Endometrial Cancer – What it is, Symptoms and Treatments with surgery and drugs. Also, Endometrial Cancer is a type of cancer that starts in the uterus . The uterus is the empty pear-shaped pelvic organ in women where fetal development takes place.
Endometrial cancer starts in the layer of cells that form the lining (endometrium) of the uterus . Endometrial cancer is sometimes called uterine cancer. Other types of cancer can form in the uterus , including uterine sarcoma, but they are much less common than Endometrial Cancer .
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Endometrial cancer is often detected at an early stage because it often produces abnormal vaginal bleeding , which prompts women to see their doctors. If Endometrial Cancer is discovered early, surgically removing the uterus often cures Endometrial Cancer .
Causes of Endometrial Cancer: Doctors don’t know what causes Endometrial Cancer . What is known is that something occurs to create a genetic mutation within cells in the endometrium – the lining of the uterus . The genetic mutation turns normal, healthy cells into abnormal cells.
Healthy cells grow and multiply at a fixed rate, eventually dying at a fixed time. Abnormal cells grow and multiply out of control, and they don’t die at any given time. The accumulated abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can separate from an initial tumor to spread throughout the body (metastasis).
Symptoms of Endometrial Cancer: Signs and symptoms of Endometrial Cancer can include:
- Vaginal bleeding after menopause
- Bleeding between periods
- An abnormal, watery, or bloody discharge from the vagina
- pelvic pain
When to See a Doctor: Make an appointment with your doctor if you have any signs or symptoms that worry you, such as vaginal bleeding or discharge unrelated to your periods, pelvic pain, or pain during intercourse.
Endometrial Cancer Risk Factors: Factors that increase the risk of endometrial cancer include:
Changes in the Balance of Female Hormones in the Body: Your ovaries produce two main female hormones: estrogen and progesterone. Fluctuations in the balance of these hormones cause changes in your endometrium. A disease or condition that increases the amount of estrogen, but not the level of progesterone, in your body can increase your risk of Endometrial Cancer .
Examples include irregular ovulation patterns, such as those that can occur in women with polycystic ovary syndrome, obesity, and diabetes. Taking hormones after menopause that contain estrogen but not progesterone increases the risk of Endometrial Cancer . A rare type of ovarian tumor that secretes estrogen can also increase your risk of endometrial cancer .
- More years of menstruation. Starting menstruation at an early age — before age 12 — or menopause later on increases the risk of Endometrial Cancer . The more periods you’ve had, the more exposure your endometrium has had to estrogen.
- I was never pregnant. Women who have never been pregnant have a higher risk of endometrial cancer than women who have had at least one pregnancy.
- Older age. As you get older, your risk of Endometrial Cancer increases. Endometrial cancer occurs more often in women who have gone through menopause.
- Obesity. Being obese increases the risk of endometrial cancer . This could be because excess body fat alters your body’s balance of hormones.
- Hormone therapy for breast cancer. Women with breast cancer who take the hormone therapy drug tamoxifen are at an increased risk of developing Endometrial Cancer . If you are taking tamoxifen, discuss this risk with your doctor. For most women, the benefits of tamoxifen outweigh the small risk of Endometrial Cancer .
- An inherited colon cancer syndrome. Hereditary non-polyposis colorectal cancer (HNPCC) is a syndrome that increases the risk of colon cancer and other cancers, including Endometrial Cancer . HNPCC occurs because of a gene mutation passed from parents to children. If a family member has been diagnosed with HNPCC, discuss the risk of the genetic syndrome with your doctor. If you’ve been diagnosed with HNPCC, ask your doctor which cancer screening tests you should undergo.
Diagnosing Endometrial Cancer: Tests and procedures used to diagnose Endometrial Cancer include:
- Pelvic exam: During a pelvic exam, your doctor carefully inspects the outside of your genitals (vulva) and then inserts two fingers of one hand into your vagina and simultaneously presses the other hand into your abdomen to feel for your uterus and ovaries . He or she also inserts a device called a speculum into the vagina . The speculum opens your vagina so your doctor can see your vagina and cervix for abnormalities.
- Using sound waves to create an image of your uterus: Your doctor may recommend a transvaginal ultrasound to examine the thickness and texture of the endometrium and help rule out other conditions. In this procedure, a wand device (transducer) is inserted into your vagina . The transducer uses sound waves to create a video image of your uterus . This test helps your doctor look for abnormalities in your uterine lining.
