Polycystic ovarian syndrome or PCOS is associated with symptoms like difficulty in getting pregnant, loss of hair, sprouting of facial hair and acne. However, if left unaddressed for long, PCOS can also lead to serious health complications, such as uterine cancer.
PCOS And Uterine Cancer: How Are They Linked?
Women with PCOS have low levels of progesterone and high levels of estrogen. Both of these hormones have opposing functions. Estrogen is responsible for secondary sexual characteristics like breasts and menstrual cycle. It also plays a vital role in the thickening of the endometrium (the lining of the uterus.)
The endometrium is composed of a tissue that is provided with a rich network of blood vessels. Each month, this lining thickens to prepare for a potential pregnancy. If the egg released by the ovaries is fertilized, it will attach to the endometrial lining and get nutrition from it. If, however, there is no fertilization, high levels of progesterone will lead to the shedding of this thick lining as menses.
High estrogen levels, as in women with PCOS, lead to endometrial hyperplasia. In this condition, the endometrium is thickened abnormally. If PCOS isn’t properly treated, endometrial hyperplasia may develop into endometrial cancer, the most common type of uterine cancer.
The risk of uterine cancer is increased if the periods are fewer and highly irregular. If you have PCOS, we advise you to keep a track of your periods and share this information with your doctor.
What Are the Warning Signs of Uterine Cancer?
Signs and symptoms of uterine cancer include:
- Unusual vaginal bleeding, discharge or spotting
- Vaginal bleeding during or after menopause
- Pain while urinating
- Pain during sex
- Pain in the pelvic region
- Loss of appetite
- Anemia and fatigue
How is Uterine Cancer Diagnosed?
Among all the symptoms of uterine cancer, the most common ones are pelvic pain and unusual vaginal bleeding. Usually, these symptoms necessitate further examination. A series of tests are performed for the diagnosis of uterine cancer.
It is a physical examination in which the doctor inserts two fingers into the vagina and simultaneously presses the abdomen gently to feel the ovaries and uterus. The doctor may also insert a slender rod-like speculum into the vagina to open it up and examine it and the cervix for anything abnormal.
This examination helps in assessing the thickness and texture of the endometrium. A small slender device, called a transducer, is gently inserted into the vagina. This transducer creates sound waves, which are then used to create a picture. These pictures help the doctor in finding the state of the endometrium and also spot any abnormalities.
A thin, slender tube is inserted into the vagina. The tube has a light and a camera on one end. These allow the doctor to see the inside of the uterus for any abnormalities.
A small tissue sample from your endometrium is removed during hysteroscopy. The sample is then sent for further analysis to the laboratory. Cells in the tissue sample are checked for abnormal growth patterns.
Stages of Uterine Cancer
Once the doctor confirms a cancer diagnosis, they will proceed to find out the extent of it. Tests like chest X-ray, CT scan and PET scan help in determining the stages of cancer.
Stages of uterine cancer include:
Stage 1 – Cancer is found only in the uterus
Stage 2 – Cancer has spread to the cervix from the uterus
Stage 3 – Cancer has spread beyond the uterus, but still hasn’t reached the bladder and rectum.
Stage 4 – Cancer has spread well past the pelvic region. The rectum, the bladder and even distant regions of the body are affected.
Staging of the cancer is important to determine the kind of treatment you’ll be recommended.
Treatment Options For Uterine Cancer
Uterine cancer is among the easily treatable cancers. If it is diagnosed in the early stages, it can be cured with surgery and a close follow up.
- Surgery: For patients diagnosed with uterine cancer, the doctor may suggest a surgery to remove the cancerous part. Depending upon the spread of cancer, the surgeon will remove the uterus & cervix or uterus, cervix, ovaries and fallopian tubes. Sometimes the surrounding lymph nodes are also removed.
- Radiation therapy: Once the affected tissues are removed through surgery, the doctor may recommend radiation therapy to kill cancer cells that might still be present within the body.
- Progestin hormone therapy may be suggested to block the growth of cancer cells.
- Chemotherapy may be recommended to kill cancer cells.
Endometrial cancer may come back. Even after treatment, it is important to follow up regularly to check signs of recurrence. If cancer comes back, the patient is likely to experience the same signs and symptoms listed above.
Can Uterine Cancer be Prevented?
If you are suffering from PCOS, you can take the following steps to prevent uterine cancer.
- Maintain healthy weight – Obese or overweight women are at 3.5 times greater risk of getting uterine cancer than women with normal weight. Fat cells produce estrogen. The more fat tissue you have, the greater your estrogen levels.
- Be physically active – Higher levels of physical activity have been linked to a lower risk of endometrial cancer. An active lifestyle with a healthy weight can reduce your risks to a great extent.
- Treat endometrial problems on time – Endometrial hyperplasia increases your chances of getting uterine cancer. If you have PCOS, it makes sense to get your endometrium checked regularly, especially if your periods are highly irregular.
PCOS And Uterine Cancer: Parting Words
Endometrial (or uterine) cancer is a serious health complication of PCOS. Skewed levels of estrogen and progesterone may put the woman at a greater risk, compounded by other problems of PCOS like weight gain. While a genetic risk cannot be controlled, other risk factors can surely be addressed with diet and lifestyle changes. Uterine cancer is treatable if diagnosed in the early stages. Hence it is vital for women with PCOS to monitor their bodies for abnormal signs and symptoms. While this becomes difficult in a complex condition like PCOS, regular discussion and consultations with your doctor as well as being part of a community of women with PCOS can help greatly. The advice of
Uterine cancer is treatable if diagnosed in the early stages. Hence it is vital for women with PCOS to keep an eye on abnormal signs and symptoms. Regular discussion with your doctor and being a part of PCOS communities can help greatly.