Cervical Cancer Symptoms

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What you need to know about uterine cancer and cervical cancer

Uterine cancer is one of the types of cancer that affects the female reproductive system and is seen more frequently, especially after menopause. In some people, the disease may cause symptoms at an early stage, while in some cases, complaints may go unnoticed for a long time. For this reason, increasing awareness of the disease is important for recognizing symptoms early.

Uterine cancer and cervical cancer are two different diseases that arise from different causes and differ from each other in terms of diagnosis and treatment processes. In this article, we discuss frequently asked questions, from the differences between uterine cancer and cervical cancer to risk factors, symptoms, and treatment approaches.

What is the difference between uterine cancer and cervical cancer?

Although uterine cancer and cervical cancer are often confused with each other, they are actually two separate types of cancer with different characteristics. Uterine cancer develops in the endometrial tissue that lines the inner part of the uterus, while cervical cancer develops in the cervix, which is the lower part of the uterus that opens into the vagina.

These two types of cancer also differ in terms of their causes. Uterine cancer is mostly associated with hormonal changes, advanced age, obesity, and some metabolic factors, while the most important cause of cervical cancer is Human Papillomavirus (HPV) infection. Therefore, prevention and screening methods also differ.

Different approaches are also applied in the diagnosis and treatment process of these diseases. The treatment plan is determined according to the type and stage of the cancer and the patient’s general health condition.

What causes uterine cancer?

Uterine cancer occurs as a result of uncontrolled proliferation of the cells in the endometrial tissue lining the inner surface of the uterus. Although the exact cause of the disease cannot always be determined, it is known that some factors increase the risk of developing it.

In particular, disruption of the balance between estrogen and progesterone hormones is one of the most important factors associated with uterine cancer. The main factors that may increase the risk are as follows:

• Postmenopausal period
• Excess weight or obesity
• Some chronic diseases such as diabetes and high blood pressure
• Long-term exposure to high estrogen levels
• Starting menstruation at an early age or entering menopause late
• Never having given birth
• A family history of uterine, ovarian, or colon cancer
• Some hereditary genetic syndromes
• Some hormone medications used in breast cancer treatment

Having one or more of these risk factors does not mean that a person will definitely develop uterine cancer. Likewise, the disease may also develop in people who have no risk factors. Therefore, it is important to pay attention to unusual symptoms such as vaginal bleeding that occurs especially after menopause and to have them evaluated without delay.

What causes cervical cancer?

Cervical cancer develops when the cells in the part of the uterus that opens into the vagina undergo abnormal changes over time and multiply uncontrollably. The most important cause of this disease is infection with certain high-risk types of the virus known as HPV.

However, not everyone with HPV infection develops cervical cancer. In most cases, the immune system can clear the virus, while in some people, the infection may persist for many years and lead to cellular changes.

Factors that may increase the risk of cervical cancer include the following:

• Being infected with high-risk HPV types
• Smoking
• Diseases or treatments that weaken the immune system
• Starting sexual life at an early age
• Having multiple sexual partners
• Neglecting regular gynecological check-ups and screening tests
• Long-lasting HPV infection
• The presence of some sexually transmitted infections

Unlike uterine cancer, cervical cancer is often a preventable disease when precancerous changes are detected and treated.

Is thickening of the uterine wall cancer?

Thickening of the uterine wall alone does not mean cancer. The endometrial layer, known as the uterine wall, may become thicker than normal for various reasons. While this condition may develop due to hormonal changes in some women, in some cases it may be a sign of precancerous cellular changes or uterine cancer.

Causes that may lead to thickening of the uterine wall include the following:

• Hormonal imbalances, especially excess estrogen
• Changes during menopause
• Obesity
• Polycystic ovary syndrome (PCOS)
• Some hormone treatments
• Excessive growth of the inner uterine lining, known as endometrial hyperplasia

Thickening of the uterine wall seen especially after menopause should be evaluated more carefully. This is because thickening that occurs during this period may, in some cases, be associated with precancerous lesions or uterine cancer.

