Endometrial cancer originates in the lining of the uterus

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Endometrial cancer arises in the uterine mucosa. Since the development and spread of endometrial cancer largely depends on the presence of estrogen in the body, hormone therapy is usually prescribed after surgery to reduce the likelihood of future cancer recurrence.

Endometrial cancer

Age is a risk factor for endometrial cancer, according to MedlinePlus. In most cases, the disease affects women between the ages of 60 and 70, with cases affecting people under the age of 40 being extremely rare. Symptoms include abnormal or excessive bleeding, lower abdominal pain, or whitish vaginal discharge that occurs after menopause.

Endometrial cancer treatment

When a tumor is caught in time, an effective treatment is surgery, in which all of the ovaries are removed. In other cases, chemotherapy or radiation, consisting of drugs or high levels of directional radiation used to destroy cancer cells, are effective alternatives.

Hormone therapy

According to the American Cancer Society, the goal of hormone therapy in treating endometrial cancer is to lower estrogen levels in the body to reduce the likelihood of future cancer recurrence, or to slow the spread of cancer cells that exist until they can be effectively treated with other treatments.

Hormone therapy medications

According to the ACS, the main drugs used in hormone therapy are progestagens. These medications reduce circulating levels of estrogen in the body, slowing the development of cancer cells. Another commonly used drug is tamoxifen, which is often used to fight breast cancer, although it can also work to prevent estrogen from stimulating cancer cell growth. A third alternative prescription is drugs called gonadotropin-releasing hormone agonists, which cause the ovaries to produce less estrogen. Side effects of these medications include menopausal symptoms such as hot flashes, weight gain, vaginal dryness, and possibly decreased bone density.

Methods of hormonal therapy

In addition to prescribing medications to change the hormonal balance of the body, other, more radical measures may be necessary. According to the ACS, additional options for fighting endometrial cancer with hormone therapy include either surgical removal of the ovaries or radiotherapy aimed at incapacitating the ovaries by removing the body’s main source of estrogen production. p>

Experimental treatment

New classes of drugs are constantly being studied for their potential usefulness in hormone therapy for endometrial cancer. According to the ACS, a class of drugs with potential is called aromatase inhibitors. These drugs act to prevent the conversion of other substances to estrogens, which further reduces the natural level of estrogen in the body. Side effects include muscle pain and hot flashes.


Endometrial cancer: treatment depending on stage

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Endometrial cancer is a disease characterized by the presence of tumor cells in the endometrial tissue, which is then distinguished from the tumor form that affects the muscular portion of the hollow organ that receives the fetus during pregnancy. The risk of developing endometrial cancer seems to be increased in women who are treated with ovarian hormones that act on the development of female character and menstruation.


If these symptoms are present, the gynecologist proceeds to visit the. Given the fact that endometrial cancer develops inside the uterus and for this reason is usually undetectable in a Pap test, the gynecologist needs to take a sample of endometrial tissue and analyze it under a microscope to determine the presence of cancer cells. The gynecologist can choose between different procedures: an endometrial biopsy consists of inserting a flexible instrument inside the uterine cavity to gently scratch the uterine wall to extract a small amount of tissue to be analyzed under the microscope.

Dilation and curettage (D C) after cervical dilation, t.е. The lower part of this organ. Cervix, the gynecologist inserts a spoon-shaped surgical instrument into the uterine cavity through which he can take large tissue samples; hysteroscopy, using a thin instrument equipped with a small camera at the tip and a small loop, the gynecologist can visualize the uterine cavity and select a tissue sample for targeted analysis. It is currently the most correct and most commonly used method of. These procedures may sometimes require anesthesia. ” The stage of the tumor (if it is limited to the endometrium, if it affects the entire uterus or has spread to other organs), as well as from general health.

Stage of the disease

After confirming the presence of the tumor, further tests must be performed to check whether the cancer cells have spread to other parts of the body (a process that establishes the extent and spread of the tumor, therefore, its aggressiveness). Staging is important for choosing the most appropriate treatment.

Endometrial cancer is classified into the following stages: – Stage I: The tumor is limited to the uterine body, but has not invaded the cervix. Divided into stages IA and IB depending on the depth of infiltration of the muscular part of the uterus; – Stage II: the tumor has spread from the endometrium to the cervix, but not beyond the uterus; – Stage III: the tumor extends beyond the uterus into the lower part of the large abdomen, vagina, and lymph nodes. Recurrence: the tumor recurs after treatment, recurrence may develop in the pelvic area, lymph nodes and/or other organs at a distance.

