Endometrial cancer

Last updated date: 13-Oct-2022

Originally Written in English

Endometrial Cancer 

 

Endometrial cancer (sometimes known as uterine cancer) is a form of cancer that develops in the uterus. It normally starts within the cells layer that makes up the uterus lining (endometrium). Endometrial cancer is one of the most prevalent gynecological cancers that affect the reproductive system in women. 

Endometrial cancer is usually diagnosed while at its early stage since the production of abnormal vaginal bleeding characterizes it. Moreover, when the cancer is detected earlier, surgical removal of the uterus can cure it. 

 

Signs and Symptoms of Endometrial Cancer 

Abnormal vaginal bleeding is usually the most common endometrial cancer symptom. It is generally characterized by;

  • Changes in the duration or menstrual periods heaviness 
  • Vaginal spotting or bleeding in between the menstruation cycle 
  • Vaginal bleeding even after menopause 

Apart from abnormal vaginal bleeding, other possible endometrial cancer signs and symptoms can include; 

  • Pain and discomfort around the pelvis or the lower abdomen 
  • Blood tinged or watery vaginal discharge 
  • Pain during or after intercourse 

Consult your doctor or gynecologist right away if you experience any of these symptoms. Although they don’t always indicate a severe medical condition, it’s essential to have them checked, just in case. 

 

Causes of Endometrial Cancer 

Normally, the actual triggers and causes of endometrial cancer are not known. Nonetheless, medical practitioners believe that shifts in the progesterone and estrogen levels in a woman’s body can contribute to cancer. 

If the levels of these sex hormones changes, the endometrium is affected. The endometrial cells also divide and multiply as the estrogen balance changes in response to more estrogen. Endometrial cells become cancerous when a particular genetic alteration occurs. These cancerous cells proliferate and develop quickly, forming a tumor. 

The research on the alterations that drive normal endometrial cells to be cancer cells is still ongoing. 

 

Risk Factors of Endometrial Cancer 

Risk Factors of Endometrial Cancer 

The following endometrial cancer risk factors can contribute to the development of the disease:

  • Changes in the female hormonal balance in the body: The ovaries produce estrogen and progesterone, which are the two main hormones in women. Shifts in the endometrium occur due to balance fluctuations of these hormones. Endometrial cancer risk can also increase because of sickness or a condition that raises estrogen levels but not progesterone levels in the body. 
  • More menstruation years: Endometrial cancer is more likely in women who start menstruating early, especially before the age of 12. Also, women who start their menopause at a later stage have increased risks. The longer you have your periods, the more estrogen the endometrium gets exposed to. 
  • Not having children or being pregnant: You are at a greater risk of developing endometrial cancer if you have never been pregnant, unlike a woman who has had even one pregnancy. 
  • Getting older: Endometrial cancer is more likely to develop as you grow older. As a result, endometrial cancer is most common after menopause. 
  • Being obese: Obesity raises the risk of developing endometrial cancer. This could happen when an increase in body fat disrupts your body's hormonal balance.
  • Hormonal therapy in breast cancer patients: Tamoxifen, a hormone treatment medicine used to treat breast cancer, has been linked to an increased risk of endometrial cancer. 
  • A genetic colon cancer syndrome: Lynch syndrome is an inheritable condition that raises the risk of malignancies such as endometrial cancer. 

 

Endometrial Cancer Stages

Endometrial cancer is likely to spread from the uterus to various regions of the body with time. Depending on how far cancer has spread or progressed, it is divided into four stages, including;

Stage 1: The malignancy is exclusively found in the uterus at this stage.

Stage 2: The cancer is only in the uterus and cervix. 

Stage 3: Cancer has progressed beyond the uterus but not to the rectum or the bladder. It can be found in the ovaries, fallopian tubes, vaginal area, or the surrounding lymph nodes. 

Stage 4: The malignancy has spread outside of the pelvis. Endometrial cancer stage 4 can be found in the rectum, bladder, as well as other distant organs and tissues. 

When the doctor discovers you have endometrial cancer, they will determine the treatment choices and the prognosis based on the stage. Early-stage endometrial cancer is easier to cure than later-stage cancer. 

 

Endometrial Cancer Diagnosis 

Endometrial Cancer Diagnosis 

See your health care provider or gynecologist if you experience symptoms that could indicate endometrial cancer. Usually, an endometrial cancer diagnosis will involve inquiring about your symptoms as well as your medical history. 