However, a definitive diagnosis cannot be made by looking only at the ultrasound result. When deemed necessary, a tissue sample may need to be taken from inside the uterus for examination.

For this reason, when thickening of the uterine wall is detected, it is important not to panic but to undergo a detailed evaluation to determine the underlying cause. If symptoms such as irregular vaginal bleeding, prolonged menstrual periods, or bleeding after menopause are present, a specialist should be consulted without delay.

How can cervical cancer symptoms be recognized?

Cervical cancer often may not cause obvious complaints in its early stages. Therefore, many people become aware of the disease only during routine gynecological examinations or screening tests. As the disease progresses, however, some symptoms may appear, and these symptoms are considered important signals that require evaluation.

Prominent symptoms of cervical cancer can be listed as follows:

• Vaginal bleeding that occurs outside menstrual periods
• Bleeding after sexual intercourse
• Bleeding after menopause
• Foul-smelling or unusual vaginal discharge
• Pain or a feeling of pressure in the pelvic area
• Pain during sexual intercourse
• In advanced stages, pain spreading to the lower back, groin, or legs

These symptoms are not specific only to cervical cancer. Infections, hormonal changes, or different gynecological diseases may also cause similar complaints. However, recurrent, unexplained, or gradually increasing complaints of bleeding and discharge should not be neglected.

The most reliable way to detect cervical cancer is not to wait for symptoms, but to undergo regular screening tests. This is because the disease can be detected at an early stage by identifying cellular changes that occur before cancer develops.

Is bleeding after menopause a symptom of uterine cancer?

Bleeding after menopause is considered one of the most important symptoms of uterine cancer. Since menstrual bleeding completely stops with menopause, any vaginal bleeding that occurs after this period is not considered normal and must be investigated.

However, not every bleeding after menopause means uterine cancer. Thinning of the inner uterine lining, hormone treatments, uterine polyps, or some benign gynecological problems may also cause bleeding. However, since bleeding after menopause is the first noticed finding in a significant portion of uterine cancer cases, this symptom should not be ignored.

The amount of bleeding may also be misleading. While some people may experience heavy bleeding, others may notice only mild bleeding in the form of spotting. Therefore, a small amount of bleeding does not mean that evaluation is unnecessary. Even a single episode of bleeding is among the symptoms of uterine cancer in menopause and should be evaluated by an obstetrics and gynecology specialist.

When necessary, the cause of bleeding can be investigated through methods such as ultrasound, hysteroscopy, or taking a tissue sample from inside the uterus, and a definitive diagnosis can be reached. In this way, a possible disease can be detected and treated at an early stage.

What are the symptoms of uterine cancer according to its stages?

Symptoms of uterine cancer may vary according to the stage of the disease. While symptoms may be limited in the early stages, the number and severity of complaints may increase as the tumor grows and spreads to surrounding tissues. However, not every patient experiences the same symptoms, and in some people, the disease may progress for a long time without being noticed.

Stage 1 uterine cancer symptoms

In the first stage of uterine cancer, the disease is limited to the uterus. The most common symptom during this period is abnormal vaginal bleeding. Bleeding seen especially after menopause should be carefully evaluated. Symptoms that may be seen at this stage are as follows:

• Menstrual irregularities
• Bleeding outside menstrual periods
• Bleeding after menopause
• Unusual vaginal discharge
• Mild discomfort in the groin area

Stage 2 uterine cancer symptoms

In the second stage, the cancer may have progressed to the cervix. In addition to the symptoms seen in the first stage, some complaints may become more noticeable. Common symptoms include the following:

• Increase in the amount of bleeding
• Persistent or recurrent vaginal discharge
• Pain during sexual intercourse
• Feeling of pressure in the pelvic area
• Groin pain

Stage 3 uterine cancer symptoms

At this stage, the disease may have spread to nearby tissues outside the uterus or to the lymph nodes. Accordingly, symptoms that affect daily life may occur. Symptoms that may be seen in the third stage can be listed as follows:

