Risk of uterine cancer among women smokers

 Consumption of tobacco and smoking is one of the main causes of varied types of oral and lung cancer. The body's immune system is weakened by the toxic substances in cigarettes, making it more challenging to eradicate cancer cells. The negative impact of this product can harm both men and women alike. It might be surprising to find that smoking has some harmful negative impacts on gynaecological health as well. Not only smoking can cause a variety of cancers in both men and women but puts women at higher risk of cervical cancer.

Uterine cancer, the fourth most prevalent kind of cancer in women, is more likely to affect female smokers. It is witnessed that smoking harms the DNA of the cervix's cells, which promotes the growth of cancer. Smoking also influences immunity, which may reduce the body's capacity to combat HPV infections, which are also another risk factor for cervical cancer.

Uterine Cancer

When the DNA of the uterine cells mutates, it hinders the normal process of cell division and proliferation, leading to the development of uterine cancer. Tumour cells are typically discovered in the endometrium, the uterus' inner lining, hence it is called endometrial or uterine cancer.

In comparison to non-smokers, women who smoke have a greater likelihood of developing uterine cancer. Patients with uterine cancer who give up smoking may have a higher likelihood of remission and survival than those who don't. Other lifestyle variables such as poor dietary plan and physical inactivity may enhance the risk of uterine cancer in women, and it is most common in postmenopausal woman. Few other common risk factors of uterine cancer include age, menopause, menstrual cycle at an early age, no pregnancies, infertility, obesity, metabolic syndrome, endometrial hyperplasia – thickening of the endometrium, and PCOS.

Symptoms

Depending on the type of cancer, uterine cancer symptoms might vary. The most prevalent and immediate evident sign of uterine cancer in most women is irregular bleeding. Both premenopausal and postmenopausal women frequently experience the symptoms of uterine tumours. Unusual vaginal discharge which is not related to menstruation, painful or difficult urination, pain during sex, pelvic pain, and weight loss are other typical symptoms.

Diagnosis

Doctors or medical specialists are prepared to help the patients to determine the cause of symptoms. All women should have regular pelvic examination that includes pap smears, and for women who smoke, the necessity is even greater. Upon witnessing the signs and symptoms, a complete physical examination using certain types of diagnostic tests may be suggested to confirm uterine cancer. Patients should also discuss the medical history with the oncologists and undergo additional tests. These tests are:

Ø  Examination of the pelvis

Ø  Imaging tests like Ultrasound, Chest X-ray, CT-scan, or MRI-scan

Ø  Hysteroscopy

Ø  D & C

Ø  Biopsy

Ø  Blood tests

Blood tests, hysteroscopic biopsy or D&C biopsy and imaging results are corelated for reaching an accurate diagnosis and draw a treatment plan.

Treatment

The first treatment option for uterine cancer is always surgical removal of the uterus, fallopian tubes, and ovaries along with the draining lymph glands. Robotics plays a vital role in surgical procedures. Few of the great advantages of robotic surgery are:

• Less bleeding.
• less scarring.
• Significantly less pain.
• Fewer complications.
• A lower risk of infection than other invasive procedures.
• A quicker recovery and return to regular bowel movements.
• The ability to resume normal work and activities.

Additionally, for patients with uterine cancer, the switch to robotic surgery has significantly reduced morbidity and shortened hospital stays.

Depending on the stage, radiation therapy, which uses strong energy beams to destroy cancer cells, is essential after surgery. Hormone therapy, which blocks the hormones that promote the development of cancer cells, and chemotherapy with potent medicines are two medication therapies for uterine cancer. Other treatments include immunotherapy, which is necessary in severe instances, and targeted therapy, which uses medications to target certain cancer cells.

However, the first preventive step towards safeguarding from uterine cancer is to quit smoking immediately. Even in cases of passive smoking and exposure to tobacco smoking, it is always better to stay away. Consult a medical professional immediately, if one observes any of the above-mentioned symptoms. 

Prof Dr Raj Nagarkar, MD & Chief of Surgical Oncology and Robotic Services, HCG Manavata Cancer Centre, Nasik