Adenocarcinoma of the uterus is a disease that every woman should learn more about

Adenocarcinoma is a malignant neoplasm that begins to develop in the glandular epithelium or other gland tissue - they secrete any mucous secretion, hormone, fluid, etc. In women, it can grow from the cervix, ovaries and mammary glands.

Adenocarcinoma of the cervix occurs as a result of mutation of glandular epithelial cells of the glands. It most often affects the uterine fundus, develops quite quickly and is asymptomatic at the very beginning.

For younger girls, with symptoms, heavier periods occur, and for women after 50 years, there is simply bleeding from the vagina. After damage to nearby tissues and organs, pain and discharge of mucus and pus from the vagina appear.

Causes

This oncology is hormone dependent. And with a sharp change in estrogen in the blood, the endometrium begins to grow profusely, which can lead to the formation of a tumor.

1. Early release of the egg in the middle of the cycle or anovulation.
2. Pathologies of the endometrium of the uterus.
3. Early menstruation.
4. Late menopause.
5. Genetic predisposition.
6. Decreased progesterone and increased estrogen.
7. Disruptions in menstrual cycles.
8. Hypertension.
9. Diabetes.
10. Obesity.
11. Polycystic ovary syndrome.
12. Women who have not given birth have a higher risk of getting the disease.
13. Poor nutrition
14. Ecology and harmful work with carcinogens.
15. Radiation.
16. HIV, immune and sexually transmitted diseases.

NOTE! Women of reproductive age are less susceptible to breast, ovarian and uterine cancer.

Symptoms

Glandular cancer of the cervix begins to somehow manifest itself only at the 2nd stage of development of the neoplasm, when the walls of the cervix are damaged.

1. Red, thin discharge that later develops into light bleeding. They are clearly visible on panties as dried clots.
2. Bleeding between periods.
3. Severe pain in the lower abdomen.
4. Irritability.
5. Weakness, fatigue, decreased performance.
6. Disruptions in menstrual cycles.
7. Insomnia.
8. The belly begins to grow.
9. Low-grade fever without signs of a cold.
10. Pain during sexual intercourse.
11. Mucous and purulent discharge with an unpleasant odor from the vagina.
12. Pain during urination.

How to treat

Therapeutic treatment of uterine adenocarcinoma has a minor effect, which involves removal of the uterus and appendages and subsequent radiotherapy and chemotherapy. Surgical methods of therapy are prescribed at stages 1-2 of pathological development. In the third stage, it is necessary to take into account various individual factors that influence the choice of therapy.

To treat this pathology, they resort to panhysterectomy and extirpation. The postoperative period takes approximately 2 months. The first few days after surgery, a woman may experience mild discomfort, pain, constant weakness, fatigue, bowel movements, nausea, and vomiting. Treatment of uterine adenocarcinoma with folk remedies is possible only after consultation with the attending physician, exclusively as an additional therapy to eliminate postoperative symptoms.

Radiation therapy can be prescribed both before and after surgery. Radiation can be performed using brachytherapy or remotely. In cases where adenocarcinoma becomes inoperable, chemotherapy becomes the main treatment option. This pathology is characterized by hormone dependence, so hormonal drugs are often prescribed for its treatment, in particular those that reduce estrogen levels.

Cervix

Occurs in only 12% of cases. The rest usually grow from squamous epithelium. Adenocarcinoma itself is exophytic or endophytic in nature, and itself grows from glandular cells. In the first case, the cancer goes deep into the cervical canal, and in the second, the tumor affects the vaginal walls.

NOTE! In the early stages, even an examination by a gynecologist may not reveal anything. So the best method is to do a Pap test. A smear from the cervix is ​​sent for histological examination.

Endometrioid adenocarcinoma with squamous differentiation

About 25% of endometrial cancers contain foci of squamous cell differentiation. Previously, such tumors were called adenoacanthoma, later - glandular squamous cell carcinoma; WHO currently recommends the term “adenocarcinoma with squamous differentiation”. It was believed that the squamous cell component was “benign”, but recently it has been proven that both components are malignant, and similar β-catenin mutations are detected in them.

The degree of tumor differentiation is determined by the glandular component, which correlates with lymph node status and 5-year survival. The squamous cell component is not taken into account in the grading.

FIGO proposed the following criteria for identifying squamous differentiation in endometrioid adenocarcinoma:

• accumulation of keratin in cells or the formation of “pearls”, visible without the use of additional stains;
• the presence of intercellular bridges;
• at least three of the following signs: areas of solid growth without the formation of glands and the formation of a “palisade”;
• clear cell boundaries;
• bright eosinophilic or “vitreous” cytoplasm;
• decreased nuclear-cytoplasmic ratio compared to other areas of the tumor.

