How long can you live after hysterectomy?

Uterine cancer is a cancer with a very high incidence rate. After being diagnosed with this disease, people will be very afraid of the spread of cancer cells. But in fact, they should accept it calmly after it happens and actively cooperate with radiotherapy and chemotherapy. If it is an early-stage patient, surgical resection can also be adopted, which can also prolong the patient's life, improve the patient's quality of life, and alleviate the patient's condition.

1. Symptoms

There are no obvious symptoms in the very early stages, but vaginal bleeding, vaginal discharge, and pain may occur later.

(1) Vaginal bleeding mainly manifests as irregular menstrual cycles, intermenstrual bleeding and postmenopausal vaginal bleeding, and the amount is generally not much. Those who have not yet reached menopause may experience increased menstruation, prolonged menstrual periods, or menstrual disorders.

(2) Vaginal discharge is mostly bloody or serous. If there is infection, there will be purulent and bloody discharge with a foul odor. About 25% of patients seek medical treatment due to abnormal vaginal discharge.

(3) Lower abdominal pain and other symptoms: If the cancer involves the uterine cavity, it may cause pyometra, lower abdominal distension and cramp-like pain. In the late stage, infiltration of surrounding tissues or compression of nerves can cause pain in the lower abdomen and lumbar spinal cord. In the late stage, corresponding symptoms such as anemia, weight loss and cachexia may appear.

2. Physical signs

Gynecological examination may reveal no abnormalities in early endometrial cancer. In the late stage, the uterus may be significantly enlarged, and there may be obvious tenderness when combined with pyometra. Cancerous tissue may occasionally protrude from the cervical canal and bleed easily when touched. When the cancer infiltrates the surrounding tissues, the uterus is fixed or irregular nodules may be felt beside the uterus.

1. Medical history and clinical manifestations

Postmenopausal vaginal bleeding and menstrual disorders during the menopausal transition period should be treated as benign diseases only after endometrial cancer is excluded. Close follow-up is indicated for women who:

(1) Those with high risk factors for endometrial cancer, such as obesity, infertility, and delayed menopause;

(2) Those with a history of long-term use of estrogen, tamoxifen, or estrogen-increasing diseases;

(3) Those with a family history of breast cancer or endometrial cancer. If necessary, segmental curettage should be performed and sent for histopathological examination.

2.B ultrasound examination, pelvic MRI examination

It can help to understand the size of the uterus, the shape of the uterine cavity, the presence of vegetation in the uterine cavity, the thickness of the endometrium, and the presence and depth of infiltration of the myometrium, providing a reference for clinical diagnosis and treatment. MRI can better evaluate the condition of the pelvic lymph nodes. The American College of Obstetricians and Gynecologists (ACOG) guidelines do not recommend routine imaging of patients with endometrial cancer to assess for metastases.

3. Segmental curettage

It is the most commonly used and valuable diagnostic method of choice for histological evaluation of the endometrium. The advantage of segmental curettage is that it can obtain endometrial tissue specimens for pathological diagnosis, and can also differentiate between endometrial cancer and endocervical adenoma; it can also determine whether endometrial cancer involves the endocervical canal, providing a basis for formulating treatment plans. Outpatient endometrial biopsy using disposable instruments is a reliable and accurate method for detecting endometrial cancer.

Although not required, hysteroscopy is recommended along with diagnostic curettage to identify discrete lesions and occult lesions. This combined examination provides the best chance of confirming a true endometrial precancerous lesion and excluding associated endometrial carcinoma. Patients with persistent or recurrent abnormal uterine bleeding should undergo a histologic evaluation of the endometrium, regardless of endometrial thickness.