Learning About Uterine Cancer
- Jackie Boothe, of West London, is spreading awareness about uterine cancer and the symptoms that shouldn’t be ignored after experiencing “heavy” periods that ultimately affected her lifestyle.
- Prior to noticing that her periods were getting “heavier” and deciding to get checked, Boothe recounted having irregular menstruation and bleeding after sex for years.
- Uterine cancer includes two types of cancer: endometrial cancer (more common) and uterine sarcoma. More than 90% of uterine cancers occur in the endometrium (the layer of tissue that lines the uterus), making them endometrial cancer.
- Uterine sarcoma, on the other hand, is very rare and develops in the myometrium, the muscle wall of your uterus.
- This type of cancer chiefly affects postmenopausal women at an average age of 60. Though it is possible for younger women, like Jackie Boothe, to be diagnosed with uterine cancer, it is rare.
Now, the 50-year-old co-founder and CEO of Empathy Souls Community Interest Company is sharing her story to spread awareness about uterine cancer and the symptoms that women shouldn’t ignore.
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Boothe decided to seek more medical advice when her periods affected her quality of life.
Her doctor ultimately sent her to get a transvaginal ultrasound (an imaging procedure of the pelvic area), which resulted in her having to also undergo a hysteroscopy (when the uterine cavity is inspected via an endoscopy) – and revealed the “possibility of adenocarcinoma of the uterus,” Boothe explained.
When Boothe received that diagnosis in March 2016, she admits she was “completely overwhelmed.”
“I was very numb and confused by the information I was being given, and very upset by the matter-of-fact manner the oncologist consultants gave me my results in, and the immediate presence of a Macmillan nurse specialist,” she said.
At the time, Boothe wanted to get a second opinion, even though she does recall having “never paid much attention” when she likened her symptoms to those of endometrial and uterus cancers after spending some time on Google.
Two months after she was informed of the likelihood of her having uterine cancer, Boothe underwent a laparoscopic hysterectomy (removal of the uterus) and oophorectomy (removal of one or both ovaries) only to be sent home with 52 injections, various medications and laxatives, putting her into a “surgical menopause” at 42 years old, she said.
By July 2016, Boothe was informed that she did in fact have uterine cancer. Thankfully, the cancer was removed during surgery, leaving her “completely clear” of the disease.
Boothe now admits that her brief cancer journey has made her “more kind and compassionate” toward herself.
Now she’s sharing her story in hopes to prevent other women from ignoring any unusual changes in their menstruation cycle and seek medical advice when necessary.
“I wish I had known the main symptoms of womb cancer, and known that even if your smear test is clear, there are other gynecological illnesses you could have,” Boothe said. “I also wish I had a better knowledge of how my gynecological parts really worked and how bleeding after sex was something to investigate further.”
Understanding Uterine Cancer
Uterine cancer also called endometrial cancer develops in the lining of a woman's uterus. The uterus, or womb, is a pear-shaped organ where a fetus can develop and grow.
More than 90% of uterine cancers occur in the endometrium (the layer of tissue that lines the uterus), making them endometrial cancer. Uterine sarcoma, on the other hand, is very rare and develops in the myometrium, the muscle wall of your uterus.
This year, approximately 66,200 people will be diagnosed with this type of cancer, according to the American Cancer Society (ACS).
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Although this type of cancer chiefly affects postmenopausal women at an average age of 60, it is possible for younger women, like Jackie Boothe, to be diagnosed with uterine cancer. Still, it’s very rare for women under 45 to get the disease. Also, uterine cancer is more common among Black women than white women.
“Endometrial cancer starts when cells in the endometrium (the inner lining of the uterus) start to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other parts of the body,” the ACS explains. “The uterus is a hollow organ, normally about the size and shape of a medium-sized pear. The uterus is where a fetus grows and develops when a woman is pregnant.”
Dr. Diana English, a Gynecologic Oncologist at Stanford Medicine, said in a previous interview with SurvivorNet that some conditions may predispose a person to develop uterine cancer.
“I think one of the challenges with uterine cancer is that it can also happen in younger patients that have certain conditions that might predispose them to cancer,” Dr English said. “And these patients might not be thinking about this, their primary care providers might not be speaking to them about this.”
