Endometrial cancer is sometimes called uterine cancer. Endometrial cancer is a cancerous tumor of the lining (endometrium) of the uterus. This disease affects usually women after their reproductive years, between the ages of 60 and 70. The most common symptom of endometrial cancer is vaginal bleeding between periods or after menopause. Early detection is the most important. If discovered early, surgeon will remove the uterus to eliminate the cancer.
Signs and symptoms
If you notice unusual vaginal bleeding, don’t wait, see your gynecologist. Endometrial cancer usually develops in postmenopausal women, whose periods have stopped. It is very rare in women younger than 40. The most common symptoms include: vaginal bleeding between periods, or prolonged periods, any bleeding after the time of menopause, more frequent vaginal bleeding or spotting during the perimenopause, vaginal discharge, pelvic pain, and pain during intercourse and weight loss.
Causes and risk factors
The cause of endometrial cancer has not yet been established although a long-established link exists to hormone related disorders. About 40% of endometrial tumors appear to be autonomous with no known etiology. Associated risk factors include adenomatous hyperplasia of the endometrium, menstrual irregularities, delayed menopause, infertility, diabetes or hypertension, and a history of breast or ovarian cancer. Some researches think that there is a link between estrogen and endometrial cancer.
Endometrial cancer is the most common of the gynecologic malignancies. This cancer is found primarily in postmenopausal women between 60 and 70 years of age. The women tend to be from highly industrialized countries, and the prevalence has increased sharply.
Cells begin as endometrial hyperplasia and change to cancer cells, beginning in the fundus of the uterus and spreading to the entire endometrium. The cancer may then extend down the endocervical canal and involve the cervix and vagina. It also spreads through the uterine wall to the abdominal cavity and adjacent structures and metastasizes to the pelvic and paraaortic lymph nodes, lungs, bone, and brain. The ovaries produce two main female hormones, estrogen and progesterone. When ovaries produce more estrogen that stimulates growth of the endometrium. Woman with increased levels of estrogen have greater risks of developing endometrial cancer. Some of the factors that increase levels of estrogen in the body include: many years of menstruation, irregular ovulation, diabetes, obesity and other.
The regular gynecologic examinations are important for all adult women. Vaginal bleeding that is not normal, especially after menopause, is the main symptom. Sometimes woman also may have lower belly and low back pain. A Pap test does not always show endometrial cancer because the tumor cells are rarely found outside the uterus in early stages of the disease. The disease is often tested for with a surgical exam of the uterus. Endometrial cancers may spread to the cervix, but rarely to the vagina. They often grow in the broad ligaments, fallopian tubes, and ovaries.
If your doctor thinks that you have endometrial cancer, s/he will send you to a gynecologist. You will probably have a pelvic exam. The gynecologist during this exam can feel lumps or changes in the shape of the uterus. The most common tests that you may have are: pap test, endometrial biopsy, dilation and curettage, and transvaginal ultrasound.
Pap test can’t help a lot, because endometrial cancer is rarely detectable by a Pap test. Endometrial biopsy is an office procedure; a doctor takes a sample of uterine lining. Then, the sample is examined under a microscope for abnormal cells.
If the endometrial biopsy suggests cancer, you'll likely need to undergo a dilatation and curettage. In this procedure, tissue is scraped from the lining of your inner uterus and examined under a microscope for cancer cells, for this procedure you will receive general anesthesia.
Transvaginal ultrasound is a painless procedure; in this procedure transducer is inserted into your vagina. This device uses sound waves. The doctor will have an image of the uterus which help him evaluate your condition.
If you have endometrial cancer you will be refered to an oncologist. You will have more tests. The role of these tests is to help oncologist determine if you have metastasis. You probably will have a chest X-ray, a computerized tomography (CT) scan and a blood test to measure cancer antigen.
The endometrial cancer can occur in four stages. In the first stage endometrial cancer is found only in uterus and hasn't spread at all. Stage II cancer is founded in the body of both your uterus and your cervix, but hasn't spread beyond the pelvic region. In stage III cancer has not involved the rectum and bladder, but pelvic area lymph nodes are, or may be. In stage IV cancer has spread and affects other parts of your body. About 70 percent of endometrial cancers are diagnosed at stage I or II.
Because endometrial cancer is successfully treated if early diagnosed, you should see your doctor if you experience any signs or symptoms of the disease. You should know that many of the symptoms you experience may be associated with benign conditions, such as vaginal infections, uterine polyps or uterine fibroids.
Treatment includes removal of the uterus (hysterectomy) and removal of both ovaries and fallopian tubes (salpingo-oophorectomy). Lymph nodes in the area should also be removed during surgery. X-ray therapy is usually given before and after surgery. High doses of a hormone may be given for advanced cases. Treatment with progestin may be an option for women with early endometrial cancer who want to have children. Your doctor may suggest you chemotherapy. It is the use of drugs to kill cancer cells. Before any treatment you should discus with oncologist about side effects. Ask your doctor what side effects you can expect and what can be done to manage them.
After treatment for endometrial cancer, you will have regular examinations to check that the cancer hasn't returned. Those examinations may include a physical exam, a pelvic exam, a Pap test, a chest X-ray and laboratory tests.
Sometimes you can decrease your risk of developing endometrial cancer. You could take hormone therapy with progestin. Taking estrogen alone after menopause may increase your risk of endometrial cancer. This combination hormone therapy lowers your risk, but this combination has side effects. Some studies have shown that the use of oral contraceptives can reduce endometrial cancer risk. If you are overweight you should reduce your weight. It is important for you to know that obesity is one of the highest risk factors for the development of endometrial cancer in most women.
Good nutrition is especially important if you are undergoing cancer treatment.
You should know that when discovered early, endometrial cancer is usually treatable.