Choose the content to read
- What are the types of endometrial cancer?
- What are the symptoms of endometrial cancer?
- What are the risk factors of endometrial cancer?
- How can I know if I have endometrial cancer?
- What are the treatments for endometrial cancer?
- How to prevent endometrial cancer?
- Preparation before your doctors appointment
Endometrial cancer
Endometrial cancer arises from abnormal cell growth in the uterine lining, also known as uterine cancer. Early detection is usual due to symptoms like vaginal bleeding, leading to successful treatment and cure of early-stage cases
What are the types of endometrial cancer?
Type 1: This is the most common and is often associated with estrogen excess in the body. It tends to grow slowly and has a relatively good prognosis.
Type 2: This refers to endometrial cancer that spreads to other organs. It accounts for around 20% of endometrial cancer.
Based on the microscopic appearance of their cells, endometrial cancer can be categorized as follows:
- Endometrioid cancer is the most common form of endometrial cancer. It originates in the glands of the endometrium. It resembles the normal uterine lining cells.
- Uterine papillary serous carcinoma is the less common form of endometrial uterine cancer that begins in the lining of the uterus and tends to recur even with early detection.
- Uterine clear cell carcinoma accounts for less than 5% of cases.
- Uterine carcinosarcoma constitutes less than 5% of cases but tends to be aggressive and grow and spread rapidly.
What are the symptoms of endometrial cancer?
- You have vaginal bleeding between periods.
- You have vaginal bleeding after menopause.
- You have pelvic pain.
When to see a doctor
If you experience the abovementioned symptoms, make an appointment for a proper diagnosis.
What causes endometrial cancer?
Endometrial cancer arises from alterations in the DNA of cells within the uterine lining, triggering uncontrolled cell proliferation. This growth can result in the formation of a mass or tumor. These altered cells threaten healthy cells, initiating the invasion and potential spread to other parts of the body.
What are the risk factors of endometrial cancer?
Endometrial cancer predominantly affects women after menopause, with over 95% of cases occurring in those aged 40 and older. Postmenopausal women face an elevated risk of developing endometrial cancer if they:
- Experienced an early onset of menstruation
- Have late menopause.
- Are overweight or obese
- Have diabetes or hypertension.
- Has never been pregnant
- Have a history of infertility, irregular menstrual cycles, or endometrial hyperplasia.
- Have a family history of endometrial, colon cancer, or breast cancer.
The risk of endometrial cancer is higher in women who use tamoxifen for breast cancer treatment or prevention, those who opt for estrogen-only hormone replacement therapy, and those with an ovarian tumor (but this is rare.). High-fat or red meat diets may contribute to an increased risk of endometrial and colon cancer.
How can I know if I have endometrial cancer?
To identify the endometrial cancer, your doctor will perform a physical examination and tests, such as:
- A pelvic exam: Your doctor will wear a lubricated glove before inserting two fingers to feel the uterus and ovaries while the other hand is pressing on the abdomen. Your doctor will insert a speculum to widen the vaginal canal and look for signs of cancer.
- Imaging tests: These include transvaginal ultrasound, CT scan, and MRI.
- Hysteroscopy
- Biopsy
- Dilation and curettage (D&C )
Once the diagnosis of endometrial cancer is confirmed, your doctor will determine the stage of cancer through additional tests such as a chest X-ray, CT scan, blood tests, and positron emission tomography (PET scan). However, surgery is the most accurate way to stage cancer. The cancer is in four stages. Stages 1-3 indicate the tumors confined within the uterus. Stage 4 refers to the cancer that has spread to nearby organs or distant body sites.
What are the treatments for endometrial cancer?
The initial approach to treating endometrial cancer is the surgical removal of cancerous growth, which may include the removal of the uterus, fallopian tubes, and ovaries. Other treatment modalities, such as radiation or chemotherapy drugs, can help eradicate residual cancer cells. The choice of treatment for your endometrial cancer depends on the stages of the cancer, your overall health, and your personal preferences.
- Surgery includes a hysterectomy and salpingo-oophorectomy. With a hysterectomy, you will not be able to be pregnant in the future. Salpingo-oophorectomy causes you to have menopausal symptoms. During the surgery, doctors may remove your lymph nodes to determine the stage of your cancer and assess the organs around your uterus for signs of invasive cancer.
- Radiation therapy can kill cancer cells and shrink a cancerous tumor before surgery. Doctors may recommend radiation therapy if you are not physically strong enough to have surgery.
- External radiotherapy: The radiation will be directed to a specific point or organ.
- Brachytherapy: An iridium-192-filled device will be inserted through your vagina into the uterus.
- Chemotherapy is the use of chemicals to kill cancer cells. They may be oral pills or injectable forms. This treatment modality can help shrink the cancer before surgery and eradicate the remaining cancerous cells after surgery. Chemotherapy is effective in treating metastatic endometrial cancer.
- Hormone therapy will decrease the hormone levels that cancer cells rely on. Therefore, cancerous cells cannot divide and grow. However, hormone therapy is only suitable for certain cancers. Your doctor may recommend this treatment if you have metastatic endometrial cancer.
- Targeted therapy can cause cancer cells to die by blocking a growth pathway in the cancer cells, often given in combination with chemotherapy.
- Immunotherapy uses monoclonal antibodies to boost your immunity to fight off cancer cells. If other treatments are not effective, your doctor may order this modality.
- Palliative care aims to improve the quality of life of you and your family. It can help relieve pain and symptoms related to endometrial cancer.
How to prevent endometrial cancer?
Endometrial cancers are not preventable. But some factors can help you lower the risk.
- Get fit and strong by eating a balanced diet, keeping a healthy weight, and exercising regularly.
- Taking oral contraceptives for at least one year can lower the risk of endometrial cancer. However, discuss the pros and cons with your doctor before use.
- Discuss with your doctor about the risks and benefits of hormone therapy after menopause. Taking estrogen alone after menopause can increase the risk of endometrial cancer, while a combination of estrogen and progestin may reduce the risk.
Preparation before your doctors appointment
- Write down all symptoms you have been experiencing and a list of medication (birth control pills, tamoxifen, and hormonal therapy) and dietary supplements you are taking.
- Prepare a list of questions you would like to ask your doctor, for instance:
- What causes endometrial cancer?
- What stage is my cancer?
- Do I have to undergo any tests?
- What treatment options are available? Which one do you recommend? Are there any side effects?
- I have other health conditions. How can I best manage them together?
- Do I have to follow any restrictions?
- Prepare answers to questions that your doctor may ask, for instance:
- What are your symptoms?
- Have you experienced pelvic pain or vaginal bleeding?
- How often do you experience those symptoms?
- What improves or worsens your symptoms?
- Do you have a personal or family history of cancer?
- Have you taken estrogen-only hormone therapy to manage your menopausal symptoms?
