Uterus present in the lower part of the abdomen, is the organ where the foetus normally resides during pregnancy.
Uterus is very much liable to develop, hard, roundish masses in its walls, which also protrude into cavity of the uterus, and cause excessive bleeding. They may be present more than one at a time. They are called fibroids and they are not cancer.
Cancer of the uterus is quite common in females in India. In Bombay, Dr. Jussawalla (1973) found its incidence to be 25.1 per 100,000 females.
Causes
It is not known. It occurs later in life.
Symptoms
Bleeding from the vagina at times other than the menstruation. Vaginal discharge.
Diagnosis
· Routine: Physical examination of the local part.
· Blood: Hb may be decreased.
· TLC may be raised and so also the polymorph count, due to infection.
· ESR is raised.
· Special: Through the procedure of dilatation of the uterus and its curettage (D&C) the uterus is slightly dilated, and a curettage introduced and scrubbed against the lining, (endometrium). The cells that come out in the bleeding are examined histologically for cancer.
Abdominal ultrasound and CT scan of the abdomen is done to gauze the site and size of the cancer.
Treatment
It depends upon the stage of the disease. Many a time, surgery, radiation and chemotherapy, are all used.
Surgery: If the cancer is yet confined to the uterus and has not spread out, surgical removal of the uterus, the fallopian tubes and the ovaries (hysterectomy with bilateral salpingo-oophorectomy) is done. The results are good in 90 per cent of the cases.
Radiation: I the cancer has spread further, extensive surgery as well as radiation are given. The results are good in only 50 per cent of the cases. Radiation is given from outside source, as well as implantation of radiation needles in the cancer mass so as to kill the cancer cells.
Chemotherapy: Progesterone, a female hormone, is helpful in reducing the size of cancer in about 30 per cent of the cases. This is given in advanced cases of cancer, along with all the other treatments.
Anti-cancer drugs are also given in cases where there is suspicion that all the cancer has not been removed.
Prevention
There is mounting evidence of a steady rise in the incidence of uterine cancer in India. It was supposed to be confined to the post-menopausal age group, but now it is seen with increasing frequency in middle-age and early-age groups. The diagnosis of cancer in its pre-invasivc stage is clearly the key to the control of uterine cancer.
Early Detection
Signs & Symptoms
· Bleeding from the vagina at times other than the time of menstruation
Investigations
· Biopsy taken of the inner uterine wall and its histo-logical examination.