• Worsening pelvic pain
• Pain spreading to the lower back and groin area
• Discomfort while urinating or during bowel movements
• Persistent fatigue
• Loss of appetite
• Unintentional weight loss

Stage 4 uterine cancer symptoms

The fourth stage is the advanced stage in which the cancer has spread to distant organs. During this period, symptoms may not be limited only to the reproductive system, and different complaints may develop depending on the organ to which the cancer has spread. Symptoms that may be seen at this stage are as follows:

• Severe and persistent pain
• Significant weight loss
• Advanced weakness
• Abdominal swelling
• Shortness of breath
• Bone pain
• Marked deterioration in general health condition

The severity of symptoms may not always be directly related to the stage of the disease. While significant bleeding may be seen in some early-stage cases, some advanced-stage cases may progress for a long time with limited complaints.

How often should a cervical cancer test be performed?

How often cervical cancer screenings should be performed may vary depending on the person’s age, health history, and previous test results. Therefore, the most appropriate follow-up plan should be determined by a doctor. However, generally accepted screening recommendations are shaped according to certain age groups.

In people between the ages of 21 and 29, the smear test, also known as a cervical cancer test, is performed at certain intervals, while after the age of 30, the smear test and HPV test can be evaluated together. If the test results are normal, screenings can be continued at longer intervals. In people who have previously had abnormal results, the doctor may recommend more frequent follow-up.

Since cervical cancer often does not cause symptoms in the early stages, it is not enough to see a doctor only when complaints appear. Thanks to regular screenings, cellular changes that occur before cancer develops can be detected and necessary interventions can be performed on time.

Recommendations from the obstetrics and gynecology specialists of Aktif International Hospital

Gynecological cancers are a group of diseases with a very high treatment success rate when diagnosed early. As the obstetrics and gynecology specialists of Aktif International Hospital, we recommend that you pay attention to the following critical points in order to protect yourself from both uterine and cervical cancer and to maintain your overall health:

• Adopt a Mediterranean-style diet: Obesity is one of the biggest triggers of uterine, or endometrial, cancer. Fat tissue in the body increases estrogen. To break this cycle, you should avoid processed sugar and animal fats and make a Mediterranean-style diet rich in antioxidants, fiber, and omega-3 a part of your lifestyle.
• Exercise for at least 150 minutes a week: Regular physical activity not only supports weight control but also directly helps maintain hormonal balance, especially the estrogen-progesterone balance, by reducing insulin resistance in the body.
• Avoid unconscious use of herbal products and supplements: Some “natural” herbal mixtures or phytoestrogens, which are frequently used among women to relieve menopausal symptoms such as hot flashes, may stimulate the uterine wall uncontrollably. Do not use any herbal estrogen supplement without consulting your doctor.
• Consider the protective effect of birth control pills: If you do not have a medical contraindication, clinical studies have shown that combined birth control pills used under medical supervision significantly reduce the risk of ovarian and uterine cancer. You can discuss this advantage with your physician when choosing a contraceptive method.
• Do not neglect barrier methods such as condoms: Although receiving the HPV vaccine provides tremendous protection against cervical cancer, condom use should remain a basic rule of sexual health for other types outside the vaccine strains and other sexually transmitted infections, which may indirectly increase the risk of cancer through inflammation.
• Do not skip examinations thinking, “There is no bleeding”: Cervical cancer can progress silently without causing any bleeding or pain. Therefore, even if you have no complaints, you should consider having a gynecological examination once a year and undergoing smear/HPV tests at the intervals determined by your doctor as part of your self-care routine.

Are cervical cancer and uterine cancer treated in the same way?

Although cervical cancer and uterine cancer occur within the same reproductive system, their treatment processes are not the same. This is because these two cancers develop in different tissues, arise due to different causes, and progress in different ways. Therefore, the treatment plan to be applied also varies according to the type and stage of the disease.

When planning uterine cancer treatment, surgery is often preferred as the first step. Especially in the early stages, removal of the uterus is one of the most commonly preferred methods. When necessary, the ovaries, fallopian tubes, and some surrounding lymph nodes may also be removed as part of the operation. After surgery, radiotherapy, chemotherapy, or hormone therapy may be applied in some patients.

