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What is uterine cancer?
Uterine cancer is a malignancy of the uterus, the hollow organ where pregnancy develops. Most cases (endometrial cancer) begin in the inner lining, the endometrium. A smaller share begins in the muscle wall (leiomyosarcoma) or supportive tissue. Endometrial cancer is driven by oestrogen: anything that increases lifetime oestrogen exposure raises risk.
Symptoms
Abnormal bleeding is the hallmark: postmenopausal bleeding, heavy or irregular periods in the forties or fifties, bleeding between periods, pink or blood-tinged vaginal discharge, pelvic pain, pain during intercourse, unintended weight loss, a palpable pelvic mass, painful urination if invading the bladder, or rectal bleeding if invading the rectum. One episode of postmenopausal bleeding warrants ultrasound and endometrial biopsy.
Risk factors
Obesity is the leading modifiable risk factor: fat tissue converts hormones into oestrogen. Diabetes and insulin resistance raise risk independently. Never being pregnant, late menopause, early menarche, and unopposed oestrogen therapy (without progesterone) increase risk. Tamoxifen used for breast cancer modestly raises endometrial risk. Lynch syndrome (mismatch repair mutations) raises endometrial cancer risk substantially. Urban living in India is associated with higher incidence due to body weight, diabetes, and dietary changes.
Diagnosis
Clinical history, pelvic examination, and transvaginal ultrasound to measure endometrial thickness are first steps. Endometrial biopsy (office procedure with a suction device) is the next step. Hysteroscopy with direct visualisation and directed biopsy is done if initial biopsy is inadequate. MRI of the pelvis shows how deeply the tumour has invaded the muscle. Pathology assigns histology, grade, and molecular classification (POLE-mutated, mismatch repair deficient, p53-abnormal, or no specific molecular profile). This molecular classification now guides treatment decisions.
Staging
FIGO 2023 staging (updated from earlier versions) incorporates molecular classification for the first time. Stage I is confined to the uterus. Stage II involves cervix. Stage III spreads beyond the uterus but stays in the pelvis or abdomen. Stage IV includes invasion of bladder or bowel mucosa, or distant metastasis. Early-stage, low-grade endometrioid cancer has excellent prognosis. High-risk histologies and stages IIIC and IVA require combination therapy.
Treatment
Surgery is the backbone: total hysterectomy with removal of both fallopian tubes and ovaries, plus sentinel lymph node biopsy. For stage I low-grade endometrioid disease, surgery alone is often curative. Stage II and above usually receive adjuvant radiation, chemotherapy, or both. Vaginal brachytherapy after surgery reduces vaginal recurrence in intermediate-risk disease. External beam pelvic radiation is used for higher-risk cases. Carboplatin and paclitaxel chemotherapy are standard for advanced disease. Immunotherapy (pembrolizumab, dostarlimab) benefits mismatch repair deficient tumours dramatically. Hormonal therapy (progestins, aromatase inhibitors) is used in low-grade disease or in women who cannot tolerate chemotherapy. Young women with early-stage, low-grade disease may be offered fertility-sparing progestin therapy with careful monitoring. VICI Healthcare coordinates surgery and delivers chemotherapy, radiation, and immunotherapy in a daycare setting.
Day at VICI Healthcare
8:00–8:15 AM: Check-in and important signs. 8:15–8:45 AM: Blood work. 8:45–9:30 AM: Consult with oncologist. 9:30–10:00 AM: IV placed, medication prepared. 10:00 AM–12:30 PM: Chemotherapy or immunotherapy infusion. 12:30–3:00 PM: Observation and discharge.
Cost
Stage IA hysterectomy with sentinel mapping: 1.5–3 lakhs. Stage IB or intermediate-risk plus brachytherapy: 2.5–5 lakhs. Stage II–IIIA surgery plus radiation: 4–8 lakhs. Stage IIIB–IIIC with surgery, chemotherapy, and radiation: 6–12 lakhs. Stage IV metastatic (immunotherapy or chemotherapy): 3–6 lakhs per month. Fertility-sparing progestin therapy: 50,000–1.5 lakhs per year. Government schemes cover a meaningful share for eligible patients.
Why VICI Healthcare
Experienced gynaecologic oncology team. Daycare chemotherapy and immunotherapy. Molecular testing and genetic counselling. Supportive care integrated. Written estimates before treatment.
FAQs
Will my uterus be removed? Yes, for almost all endometrial cancers. Do I need chemotherapy after surgery? Depends on stage, grade, and molecular group. Many stage I cancers do not. Does radiation hurt? No. Side effects (bowel, bladder, skin irritation) develop gradually and modern techniques have reduced them. Will I go into menopause? Yes, if your ovaries are removed. Non-hormonal options manage symptoms well. Is genetic testing available? Yes. We test for Lynch syndrome and counsel family members. Can I work during treatment? Yes, many women work part time or from home during radiation and between chemo cycles. What is my chance of recurrence? Highly stage and molecular-group dependent. Your team will discuss your specific numbers after final pathology.