(As most uterine cancers develop from the endometrium, the term “endometrial cancer” may sometimes be used interchangeably with uterine cancer although there are differences)

Although abnormal vaginal bleeding may not always be indicative of cancer, those at a higher risk of developing uterine cancer should consider going for annual screenings. If detected at an early stage, the five-year survival rate for uterine cancer is as high as 95%.

Risk Factors of Uterine Cancer

• Obesity
• Diabetes
• Women who have never been pregnant
• Women who had their first periods by age 12; and women who have undergone menopause after age 55
• Irregular or infrequent menstrual periods of less than 4 times a year
• Women with Polycystic Ovarian Syndrome (PCOS)
• Family history of uterine cancer
• Personal history of breast or ovarian cancer
• Hormone Replacement Therapy that involves only Oestrogen
• Use of contraceptive Intrauterine Devices (IUDs)

Signs and Symptoms

The most common symptom of uterine cancer is unusual vaginal bleeding. While vaginal bleeding is not always a sign of cancer, it is recommended that a doctor be consulted as this could indicate other problems as well.

Unusual vaginal bleeding includes:

• Bleeding after menopause
• Bleeding between menstrual periods
• Abnormally heavy periods

Other signs of uterine cancer are:

• Vaginal spotting
• Pink or white water vaginal discharge
• Vaginal discharge that has a foul odour
• Pain during or after sexual intercourse
• Painful urination
• Pelvic pains

Screening and Diagnosis

Women who are at higher risk of developing uterine cancer should consider going for annual screenings of uterine cancer with transvaginal ultrasound and endometrial biopsy by the age of 30-35.

Primary evaluation in the doctor’s office may involve a pelvic examination to detect lumps or unusual findings, as well as an ultrasound scan to identify abnormalities in the uterus.

Endometrial Biopsy

A thin tube is inserted through the cervix into the uterus to obtain a small amount of uterine tissue. This biopsy is necessary to confirm the diagnosis of uterine cancer.

Dilatation and Curettage (D&C) may also be performed to remove the uterine tissue for testing, to determine the progress of uterine cancer prior to treatment

Treatment for Uterine Cancer

1. Surgery

This is the most common form of treatment for uterine cancer that removes the uterus and cervix. If the cancer has spread, the ovaries, fallopian tubes and lymph nodes may be removed too.

2. Radiotherapy

This can be used in all stages of uterine cancer, where high-energy rays target the cancer calls. It may also be introduced before surgery, or after to remove remaining cancer cells.

3. Chemotherapy

Usually given after surgery, drugs are administered either intravenously (IV) or taken orally in a pill/capsule. Sometimes, the chemotherapy treatment plan may involve a combination of drugs to improve the success rate of the treatment. Read about caring for a loved one going through Chemotherapy here.

4. Hormone Therapy

Aimed at slowing the growth and development of some types of uterine cancer, this is usually given by an oral pill containing a sex hormone called progesterone, which helps to balance out the hormone levels in the body.

This article is part of our Gynaecological Cancers series. To know more about other Gynaecological Cancers, continue reading about Ovarian Cancer and Cervical Cancer.

References:

1. Singapore Cancer Society (2016). Uterine Cancer. Retrieved from https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/uterine-cancer.html
2. Singhealth Group. (2019). Uterine Cancer. Retrieved from https://www.singhealth.com.sg/patient-care/conditions-treatments/uterine-cancer
3. The Straits Times (2016, March 29). High survival rate for uterine cancer if detected early.  Retrieved from https://www.straitstimes.com/singapore/health/high-survival-rate-for-uterine-cancer-if-detected-early
4. Cancer Research UK (2017, September 3). Womb Cancer – Risks and Causes. Retrieved from https://www.cancerresearchuk.org/about-cancer/womb-cancer/risks-causes

At Jaga-Me, we believe that healthcare should be a social good – it is a basic human need, and should be available to as many people as possible. We aim to deliver the highest quality care through innovation and a commitment to building meaningful relationships.