- Using a scope to examine your endometrium: During a hysteroscopy, your doctor inserts a thin, flexible, lighted tube (hysteroscope) through your vagina and cervix into your uterus . A lens on the hysteroscope allows your doctor to examine the inside of the uterus and endometrium.
- Removing a tissue sample for testing: To obtain a sample of cells from inside the uterus , you will likely undergo an endometrial biopsy. This involves removing tissue from the uterine lining for laboratory analysis. Endometrial biopsy can be done in your doctor’s office and usually does not require anesthesia.
- Performing surgery to remove tissue for testing: If enough tissue cannot be obtained during a biopsy, or if the biopsy results are unclear, you will likely need to undergo a procedure called dilation and curettage (D&C). During D&C, tissue is scraped from the lining of the uterus and examined under a microscope for cancer cells.
If Endometrial Cancer is found, you will likely be referred to a doctor who specializes in treating cancers involving the female reproductive system (gynecological oncologist).
Endometrial Cancer Agitation: Once your cancer has been diagnosed, your doctor works to determine the extent (stage) of your cancer. Tests used to determine the stage of your cancer may include a chest X-ray, a CT scan (computed tomography), positron emission tomography (PET), and blood tests. A final determination of the stage of your cancer may not be made until after you have had surgery to treat your cancer. The stages of Endometrial Cancer include:
- Stage I cancer is found only in the uterus .
- Stage II cancer is present in the uterus and cervix .
- Stage III cancer has spread beyond the uterus , but has not reached the rectum and bladder. Lymph nodes in the pelvic area may be involved.
- Stage IV cancer has spread to the pelvic area and can affect the bladder, rectum, and more distant parts of the body.
Your options for treating Endometrial Cancer will depend on the characteristics of the cancer, such as the stage, general health, and your preferences.
Endometrial Cancer Treatments: Your options for treating Endometrial Cancer will depend on the characteristics of the cancer, such as the stage, general health, and your preferences.
Surgery: Surgery to remove the uterus is recommended for most women with Endometrial Cancer . Most women with Endometrial Cancer undergo a procedure to remove the uterus (hysterectomy) as well as to remove the fallopian tubes and ovaries (salpingo-oophorectomy).
A hysterectomy makes it impossible for you to have children in the future. Also, once your ovaries are removed, you will experience menopause if you haven’t already. During surgery, your surgeon will also inspect the areas around the uterus for signs that the cancer has spread. Your surgeon may also remove lymph nodes for testing. This helps determine the stage of your cancer.
Radiation: Radiation therapy uses powerful beams of energy, such as X-rays and protons, to kill cancer cells. In some cases, your doctor may recommend radiation to reduce your risk of cancer recurrence after surgery. In certain situations, radiation therapy may also be recommended before surgery to shrink a tumor and make it easier to remove.
If you are not healthy enough to undergo surgery, you can opt for radiation therapy alone. In women with advanced endometrial cancer , radiation therapy can help manage cancer-related pain. Radiation therapy may involve:
- Radiation from a machine outside your body: During external beam radiation, you lie on a table while a machine directs radiation to specific points on your body.
- Radiation placed inside your body: Internal radiation (brachytherapy) involves placing a device filled with radiation, such as tiny seeds, threads, or a cylinder, into the vagina for a short period of time.
Hormone Therapy: Hormone therapy involves taking medications that affect hormone levels in the body. Hormone therapy may be an option if you have advanced Endometrial Cancer that has spread beyond your uterus . Options include:
- Medicines to Increase the Amount of Progesterone in Your Body: Synthetic progestin, a form of the hormone progesterone, can help stop endometrial cancer cells from growing.
- Drugs to Reduce the Amount of Estrogen in Your Body: Hormone therapy drugs can help lower the levels of estrogen in your body or make it more difficult for your body to use available estrogen. Endometrial cancer cells that rely on estrogen to help them grow can die in response to these drugs.
Chemotherapy: Chemotherapy uses chemicals to kill cancer cells. You may be given a chemotherapy drug, or two or more drugs may be used in combination. You may receive chemotherapy drugs through a pill (orally) or through your veins (intravenously).
Chemotherapy may be recommended for women with advanced or recurrent Endometrial Cancer that has spread beyond the uterus . These drugs enter your bloodstream and then travel through your body, killing cancer cells.
Supportive (Palliative) Care: Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all other appropriate treatments, people with cancer can feel better and live longer. Palliative care is provided by a team of specially trained doctors, nurses and other professionals.
Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.