Endometrial cancer , the most common type of uterine cancer, begins in the cells of the endometrium , the lining of the uterus that builds up and then disappears every month in non-pregnant women during their period .
The disease is more common after menopause. It is generally curable, and factors such as the stage and the effect of hormones on the tumor can determine a person's prognosis.
Endometrial Cancer Symptoms
The most common sign of endometrial cancer is unusual vaginal bleeding that occurs between periods or a year or more after menopause. If you have unusual discharge or abnormal bleeding unrelated to your period, it is important to be evaluated by your doctor.
Other symptoms include pain during intercourse or abnormal liquid or bloody discharge. In the later stages of the disease, you may experience pelvic pain, weight loss, and swelling in your pelvis.
There are several different types of endometrial cancer, including adenocarcinoma (the most common), squamous cell carcinoma, carcinosarcoma, small cell carcinoma, undifferentiated carcinoma, clear cell carcinoma, and transitional carcinoma.
Risk factors for endometrial cancer include:
- Menopause is over
- Menstruation before 12 years
- I have never been pregnant
- High levels of estrogen; changes in the balance of your hormones
- Use of estrogen hormone replacement therapy
- Polycystic Ovarian Syndrome (PCOS)
- Personal or family history of breast or ovarian cancer;
- Hereditary cancer syndromes such as Lynch syndrome (hereditary nonpolyposis colorectal cancer or HNPCC)
Endometrial cancer occurs when normal cells mutate and multiply. As they accumulate, a tumor begins to form. Abnormal cells can spread to other parts of the body.
The earlier endometrial cancer is found, the better the outcome. Endometrial cancer is often diagnosed early due to abnormal bleeding.
Your healthcare provider can detect abnormalities in the uterus and cervix during a pelvic exam, pelvic ultrasound, or transvaginal ultrasound. You may also be scheduled for a hysteroscopy, a diagnostic test in which a flexible, lighted tube is inserted into your uterus so your doctor can visualize internal structures.
There are two procedures that can be used to definitively diagnose endometrial cancer:
- During an endometrial biopsy , your doctor will remove various cells from the endometrium so that they can be examined under a microscope for abnormalities in the shape, structure, or growth of the cells.
- During a surgical procedure called dilation and curettage (D&C), which usually requires general anesthesia, the cervix is dilated and endometrial cells are removed for microscopic examination.
Discussion Guide for Healthcare Professionals on Endometrial Cancer Treatment
Get our printable guide to your next doctor's appointment to help you ask the right questions.
If cancer is diagnosed, your doctor will likely order additional tests to find out if the cancer has spread outside of the uterus. These tests may include computed tomography (CT), chest x-ray, positron emission tomography (PET), and blood tests. The results of these tests will determine the stage of your cancer:
- Stage 0: Also called carcinoma in situ. Cancer cells are found in the surface layer of the endometrium and have not developed into other cell layers.
- Stage I: The cancer is present only in the uterus.
- Stage II: Cancer is present in the uterus and cervix.
- Stage III: Cancer has spread outside the uterus and may affect the pelvic lymph nodes, fallopian tubes, and ovarian ligaments, but it does not spread beyond the pelvic region.
- Stage IV: Cancer has spread beyond the pelvic region, possibly to the bladder, rectum, or other areas.
If you are diagnosed with endometrial cancer, you and your doctors will need to discuss the best treatment options for you based on the stage of the cancer, your symptoms, and any other health problems you have.
- Surgery: Your doctor may recommend a hysterectomy, which is the surgical removal of the uterus. If your cancer has spread, you may also need to surgically remove other organs, such as the fallopian tubes, ovaries, part of the vagina, or lymph nodes . Before or after surgery, you may also need chemotherapy or radiation therapy to prevent the cancer from spreading.
- Radiation: This type of therapy involves exposing cancer cells to high-energy radiation. Radiation can be delivered externally through a device that directs radiation to the cancerous tissue or through seeds, needles, or catheters that are placed inside for direct contact with the cancerous tissue.
- Chemotherapy: This type of treatment includes drugs that kill cancer cells . It can be taken orally or intravenously. Sometimes chemotherapy can be injected into a body cavity to attack the tumor more directly.
- Hormone therapy: If your cancer responds to hormonal stimulation, there are medications that can help prevent the cancer from developing further. This may include drugs to increase the amount of progesterone in the body or drugs to lower the amount of estrogen.
You can't completely prevent endometrial cancer, but you can reduce your risk of developing it by staying active, maintaining a healthy weight, eating a balanced diet, talking to your healthcare provider about hormone therapy, and making sure you receive treatment. for any endometrium. problems (such as irregular bleeding) you have.
Endometrial cancer usually takes years to develop, and often after less serious endometrial problems have started. If you have abnormal bleeding, be sure to see your doctor.
Taking birth control pills for at least a year can reduce the risk of endometrial cancer. Using a hormone-free intrauterine device (IUD) may also reduce risk, although no research has been done on the effects of hormone-secreting IUDs. Talk to your doctor about the risks and benefits of using any of these types of contraception.
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The most common symptom of endometrial cancer is abnormal bleeding. This means that many cases are found early and the overall prognosis for this type of cancer is good. Once you've been diagnosed, it's important to be your advocate when it comes to your treatment. Ask your doctor lots of questions. Consider getting a second opinion. Take your time to relax and unwind. Enlist the help of your family and friends as needed. Teach yourself and your loved ones what to expect. The most important thing is to take one day at a time.