Uterine cancer (endometrial cancer, endometrial carcinoma) is most common cancer of female reproductive organs in the developed countries.
This type of cancer is increasing from year to year, and this is due not only to the increase in the average age of people, but with a change of lifestyle.
The greatest rates of increase are in patients under the age of 29 years old. In the last 10 years, the incidence has increased by 50%.
Currently, the amount of uterine cancer in the world is an average of 15 cases per 100 thousand of female population per year. The risk of disease increases with age. Uterine cancer is most often diagnosed among older patients (65-70 years). The most frequent localization of the tumour is the body or the bottom of the uterine. Less often cancer develops in the lower uterine segment.
There are two basic pathogenic kinds of uterine cancer: hormone-dependent and autonomous.
The first type is experienced more often by 70% of patients, and has a more favourable prognosis with regards to survival.
Autonomous pathogenic type develops without the preceding ovulation disorders and it is characterized by an unfavourable prognosis.
Uterine cancer risk factors:
Uterine cancer can develop against a background of other pathologies (e.g. hormone-producing ovarian tumours give rise to endometrial cancer with a 20% probability).
Uterine cancer is asymptomatic during the early stages. That’s why uterine cancer cannot be diagnosed during the early stages.
Among the early signs of uterine cancer are:
Uterine cancer doesn’t have pathognomonic symptoms. These signs may indicate a number of other diseases that are not related to the cancer process.
Women can be observed and treated by a gynaecologist for hormonal disorders and cancer can be suspected only after the appearance of clear clinical symptoms or lesions of the bladder and bowel joining.
Considering the asymptomatic course of the disease, diagnostic procedures and analysis that help to detect the cancer are of utmost importance. The earlier the tumour will be detected, the better the prognosis.
The basis of the treatment is the surgery. Its volume is defined by the doctor on the basis of the examination results. The goals of treatment are the removal of the tumour, prevention of the metastases, and removal of the lymph nodes if necessary.
The following kinds of operations can be performed:
Radiation therapy usually gives good results in uterine cancer treatment. Distant radiation of the pelvic is indicated if:
For the inoperable uterine combined radiotherapy is indicated (not only the remote exposure is applied, but also the introduction of radioactive intracavitary applicators is performed).
Such treatment is applied, if:
Patients are prescribed the hormonal therapy and correction of the metabolic processes after the surgery. The medications are chosen individually. The scheme of the medications treatment depends on the number of factors that are taken into the consideration by a doctor.
Prognosis depends on the stage and extent of the pathological process, histological forms of cancer (prognosis is better if the tumour is of high differentiation), pathogenic variants (better to treat hormone-dependent form of the disease than the autonomous cancer) and the quality of medical care.
The five-year survival rate of patients, depending on the stage is:
Recent medical achievements to the greatest extent help to extend the life of patients with cancer of the uterus while in the first and second stages, whereas treatment at stages 3 and 4 are not so successful.
Photodynamic therapy (PDT) is one of the methods of uterine cancer treatment which is based on the possible influence of light waves of a certain length on abnormal cells. The essence of the procedure is in administering the special substances – photosensitizer – to the patient.
The latter can accumulate in the pathologically altered cancer cells. After absorption of the drugs into the organism a laser that can generate light at specific wavelengths is introduced. Due to the selectivity of the impact, the laser effectively impacts only the cancer cells with the photosensitizer inside.
When exposed to the light the triplet oxygen turns into the singlet in the structures with parallel release of large amounts of free radicals. This reaction leads to tumour necrosis and apoptosis at the molecular level.
The main advantage of PDT in the treatment of endometrial cancer is the organ conserving ability. Healthy cells that have no photosensitizers are not exposed to laser irradiation.
Immunotherapy. The essence of the method is in the ability to "teach" the body to deal with its own cancer cells. Under laboratory conditions it was possible to recreate the specific biological response modifiers (BRMS), which have the ability to stimulate and inhibit certain functions of the immune system.
The technique allows to:
After the introduction of specific biological response modifiers, the body's own immune system starts to fight against the tumour.
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