

 

Our Best Uterine Cancer Oncologist

Onco Life Centre combines key elements of uterine cancer care and uterine cancer treatment under one roof, with convenience and speed. At Onco Life Centre, we have the necessary medical disciplines to achieve this. Our board certified highly experienced consultant oncologists have earned recognition for excellence in the field of uterine cancer treatment, providing our patients with the most advanced uterine cancer treatment options.

DR. CHRISTINA NG VAN TZE

Dr. Christina Ng is a Consultant Medical Oncologist and Founder President of Empowered, The Cancer Advocacy Society of Malaysia.…

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Cost of uterine cancer treatment

Treatment cost for uterine cancer depends on several factors, such as the staging and the type of the uterine cancer. Generally, using only chemotherapy is cheaper compared to using targeted therapy or immunotherapy. The more advanced the cancer stage, the more expensive it becomes to treat the cancer. At Onco Life Centre, the cost for treating uterine cancer using chemotherapy for most of our patients is around MYR6,000 per cycle. Adding in Targeted Therapy can go up from MYR8,000, depending on the specific type of targeted therapy drug used. The cost of uterine cancer immunotherapy can range from MYR10,000 and above depending on the specific type and dosage of immunotherapy drug used.

 

Patients and their families have opportunities to talk about the way they are feeling with our oncologists, nurses, counselors, or join our psychosocial program and support group at Onco Life Centre.

 

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