How to care

The current treatment options for endometrial cancer are as follows:

  • surgery;
  • chemotherapy;
  • therapy;
  • administration of hormones for therapeutic purposes.

Surgery is the most common method of treatment. The surgeon may decide to remove the tumor by performing one of the following types of surgery: ” Bilateral: is an operation in which the surgeon removes the uterus, salpingitis (or fallopian tubes), and ovaries.To check the condition of the lymph nodes, the surgeon may proceed at the same site to excise the lymph nodes by removing the pelvic and/or aortic lymph nodes, with the role of examining the sentinel lymph node (the first lymph node that drains clear, clear, colorless fluid circulating in the vessels) still considered experimental-mphatic and which contains lymphocytes. ” Lymph from the tumor area; even if the surgeon removes the entire tumor during surgery, in some cases, based on certain risk factors identified by microscopic analysis of a tissue sample taken during biopsy. ” The oncologist may recommend radiotherapy or postoperative chemotherapy to induce death of any remaining tumor cells and prevent recurrence. Chemotherapy is a treatment that destroys cancer cells by administering drugs that can be taken by mouth in pill form or injected intravenously or intramuscularly. Chemotherapy is defined as a systemic treatment because the drug enters the bloodstream, spreads through the body, and thus can reach and destroy cancer cells that have spread away. Radiotherapy (also called radiation therapy) uses high-frequency radiation to kill neoplastic cells. Radiation can be delivered by a device outside the body (external radiotherapy) or by a radioactive substance ((or radionuclide) A substance capable of emitting radiation. ” The radioisotope) can be placed directly into the area affected by the tumor using plastic tubes (internal radiotherapy or intracavitary). Endometrial cancer radiotherapy can be done alone or in combination with surgery, chemotherapy, or both. Hormone therapy (or hormone therapy) consists of taking hormones to block the growth of cancer cells. Estrogens and progestagens are hormones that can somehow affect the growth of some cancer cells. If tests show that the tumor cells have proteins that recognize and selectively bind certain substances (e.g., hormones, antigens, sugars) or even microorganisms (e.g., viruses, bacteria). Receptors located on the surface or inside cells. Receptors for estrogen and/or progestagens, hormone therapy may be considered a therapeutic option.

Treatment depending on stage

The specialist may suggest standard treatment because of its proven efficacy, confirmed by previous experience, or participation in a clinical trial. Standard therapy is not always appropriate for all patients and sometimes comes with more side effects than you think. For this reason, clinical trials are being conducted to identify more effective therapies based on the most current information available.

Stage I

Treatment options are as follows: – in selected cases, in very initial very early stage tumors and in young patients who wish to become pregnant, conservative uterine therapy with hormone therapy and possible hysteroscopic removal of only a small portion of the endometrium affected by the cancer may be offered; – hysterectomy and bilateral adnexectomy; – hysterectomy and bilateral adnexectomy with excision of pelvic and/or abdominal lymph nodes, followed by internal or external pelvic radiotherapy. After surgery, a plastic tube can be inserted into the vagina, inside which a radioactive source is placed in order to destroy any residual tumor cells; – Radiotherapy only for inoperable patients.

Stage II

The treatment options are as follows: – Hysterectomy and bilateral adnexectomy with or without excision of pelvic and abdominal lymph nodes, followed by radiotherapy; – Hysterectomy and bilateral adnexectomy with or without excision of pelvic and abdominal lymph nodes, followed by internal or external pelvic radiotherapy. Internal radiotherapy may be recommended after surgery; – Radiotherapy alone for inoperable patients.

Stage III

Treatment options are as follows: – Radical hysterectomy with excision of the pelvic lymph nodes followed by internal and external radiotherapy; – Radiotherapy alone for inoperable patients; – Chemotherapy plus radiotherapy.

Stage IV

Treatment options are as follows: – Radiotherapy, aimed at relieving symptoms; – Palliative surgery, aimed at relieving symptoms.

Recurrent endometrial carcinoma

In this case, the therapeutic options are as follows: – Palliative radiotherapy, t.е. Directed dilatationTo reduce symptoms and improve quality of life.


Thanks to Prof. G Scambia and Dr. R. De Vincenzo (Women’s and Child Health Center – A. Gemelli University Polytechnic Foundation, Catholic University of the Sacred Heart – Rome) for critical revision of the text.

What is endometrial cancer, what are the symptoms, life expectancy and treatments?

