What is endometrial cancer?
The term endometrium refers to the layer of cells and tissues that line the uterus (womb) of the women. An abnormal and uncontrolled growth of these cells and tissues is known as endometrial cancer.
Adenocarcinoma is the most common type of endometrial cancer noted in women. It has been estimated by the National Cancer Institute that about 42,160 new cases of endometrial cancer will be diagnosed in the United States in 2009.
Who is at risk of developing endometrial cancer?
There are no specific causative factors that have been associated with the occurrence of endometrial cancer. However, several factors have been noted to increase the risk of endometrial cancer in women. The female hormone, estrogen has been believed to play a major role in the progression of endometrial cancer wherein increased amounts of estrogen in the body may result in abnormal changes.
Old age has been projected as one of the risk factors as endometrial cancer was more commonly noted in women between the ages 60 and 70 years. In some cases endometrial cancer may also be noted in women below the age of 40 years.
The age at which menstrual periods begin may be considered as a factor predicting the risk of endometrial cancer. It was noted that girls who started menstruating before 12 years of age were at a higher risk of developing endometrial cancer during old age. A similar relation was also noted with the age at menopause wherein, later the age of menopause, higher was the risk of developing endometrial cancer. Irregular menstrual patterns also tend to increase the risk of endometrial cancer.
Women who have never been pregnant in their lifetime have an increased risk of developing endometrial cancer. Although the exact reason for this pattern has not been discovered, lack of adequate amounts of another hormone, progesterone that regulates the actions of estrogen may have a role.
Obesity is noted to be a known risk factor wherein women who were obese had a 3 times higher risk of developing endometrial cancer in comparison to women with normal weight. Being overweight on the other hand increases this risk by 2 times.
Presence of underlying disorders such as diabetes and hypertension (high blood pressure) was noted to increase the risk of endometrial cancer in some women.
Consuming diets rich in fats may increase the risk of endometrial cancer by either promoting obesity or promoting increased estrogen secretion.
Presence of tumors in the ovaries that lead to increased secretion of estrogen also has a role in the development of endometrial cancer. Certain other factors that are also associated with increased incidence of endometrial cancer include: family history of endometrial cancer, tamoxifen therapy (a medication advised to treat breast cancer), personal history of ovarian or breast cancer or colon cancer.
What are the symptoms of endometrial cancer?
Abnormal vaginal bleeding is the most common symptom that is associated with endometrial cancer. In most of the cases, endometrial cancer is noted in women who have reached menopause. Therefore post menopausal women should consult a doctor if they notice any vaginal bleeding. In cases of women who are still menstruating, bleeding in between the menstrual periods or abnormal bleeding during menstrual periods should raise a doubt. Prompt medical consultation should be sought if these features are noted. In some instances the vaginal discharge may be white or clear.
Pain in the lower abdominal region or cramping is noticed in some women affected with endometrial cancer. Other symptoms and signs include pain during intercourse and unintended weight loss.
Endometrial cancer is generally diagnosed based on the physical examination and certain specific diagnostic tests. Physical examination may reveal any abnormalities in the endometrium or other associated structures, while certain specific tests such as endometrial aspiration or biopsy, dilatation and curettage and Pap smear may be advised to either identify the presence of cancer or to evaluate the severity of the condition.
How is endometrial cancer treated?
The treatment of endometrial cancer is individualized based on several factors such as severity of the cancer, age of the affected woman, spread of cancer, and presence of other related disorders.
Surgery is the best suited option for the treatment of endometrial cancer in many women. This involves the surgical removal of the affected regions of the uterus. The extent of removal is based on the stage of cancer. Early and minor cases of cancer may require minimal removal while advanced cases may require complete removal of the uterus. In some instances where the cancer has spread to other adjacent reproductive organs such as the fallopian tubes or ovaries a more extensive operation to remove all the affected portions of the reproductive system may be advised.
Radiation therapy with controlled exposure of the cancerous regions to x-rays may also be advised in some instances. This is often combined with surgical treatment to prevent the recurrence of endometrial cancer.
Chemotherapy which involves the administration of anti-cancer medications is advised in cases of advanced stages of endometrial cancer.
Hormone therapy may be advised when spread of cancer to other regions of the body is suspected.
How can endometrial cancer be prevented?
Endometrial cancer can be treated successfully if identified in its earlier stages. Periodic pelvic examinations once you are sexually active help in the early detection of any abnormal changes that are taking place in the endometrium. This is especially true if any of the above listed risk factors are noted. Further, women who are taking estrogen replacement therapy should also get a pelvic examination done at regular intervals.
Hormone replacement therapy (HRT) is generally advised in postmenopausal women to counter the altered hormone levels in the body. While this may be beneficial in many women, HRT itself may be associated with increased incidence of breast cancer and other abnormalities. Consult your doctor to know the pros and cons of hormone replacement therapy.
Consumption of birth control pills is known to decrease the risk of endometrial cancer. Decreasing the body weight if you are obese or overweight decreases your risk of developing endometrial cancer. Regular exercise was also noted to be beneficial in preventing endometrial cancer.