What is endometrial cancer?

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begins in the layer of cells that form the lining of the uterus, called the endometrium. Endometrial cancer can also be called uterine cancer or uterine cancer.

Most uterine tumors are endometrial cancer. In another type of cancer, uterine sarcoma, malignancy begins in the muscles around the uterus. Endometrial cancer and uterine sarcoma are usually treated differently.

Uterine cancer is the fourth most common cancer in women in the United States

It normally affects women over the age of 55.

Signs and symptoms of endometrial cancer

Endometrial cancer begins in the lining of the uterus and can spread from there.

Signs and symptoms of endometrial cancer include:

      

  • Vaginal bleeding between menstrual periods
      
  • Periods that are heavier than usual
      
  • Vaginal bleeding in post-menopausal women
      
  • Abnormal vaginal discharge, which may be watery or veins of blood.

Pain in the pelvic area or during sexual intercourse is less common.

With the progression of the disease, fatigue, nausea and pain in the legs, back and pelvic area may occur.

Some women also experience pain during urination, while others have difficulty emptying the bladder.

Other non-cancerous health problems have similar symptoms, such as fibroids, endometriosis, endometrial hyperplasia or polyps in the lining of the uterus.

Risk factors for endometrial carcinoma

An important factor in endometrial cancer is increased exposure to high estrogen levels. Women who have never been pregnant, who begin menstruation before 12 years of age or who are undergoing a late menopause, after 55 years, are more at risk.

Hormone replacement therapy (HRT), particularly estrogen therapy, used by women after hysterectomy, also contributes. Polycystic ovarian syndrome (PCOS) is also a risk factor, as it increases estrogen levels.

Diabetes can contribute because when insulin levels rise, so does estrogen levels. The high level of long-term estrogen increases the likelihood of uterine cancer.

Other factors include:

      

  • Endometrial hyperplasia or excessive excessive growth or thickening of the lining of the uterus
      
  • Obesity
      
  • Hypertension
      
  • Use of to prevent or treat breast cancer
      
  • Radiation therapy at the pelvis
      
  • A family history of uterine cancer
      
  • A previous diagnosis of ovarian or mammary carcinoma.

Acrylamide, a carcinogenic compound found in cooked food, particularly burned, rich in carbohydrates, has been linked to endometrial and ovarian cancer in postmenopausal women.

Diagnosis of endometrial carcinoma

A doctor will examine the patient’s medical and family history and medical history and perform a pelvic exam.

This involves inspection and perception of the cervix, uterus, vagina and lips to detect any lumps or changes in shape or size.

A transvaginal ultrasound scan (TVU) can determine the size and shape of the uterus, and the consistency and thickness of the endometrium, to rule out other conditions. A transducer is inserted into the vagina and the sound waves create a video image of the uterus on a monitor.

Blood tests can reveal cancerous cells.

A biopsy involves taking a sample of tissue or cells for examination under a microscope. This could be a hysteroscopy, in which a thin telescope is inserted into the vagina and uterus, or a suction biopsy, using a small and flexible tube to take the cells of the sample.

If cancer is detected, the “grade” of the tumor will be evaluated to see how quickly the cells are dividing and how quickly the tumor is likely to grow.

A higher grade tumor is more likely to grow rapidly and to metastasize, or spread to other parts of the body.

Tests to detect the spread of endometrial cancer include a pap test, lymph node biopsy and imaging tests, such as radiography, CT, PET or MRI.

Removing the uterus surgically or hysterectomy can reveal the scale of cancer in the uterus.

Staging endometrial cancer

The treatment will depend on dat the stage or how much cancer has spread.

The following steps can be used:

      

  • Stage 0: Cancer cells remain where they started, on the surface of the lining of the uterus.
       Stage I: the tumor has spread through the lining of the uterus to the endometrium and possibly to the myometrium.
      
  • Stage II: the tumor has spread to the cervix.
      
  • Stage III: the tumor has spread through the uterus to the nearby tissue, including the vagina or a lymph node.
      
  • Stage IV: the tumor has spread to the bladder or intestine and probably to other areas such as bones, liver or lungs.

When endometrial cancer spreads from the endometrium to other parts of the body and when a new tumor forms, for example, in the lung, that new cancer is not a lung cancer. It is known as metastatic endometrial carcinoma.

Treatment for endometrial cancer

Treatment depends on the patient’s age and general health, grade and stage of the tumor. A doctor will discuss the options and possible adverse effects with the patient.

Overall, options include surgery, radiation, chemotherapy and hormone therapy.

Treatment for endometrial cancer is normally a hysterectomy or surgical removal of the uterus, along with the fallopian tubes and ovaries. Normally this is a 2-day hospital stay, but the resumption of normal activities can take between 4 and 8 weeks.

A premenopausal woman will no longer menstruate after surgery and will not be able to conceive. There may be symptoms of menopause, such as hot flashes, night sweats and vaginal dryness.

Radiation Therapy

Radiation therapy uses powerful rays to kill cancer cells and damages their DNA so they can not multiply.

In external beam radiation (EBRT), a beam is directed to the pelvis and other areas with cancer. There can be up to five sessions a week for several weeks. A session takes about 15 minutes.

Brachytherapy, or internal radiotherapy, uses small devices full of radiation, such as wires, a cylinder or small seeds. These are placed inside the vagina for a few minutes and then removed, after which the patient returns home. The therapy is repeated two or more times for several weeks. Removal of the device removes radiation from the body.

Adjuvant radiotherapy reduces the tumor before surgery, making it easier to remove.

Adjuvant radiotherapy is applied after surgery to remove any remaining tumor cells.

Side effects of radiation therapy include burned skin in the treated area, hair loss, fatigue, disease and diarrhea. After treatment, side effects usually disappear.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. In combination with radiation therapy, it can remove the remains of a tumor.

Chemotherapy can destroy cancer cells and prolong life.

In advanced cancer, chemotherapy can slow down progression and prolong life.

Both radiotherapy and chemotherapy can help alleviate symptoms in patients with advanced cancer.

For endometrial cancer, chemotherapy is usually given intravenously in treatment cycles and a rest period. The cycle is repeated several times, depending on the stage and objectives of the treatment.

Possible adverse effects include a reduction in healthy blood cells, leaving the patient prone to bruising, bleeding, anemia, fatigue and increased risk of infection. If these symptoms occur, the patient should consult a doctor.

Other effects include hair loss and gastrointestinal problems, including nausea, vomiting, diarrhea and poor appetite. There may be sores in the mouth and lips.

These problems typically disappear at the end of treatment.

Less common effects include swollen legs and feet, joint pain, balance problems, hearing difficulties, rashes and numbness and tingling in the hands and feet.

Hormone therapy

Hormone therapy can help patients with advanced endometrial cancer.

Women with very early stage cancer and low-grade tumors who wish to become pregnant can opt for hormone therapy rather than surgery.

This is not a standard treatment and requires careful monitoring. If there is a completeat remission of cancer after 6 months of hormone therapy, they will be encouraged to conceive and give birth, and then to undergo postpartum surgery.


Hormone therapy for endometrial cancer includes the administration of progestogens to help reduce the tumor and control symptoms and reduce estrogen levels, making tumor cell growth more difficult.


Side effects include weight gain, slight muscle cramps and mild nausea.


Prognosis for endometrial cancer


The 5-year survival rate for endometrial cancer is about 81.7%, according to the American Cancer Society, and 95.4% or higher for those diagnosed at an early stage.


The National Cancer Institute recommends avoiding smoking, exercising and following a healthy diet to reduce the risk.

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