Save travelling and long wait times at the hospitals. Get specialised medical treatments:
– Urinary Catheterisation
– Complex Wound Care
– Nasogastric (NG) Feeding Tube
– IV Infusion Therapy

Jaga-Me: Your Trusted Medical Home Care Professional

Cervical cancer is the only gynaecological cancer that can be detected early through regular screening and vaccination, with 99% of cases caused by HPV, or Human Papillomavirus (pap-ah-LO-mah-VI-rus).

There are 2 cells that make up the cervix – squamous cells that protect the outside of the cervix, and glandular cells which are mostly inside the cervix and responsible for fluid and mucus production commonly seen during ovulation.

Thus, any changes to these 2 types of cells can be indicative of cancer may present themselves in the following symptoms.

Signs of Cervical Cancer

Even though these symptoms are also very common in other conditions, it is recommended that you consult a doctor if you notice any of these changes in your body:

1. Unusual vaginal bleeding
   • The most common symptom of cervical cancer is abnormal vaginal bleeding between periods, during or after sex, as well as after menopause.
2. Pain or discomfort during sexual intercourse
3. Vaginal discharge that smells unpleasant
4. Pain in the pelvis, or the area between the hip bones

Cancer of the cervix is detected with a Pap smear. Early changes to the cervical cells can be picked up through a Pap smear test, where treatment can then be given to prevent cervical cancer from developing. The Singapore Cancer Society offers free HPV screening and Pap smear tests if you meet their criteria.

Because 99% of cervical cancer is due to infections caused by the HPV, HPV vaccinations are recommended especially to women from 9 to 26 years old. It is most effective if administered before one’s first sexual exposure. The HPV vaccine isn’t recommended for pregnant women or people who are moderately or severely ill.

To diagnose cervical cancer, a pelvic examination is usually first performed by a doctor, followed by an HPV test and a colposcopy which involves looking at the cervix through a magnifying scope. A biopsy will then be performed if deemed necessary.

Treatment

Surgery

This is the most common treatment of early cervical cancer, with various options of removal of cancer cells depending on one’s cervical cancer stage and treatment goals:

1. Removal of only the cancerous (or pre-cancerous cells) of the cervix. This is the option for earliest detection and for women who still wish to preserve their fertility.
2. Removal of cervix and surrounding tissues, while preserving the upper uterus for future pregnancy.
3. Removal of uterus and cervix
4. Removal of ovaries and fallopian tubes if the cancer has spread to these organs.

Radiation Therapy (or Radiotherapy)

Another effective treatment for early cervical cancer, radiation therapy involves the use of high-energy radiation to kill off cancer cells or prevent them from growing. It is commonly used after surgery if the cancer has spread to other areas, or as a preventive measure for patients believed to be at a higher risk of recurrence of the cancer.

In other cases, radiation therapy is combined with chemotherapy for a more effective treatment.

Chemotherapy

A chemotherapy drug is usually administered intravenously (or into the vein) so that it enters the bloodstream to reach all parts of the body. While it is worth noting that chemotherapy may also damage healthy cells in the process, it is also effective to target cancer cells that have already spread to other areas beyond the cervix.

Cervical Cancer can be prevented from developing if detected early! This article is part of our Gynaecological Cancers series. To know more about other Gynaecological Cancers, continue reading about Ovarian Cancer and Uterine Cancer.

References:

1. Singapore Cancer Society (2019). About Women Gynaecological Cancers. Retrieved from https://www.singaporecancersociety.org.sg/ events/campaigns/women-s-gynaecological-cancer-campaign.html
2. Foundation for Women’s Cancer (2019). Gynaecologic Cancer Basics. Retrieved from https://www.foundationforwomenscancer.org/gyneco- logic-cancers/gynecologic-cancer-basics/frequently-asked-questions/
3. Foundation for Women’s Cancer(2019). Cervical Cancer. Retrieved from https://www.foundationforwomenscancer.org/gynecologic-cancers/ cancer-types/cervical/

At Jaga-Me, we believe that healthcare should be a social good – it is a basic human need, and should be available to as many people as possible. We aim to deliver the highest quality care through innovation and a commitment to building meaningful relationships.

Save travelling and long wait times at the hospitals. Get specialised medical treatments:
– Urinary Catheterisation
– Complex Wound Care
– Nasogastric (NG) Feeding Tube
– IV Infusion Therapy

Jaga-Me: Your Trusted Medical Home Care Professional