Understanding the Risks and Symptoms of Uterine Cancer
Dr. English noted the risk factors for this disease as well. “Some of the common risk factors for uterine cancer include hypertension, diabetes, and polycystic ovarian syndrome. This is a syndrome that's marked by anovulation or the absence of regular periods, which tends to happen in premenopausal patients.”
“And some of these patients are obese, some of these patients have signs and symptoms of hyperandrogenism or elevated male sex hormones, and Lynch Syndrome. The one good thing about uterine cancer, if there can be a good thing about any cancer, is that there's usually an early warning system, which is abnormal bleeding.”
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Signs & Symptoms of Uterine Cancer
According to the U.S. Centers for Disease Control and Prevention, the following are signs and symptoms of uterine cancer:
- Vaginal discharge or bleeding that isn't normal for you
- Bleeding may be abnormal because of how heavy it is or when it happens, such as after you've gone through menopause and between periods
- Pain or pressure in your pelvis
If you experience unusual bleeding, especially if you've already gone through menopause, see a doctor right away, the CDC advises. Notify a doctor if have any other signs or symptoms lasting for two weeks or longer.
Types of Uterine Cancer
There are a few kinds of endometrial cancer, also called endometrial carcinoma. Those types include:
- Adenocarcinoma, which is the most common type
- Uterine carcinosarcoma or CS
- Squamous cell carcinoma
- Small cell carcinoma
- Transitional carcinoma
- Serous carcinoma
And as for uterine sarcomas, which arise in the uterus muscle wall and make up less than 4% of all uterine cancers, according to the City of Hope Cancer Center, those types include:
- Uterine leiomyosarcoma (most common type of uterine sarcoma, accounting for two percent of uterine cancers)
- Endometrial stromal sarcomas (accounting for less than one percent of all uterine cancers)
- Undifferentiated sarcoma (a rare, more aggressive subtype of uterine sarcomas, which also accounts for less than one percent of uterine cancers)
How Is Uterine Cancer Diagnosed?
The following are ways women can check if they have uterine cancer:
Endometrial Biopsy
With this procedure, a thin and flexible tube is inserted through the cervix and into the uterus and used to gently scrape tissue from the endometrium. A specialist looks at the tissue under a microscope for cancer cells.
Dilatation and Curettage
With this procedure, a tool is used to open the vagina and a small spoon-shaped instrument is inserted into the uterus to gently remove tissue. to remove samples of tissue from the inner lining of the uterus.
Hysteroscopy
With this procedure, a thin tube with a light and camera is inserted through the vagina and cervix and into the uterus to look for abnormal areas. This procedure may also gently remove tissue to look for cancer.
Doctors may also perform a physical exam or pelvic exam, as well as a transvaginal ultrasound, in which an ultrasound probe is inserted into the vagina to examine the examine the vagina, uterus, fallopian tubes, and bladder for tumors.
Stages of Uterine Cancer
Endometrial cancer can be divided into the following stages:
Stage 1: Found in the uterus only.
Stage 2: Has not spread beyond the uterus, but cancer has been found in the connective tissue of the cervix.
Stage 3: Spread beyond the uterus and cervix, such as to the outer layer of the uterus, the fallopian tubes, the ovaries, ligaments or vagina. Stage 3C means the cancer has spread to the lymph nodes in the pelvis or near the aorta artery.
Stage 4: Spread beyond the pelvis, such as to the bladder, bowel wall, abdomen, or groin lymph nodes.
Treatment for Endometrial Cancer
Treating your uterine cancer can depend on a few factors, including whether the cancer has spread to other areas beyond the endometrium, what the cancer cells look like, and whether the cancer cells are affected by the hormone progesterone.
Low-risk endometrial cancer tend not to spread, and high-risk cancer has a tendency to spread.
Based on the risk and stage of the cancer, standard treatment options include:
- Surgery to remove cancer, which may include removing the entire uterus (total hysterectomy)
- Radiation therapy
- Chemotherapy
- Hormone therapy
- Targeted therapy, including immunotherapies
According to City of Hope Cancer Center, “The five-year relative survival rate of all combined stages of endometrial cancer is 81 percent, according to the Surveillance, Epidemiology, and End Results (SEER) database. However, it varies based on whether the cancer has spread, from 95 percent for localized cancer down to 18 percent if it's spread to other parts of the body. ”
Contributing: SurvivorNet Staff
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