Stages

• Stage 1 - a malignant tumor of the uterus is in one tissue layer and is located in the uterine body.
• Stage 2 - damage to the cervical canal.
• Stage 3 - the vaginal walls and nearby lymph nodes are affected.
• Stage 4 - metastases affect distant organs: bones, liver, kidneys. The tumor can grow into the bladder, intestines, etc.

Forms

Adenocorcinoma usually differs in the degree of differentiation, which indicates the maturity of the cells. The higher the differentiation, the more mature the cells and the more similar they are to healthy tissue. This species is slower and not aggressive.

1. Endometrioid adenocarcinoma of the uterus
2. Well-differentiated endometrial adenocarcinoma - G1
3. Moderately differentiated adenocarcinoma - G2
4. Low differentiated - G3

Highly differentiated

Located in the meometry of the uterine localization. The cells themselves are practically no different from healthy cells. There are, however, some differences in the size of the nucleus and at the cytological level of the structure of the cell itself. The tumor grows slowly and is not aggressive.

Moderately differentiated

The cells already have a greater abnormality, and the cellular structure is more chaotic. Because of this, the tumor can also involve neighboring tissues, growing and destroying them. In this case, the risk of metastasis increases greatly, since the intercellular structure is already thinner.

Poorly differentiated

The tumor grows very quickly and affects nearby tissue structures. Poorly differentiated adenocarcinoma of the uterus is very dangerous and can ruin the patient’s life within a few months. The cellular structure is unstructured and chaotic, and the cells themselves are very different in structure from healthy ones. Intercellular connections are very thin, and the risk of metastasis increases.

Stages, forms and types of uterine adenocarcinoma

There are four stages of development of uterine adenocarcinoma:

• Initial. The tumor is localized in the body of the uterus on the endometrium.
• Second. The tumor grows into the cervical canal.
• Third. The tumor invades neighboring tissues. The process of metastasis into the lymphatic system begins.
• Fourth (terminal). The tumor process extends beyond the pelvic organs. Metastases occur in distant organs and tissues.

Uterine adenocarcinomas are also distinguished according to the forms of cellular differentiation of the oncological process:

• Highly differentiated. Mutant cells adapt to the healthy cellular structure of the uterine endometrium. This kind of cancer is usually called “superficial”. A tumor that does not extend beyond the uterine myometrium has a low probability of metastasis - about 1-3%.
• Moderately differentiated. Characterized by a wide variety of mutating cellular structures. A larger number of cells begin to connect to the oncological process, creating a high severity of localization. The infection spreads through the blood and lymph flow into the pelvic organs. The risk of metastasis is observed in 8-10% of cases. In patients of reproductive age, metastasis may not be observed for a long time.
• Poorly differentiated. The tumor is characterized by a high degree of malignancy and grows rapidly, invading new areas of neighboring tissues. The prognosis for adenocarcinoma of this form is unfavorable due to lymph node metastasis.

The following types of uterine adenocarcinoma are classified:

• Endometriotic. The most common cancer pathology. The probability of development in women of different age groups is 70-75%. The tumor grows into the myometrial layer, and if measures are taken in time, the prognosis can be very positive.
• Squamous. Develops on squamous cell structures of the uterine walls. Such a tumor is rarely diagnosed. Most often it manifests itself as a component of cervical cancer.
• Papillary. At risk are women who are carriers of the papilloma virus. The tumor is formed from clusters of outgrowths of papillomas. In general, the tumor is similar to a head of cauliflower.
• Clear cell. The tumor affects glandulocytes and glandular structures. Clear cell adenocarcinoma detected in the early stages of development can be treated without subsequent metastasis.
• Mixed. A tumor of this type combines several cellular neoplasms. It can develop slowly or rapidly and is difficult to diagnose. It is impossible to predict the “behavior” of mixed adenocarcinoma in the body.
• Muciotic. The tumor contains a large amount of mucin in its atypical cells and is a nodular formation with unclear boundaries. Radiation therapy is powerless in these situations. Mucious adenocarcinoma poses a high risk of metastasis to regional lymph nodes.
• Serous. Develops from serous endometrial interepithelial carcinoma of the lower segment and cervix. This type of uterine adenocarcinoma is considered the most aggressive. Serous adenocarcinoma is not associated with excess estrogen. Tumor cells are round in shape with a large nucleus. Some cells may have several nuclei. Women who have survived childbirth are most prone to developing serous adenocarcinoma.

Kinds

1. Papillary - a collection of several papillary papillomas.
2. Endometrioid - the tumor is quite common in 73% of cases. The neoplasm itself grows into the myometrial layer and rises slightly on the surface.
3. Squamous cell - occurs together with cervical cancer from squamous cell tissue.
4. Clear cell adenocarcinoma - consists predominantly of light nail-shaped cells.

