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Fig.: Uterine Body CancerCancer developed in uterine corpus (i.e. main body of the womb) is Uterine Body Cancer. Most of this cancer are developed from uterine mucous membrane which covers uterine body part inner cavity, and therefore it is called as endometrial cancer (refer the below fig.). Unlike cancer of the cervix, it is rare in under developing country, and it is female-specific cancer common in the developed country. Recently in Japan, like western countries, this is one of the increasing cancers amongst young female. It is said that this relates to obesity and non-active lifestyle habit.
Source: Center for Cancer Control and Information Service, National Cancer Center, Japan
Source:Center for Cancer Control and Information Service, National Cancer Center, Japan
Overstimulation of the female hormone named estrogen relates to the most of development of endometrial cancer. Obesity or menstrual irregularities causes the excess secretion of estrogen or stimulation so that they are considered to have high risks of inner membrane cancer. Also, the same may apply for the person having hormone therapy with only estrogen in hormone replacement therapy. In these cases, inner membrane cancer is developed through the phase of precancerous change so called as atypical endometrial hyperplasia. On the other hand, there is a cancer developed with no relation to hormone stimulation. Most of these type cancers are known that they are developed by the disorder of cancer-critical gene in the atrophied inner membrane, hence they are common among aged persons. Other than these, there are people who is more likely to genetically develop endometrial cancer.
Most common subjective symptom is an abnormal vaginal bleeding. Person who have above mentioned risk, over age 35, especially post-menopausal bleeding is a symptom to watch out, so that in case such symptom has appeared, it is necessary to visit obstetrics and gynecology, without hesitation, for the checkup.
As like medical check for cancer of the cervix, examination for endometrial membrane can be conducted at outpatient department. It is diagnosed by endometrial tissue examination which thin tube-type equipment is inserted into intrauterine cavity and harvest inner membrane tissue. In case when diagnosis is vague or in case diagnosis of atypical membrane growth disease known as precancerous change (lesion) is made, there is a case where tissue is picked up with anesthesia by entire endometrium curettage, then diagnosis is decided. This is normally one day surgery. When diagnosed as cancer, cancer size or spreading, lymph node metastasis, or with/without metastasis to other organs are examined.
Unlike medical check for cancer of the cervix, effectiveness of the checkup for uterine body cancer is not yet proved. Uterine body cancer is generally in good prognosis even cancer is found after when symptoms has appeared. But it is important to have inner membrane examination proactively in case upper endometrial hypertrophy is recognized at echography or afore mentioned risk exist, it is important to have inner membrane examination proactively.
Basic treatment for the disease is surgery, Unlike the cancer of the cervix, surgical operation can be applied even if disease is advanced. Secretion of Uterus, ovary/oviduct and lymph node is the standard surgical operation. Currently, laparoscopic operation for uterine body cancer is covered by health insurance so that less invasive surgical operation is possible at authorized facilities. At Shonan Kamakura General Hospital, in case of surgical operation for uterine body cancer, treatment is completed in four-day three-nights hospitalization.
Basic treatment for the disease is surgery, Unlike the cancer of the cervix, surgical operation can be applied even if disease is advanced. Secretion of Uterus, ovary/oviduct and lymph node is the standard surgical operation. Currently, laparoscopic operation for uterine body cancer is covered by health insurance so that less invasive surgical operation is possible at authorized facilities. At Shonan Kamakura General Hospital, in case of surgical operation for uterine body cancer, treatment is completed in four-day three-nights hospitalization.
Uterine body cancer (endometrial cancer) is in increasing tendency in recent years, but if it is diagnosed at early stage, it is a disease which complete cure is expected so that it has relatively good prognosis. In order to overcome cancer, needless to say, it is important to have early detection and early treatment. If there is any worrying symptom, it is important to visit gynecology for checkup without hesitation.
| Phase I | Cancer exist at uterine body only. |
|---|---|
| IA | Cancer is limited in less 1/2 of uterine muscular wall. |
| IB | Cancer infiltrates with exceeding 1/2 of uterine muscular wall. |
| Phase II | Cancer infiltrate to cervical stromal over uterine muscular wall |
| Phase III | Cancer spreads out to outside of womb. Or, metastasized to interior of pelvis or para-aortic lymph node. |
| IIIA | Cancer is metastasized to serous membrane of uterus, pelvic peritoneal or ovaria/oviduct. |
| IIIB | Cancer is spread out to vagina or parametrium. |
| IIIC1 | Pelvic lymph node metastasis exists. |
| IIIC2 | Para-aortic lymph node metastasis exists. |
| IVA | がんが膀胱もしくは腸粘膜まで浸潤をしているもの |
| IVB | Para-aortic lymph node metastasis exists. |