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Endometrial cancer is a disease that causes tumor cells to appear in the endometrial tissue. This is the difference with the tumor affecting the muscular component of the uterus, which is called uterine sarcoma. Since the causes of the disease are not known, there are several recognized risk factors. Other important risk factors include first menstruation at a very young age (premature menarche), menopause at an older age (also called late menopause), diabetes, obesity, and tamoxifen treatment in women with breast cancer. The risk of developing an endometrial tumor seems to increase in all those women who are forced to follow a therapy based only on estrogen hormones, which can cause and contribute to the development of certain tumors. However, when estrogen administration is combined with other progestagens, this risk does not appear to increase further.

What are the symptoms of endometrial cancer

With this tumor, diagnosis is always particularly difficult because the symptoms are quite often late. Among the most common symptoms are bloody vaginal discharge (called metrorrhagia), which may be of various types (for example, pink, dark red and bright red). In particular, we should try to deepen the issue if such losses begin to occur after menopause, since this is the ideal age at which the tumor develops. Among the various symptoms are also vaginal discharge, usually whitish in color (they are called leucorrhea), in some cases accompanied by an unpleasant odor. Pain, in most cases, is delayed when the neoplasm affects organs inside the abdomen or in the pelvis. In the early stages, in some cases, patients may feel mild pain due to uterine distension caused by the proliferation of tumor vegetations, and the uterine contractions that this distension can reactivate.

Endometrium in menopause

Regarding endometrial cancer, it should be noted that age is the most important risk factor for developing endometrial cancer. In fact, this disease is very rarely diagnosed in people who are less than 50 years old. Quite often during menopause, a gynecologist or doctor may suggest an endometrial test. With this particular test, the actual collection of cells in the uterus is carried out in such a way that potentially dangerous situations (such as hyperplasia) or, in the case, also tumors detected at the stage of. initial stage. Cell sampling is a test that is performed without any anesthesia and, moreover, causes very little pain: in most cases, it is performed in the clinic in a few minutes. This examination is recommended when the patient suffers from persistent but irregular bleeding, both during menopause and menopause, as well as during substitution therapy. Among other tests that can be helpful in detecting ovarian cancer when it is at a particularly early stage, we of course find the following transvaginal ultrasound. This is an examination that involves inserting a probe inside the vagina, and it is certainly important to keep an eye on the condition of the genital apparatus around and, in particular, the endometrium and ovaries. This examination cannot be considered unequivocally painful, but at the same time it allows us to evaluate several important aspects, such as measuring the thickness of the endometrium, which is usually very thin during the menopause, as it is about 5 millimeters.

Endometrial adenocarcinoma g2

Endometrial cancer is also often referred to as adenocarcinoma because it originates from the glandular part. At each stage, there are different degrees of tumor severity based on the cells that make up the tumor mass. The degree of differentiation is a fundamental factor in making the right prognosis to be able to understand what treatment is most appropriate. According to the most common classification, which is called FIGO, there are essentially three grades of endometrial cancer, namely G1, G2 and G3. As is easy to understand, G1 tumors have the best prognosis. Grade G1 is an adenocarcinoma composed of a portion of glands that share many features with normal glands, but have an extremely complex structure. This degree of cancer should be distinguished from endometrial polyps, as well as from chronic inflammatory processes affecting the endometrium, but also from endometrial hyperplasia. In the grade that is defined by G2, we find a less important distinction between the tumor and healthy glands, and for this reason they are defined as atypical. In the degree, which is defined as G3, glandular tumor masses are particularly bizarre, and in some cases they cannot even be defined as such. In these cases, both hemorrhages and areas of cell death are more common: the tumor is called undifferentiated adenocarcinoma.

What are the chances of survival for endometrial cancer

The five-year survival rate of endometrial cancer patients depends strongly on several factors: among others, the involvement of the lymph nodes, the degree characterizing the tumor and its severity, the achievement or absence of myometrium, the more or less aggressive type of tumor mass, whether or not the peritoneal fluid is positive for malignant cells, the cancer size and the patient’s age should be emphasized. Generally, the five-year survival rate for patients who have undergone surgery varies depending on the stage at which the tumor is. The five-year survival rate for endometrial cancer for those at stage zero is 100%, those at stage one between 72 and 98%. Patients in the second stage have a five-year survival probability of 30-75%, while in the third stage it drops to 15-60%, to drop to 3-10% when the cancer has reached terminal stage, or the fourth.