A pelvic examination will be performed to check for abnormalities inside the uterus or other reproductive organs. The doctor can also prescribe a transvaginal ultrasound examination to look for tumors or any other anomalies. 

An ultrasound examination is a form of imaging test that creates images of the inner body parts using sound waves. Your doctor can perform a transvaginal ultrasound by inserting an ultrasound probe in the vagina. The photos from this probe will be displayed on a monitor. 

If abnormalities are discovered during an endometrial cancer ultrasound scan, your doctor may request one or more tests to obtain a tissue sample for more testing. These tests and procedures include; 

  • Hysteroscopy: A small flexible tube attached to a fiber-optic camera is inserted into the uterus through the cervix during this procedure. This endoscope is used to visually inspect the endometrium as well as biopsy samples for any anomalies. 
  • Endometrial biopsy: Your doctor puts a tiny flexible tube into the uterus via the cervix during an endometrial biopsy. Through the tube, he or she uses suction to extract a small tissue sample from the endometrium. 
  • Dilation and curettage (D&C): The doctor can use this procedure to obtain another endometrial tissue sample if the biopsy results are uncertain. To achieve this, he or she widen the cervix and scrape out the tissue from the endometrium with special equipment. 

Your provider will send the tissue sample from the endometrium to the laboratory for analysis after obtaining it. A lab professional inspects the sample beneath a microscope to check for the presence of any cancerous cells.  

 

Endometrial Cancer Treatment 

Endometrial cancer treatment involves a variety of options. The treatment approach chosen by your doctor will be based on cancer's subtype, its stage, your general health, and individual preferences.

Every treatment choice comes with its own set of advantages and disadvantages. Your provider will explain to you in detail the potential advantages and disadvantages of each option.

The endometrial cancer treatment options can include; 

Surgery:

A surgical procedure is an effective way of treating endometrial cancer in women. It entails hysterectomy (the removal of the uterus) and salpingo-oophorectomy (the fallopian tubes and ovaries removal). A hysterectomy prevents you from having children in the future. You'll also begin your menopause if your ovaries are taken out if you have not started already. 

During the procedure, the surgeon will check for indicators of the spread of cancer to the areas surrounding the uterus. The surgeon might as well extract the lymph nodes sample for testing—this aids in determining the stage of cancer.

Radiation therapy:

To destroy the cancerous cells, radiation therapy employs high-energy beams, including x-rays and protons. Your doctor can suggest radiation to lower your chances of cancer recurring following surgery in certain cases. Radiation treatment might also be administered prior to surgery in some cases to shrink the tumor. This makes it much easier to eliminate. 

If you are not in good health to have surgery, radiation therapy may be your only option. It can include the following procedures:

  • External beam radiation therapy: This concentrates radiation beams from outside of the body on the uterus. 
  • Internal radiation therapy: This involves putting radioactive elements inside the body, such as in the vaginal or uterine cavity.

Chemotherapy:

Chemotherapy is a form of cancer treatment that uses chemicals to destroy cancerous cells. You can receive a single chemotherapy treatment or a combination of two or more medicines. Chemotherapy medications can be given either orally or injected into the veins (intravenously). These medications get into the bloodstream and kill cancer cells as they move through the body.

If endometrial cancer has progressed to other regions of your body, your doctor may consider chemotherapy. This treatment may also be recommended for endometrial cancer that has recurred after previous treatment. 

Hormone therapy:

Hormone therapy entails modifying the levels of the hormone in the body with hormonal or hormone-blocking medications. This may assist in slowing down the endometrial cancer cells' growth. 

If you have stage 3 or 4 endometrial cancer, your doctor may suggest hormone therapy. He or she can also recommend the treatment for endometrial cancer that has recurred after treatment. In most cases, chemotherapy and hormone treatment are used together.

 

Conclusion 

Endometrial cancer is the most frequent malignancy of the reproductive system in women. It commonly occurs following menopause. It can, however, develop in younger women as well. The common symptoms of endometrial cancer include vaginal bleeding after menopause or in between periods. 

A surgery procedure can treat endometrial cancer if the doctor diagnoses it early enough before it metastasizes. Visit your healthcare practitioner right away if you notice any signs of cancer.