Secretory variant

Secretory adenocarcinoma is a variant of endometrioid cancer with the presence of morphological features characteristic of the early or middle phase of secretion. Secretory subnuclear vacuoles are revealed; the cells are polygonal, but not signet ring-shaped. The tumor may consist entirely of secretory areas, but more often they are detected focally. Characterized by a favorable prognosis . It is important to note that the secretory variant retains the structural features of endometrioid adenocarcinoma and the cylindrical shape of the cells, which distinguishes it from clear cell adenocarcinoma. Secretory adenocarcinoma in young women may be subject to cyclic hormonal changes. It is not uncommon for secretory adenocarcinoma to be detected in a scraping, but only endometrioid adenocarcinoma of a typical structure is detected in the material after hysterectomy. In postmenopause, the tumor loses its ability to change cyclically under the influence of hormones.

Diagnostics

1. Gynecologist - conducts an initial examination and palpation for the presence of growths in the cervix.
2. Pap test - a curettage of the cervix is ​​performed, and the sample is later sent for a biopsy.
3. Biopsy is a histological examination of uterine tissue for the presence of atypical cells.
4. Ultrasound of the pelvis - view the walls of the organs in more detail.
5. Hysteroscopy - a hysteroscope is inserted into the uterus and the organ is examined for the presence of formations, growths and polyps.

Treatment

Therapy involves surgical removal of the tumor, along with part of the organ itself. Extirpation and panhysterectomy are performed if the tumor does not metastasize and does not have extensive damage to nearby organs: intestines, bladder at stage 4.

Before surgery, courses of radiation and chemotherapy are usually given to reduce the aggression of tumor cells and reduce the size of the tumor. This method is also used after surgery to reduce the risk of relapse.

If surgery is not possible, then doctors can only use chemotherapy (drugs: 5-Fluorouracil, Mitomycin, Docetaxel, Cisplatin, etc.) and radiation. Plus, hormone therapy is prescribed to reduce the level of estrogen in the blood and reduce the sensitivity of the tumor itself to female hormones. In some cases, the tumor itself can be reduced in this way.

Life after surgery can be complicated by side effects from radiotherapy and chemotherapy. That is why oncologists additionally prescribe a complex of drugs for recovery. Plus, the patient will have to adhere to a number of rules and a proper diet.

Treatment methods depending on the stage of the disease

In menopause, the disease in the first stage is treated with radical surgery. The uterus is removed along with the cervix, fallopian tubes and ovaries. If muscle tissue is damaged, the organ is removed along with regional lymph nodes. This reduces the likelihood of tumor metastasis through the lymphatic system. Chemotherapy is used to destroy remaining cancer cells and metastases.

When treating young patients, organ-preserving operations are performed to remove tumors, before which the woman undergoes several courses of neoadjuvant chemotherapy.

Cytostatic drugs are also used at later stages.

The following agents are used to suppress tumor growth:

1. Epirubicin. The drug is administered intravenously slowly. The contents of the ampoule are diluted with saline solution. The dose is selected depending on the stage of cancer, the general condition of the patient, and the use of other therapeutic agents.
2. Paclitaxel. The dose is calculated individually. The solution is administered by infusion over 3 or 24 hours. The intervals between administrations are 3 weeks.

Since the tumor is hormonally active, progesterone drugs are used to suppress its growth. Medroxyprogesterone acetate is taken orally. The recommended daily dose is 300-600 mg. The therapeutic effect develops after 8-10 weeks of taking the medicine. The drug can be administered intramuscularly. Injections are given once a week. The initial single dose is 1 g, subsequently it is reduced to 500 mg.

Prevention

By following the following recommendations, you will significantly reduce the risk of uterine cancer.

1. Have an annual examination with a gynecologist. Take blood, urine and stool tests.
2. Protected sex with a regular sexual partner.
3. Do a pelvic ultrasound once a year.
4. Eat normally and watch your weight.
5. Dress warmly to avoid colds in the pelvic organs.
6. Quit smoking and alcohol.
7. Exercise.

NOTE! For women whose mothers or grandmothers suffered from uterine cancer, it is necessary to undergo examination twice a year.

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Diet

All persons with cancer pathologies are recommended to adhere to a special diet to minimize the amount of toxins in the body and normalize metabolism. For this purpose, it is necessary to exclude pesticides from the diet, give up potentially unsafe products (instant noodles, mayonnaise, etc.

Women with endometrial adenocarcinoma are advised to eat 5 servings of fruits and vegetables every day and avoid alcoholic beverages and overeating.

It is advisable to include the following products in your diet:

• green tea;
• turmeric, curry;
• soya beans;
• peas, beans;
• tomatoes;
• garlic;
• cabbage;
• ginger;
• raspberries;
• strawberries;
• blueberries;
• grape;
• nuts;
• mint;
• fish and seafood;
• dietary meat;
• kefir, cottage cheese, cheese.

The products listed above are the basis of proper nutrition; their effect on the body can be compared to a medicinal option. Therefore, to increase the chances of recovery, it is important to include them in your menu daily, and it is better to start the day with a cup of green tea with a piece of ginger.