In cervical cancer, the treatment choice may follow a different course depending on the extent of the disease. While surgical treatment is prioritized for small tumors detected at an early stage, the combined use of radiotherapy and chemotherapy is a common approach in more advanced stages. In some patients, methods such as targeted therapies or immunotherapy may also be used.

In short, although some treatment methods used for cervical cancer and uterine cancer may be similar, these diseases are not treated in the same way. The most appropriate approach is determined individually according to the location of the cancer and the characteristics of the disease.

Is uterine cancer fatal?

Uterine cancer is a serious disease that can be life-threatening if left untreated. However, it would not be correct to say that every case of uterine cancer results in death. The course of the disease varies depending on the type of cancer, the stage at which it is diagnosed, the extent of spread, and the response to the treatment applied.

Since uterine cancer often appears with symptoms that can be noticed early, such as abnormal vaginal bleeding, the disease can be diagnosed at an early stage. In patients diagnosed early, treatment success is generally higher, and the disease can be brought completely under control.

On the other hand, when the cancer progresses and spreads to tissues outside the uterus or to distant organs, the treatment process may become more complex. In advanced stages, the preferred approach may be to control the spread, reduce symptoms, and maintain quality of life rather than completely eliminate the disease.

Frequently Asked Questions

Is uterine cancer sexually transmitted?

Uterine cancer is not a sexually transmitted disease. Cancer cells do not pass from one person to another during sexual intercourse. However, HPV infection, which is associated with cervical cancer, can be transmitted through sexual contact. This may sometimes cause uterine cancer and cervical cancer to be confused with each other.

Uterine cancer is generally associated with hormonal changes, age, genetic predisposition, and some health problems. Therefore, sexual contact does not have a direct role in the development of the disease.

Who is the cervical cancer vaccine suitable for?

The HPV vaccine developed against cervical cancer is one of the vaccines that provides the highest level of protection when administered before exposure to the virus. Therefore, although the vaccine is primarily recommended for individuals in childhood and adolescence, it can also be administered in different age groups. The HPV vaccine is generally considered suitable for the following people:

• Children and adolescents
• Young adults
• People who have not previously received the HPV vaccine
• Adults who are considered likely to benefit from the vaccine after a doctor’s evaluation

A person does not need to have an active infection in order to receive the vaccine. In fact, the vaccine may provide more effective results when administered before exposure to HPV. However, having had an HPV infection before does not always mean that the vaccine will not be beneficial. This is because the vaccine can provide protection against multiple types of the virus.

Does obesity increase the risk of uterine cancer?

Obesity is considered one of the important risk factors for uterine cancer. An increase in body fat percentage may cause estrogen levels to rise. This may lead to prolonged exposure of the inner uterine lining to hormonal effects, increasing the risk of cancer development.

Is it possible to have children after uterine cancer treatment?

The answer to this question varies depending on the treatment method applied and the stage of the disease. Since the uterus often needs to be removed in the treatment of uterine cancer, pregnancy through natural means is not possible after this procedure. On the other hand, in some early-stage cases, fertility-preserving treatment options may be considered in suitable patients and in line with a doctor’s evaluation.

For this reason, it is important for people who plan to have children to discuss this issue with their doctors before the treatment process begins. In this way, the available options can be evaluated and a suitable roadmap can be created for the individual.

How does uterine cancer affect sexual life?

Uterine cancer and the treatments applied may have physical and emotional effects on sexual life in some people. After surgical interventions, radiotherapy, or other treatments, vaginal dryness, discomfort during sexual intercourse, or changes in sexual desire may occur. In addition, the stress, anxiety, and emotional burden caused by the diagnosis process may also affect a person’s view of sexuality.

However, these effects do not occur in the same way in every patient. After treatment, many people can return to their daily life and sexual life over time. Sharing problems experienced during the process with a doctor can help determine appropriate support and solutions.