About Endometrial Cancer

The endometrium is the uterus lining shed during each menstrual cycle. Cancer that begins in this uterine lining is called endometrial cancer. It is the fourth most common cancer in the UK. There are different uterine cancers, but endometrial cancer is most commonly occurring. Endometrial cancer grows very slowly, so routine check-ups help detect the condition and prevent further spread. Endometrial cancer is a condition usually occurring in women above 50 years. Since this cancer causes early symptoms like vaginal bleeding, most women seek medical care promptly. Early diagnosis and prompt treatment help improve prognosis and prevent recurrence of endometrial cancer. The five-year survival rate or endometrial cancer life expectancy is 72%. Family history, obesity, metabolic syndrome, taking medications containing oestrogen without progesterone or tamoxifen for breast cancer increase your risk of developing endometrial cancer. If not diagnosed and treated in time, endometrial cancer can spread to nearby organs like the bladder, rectum, vagina, ovaries of the fallopian tubes.

Symptoms

The most common and earliest symptom of endometrial cancer is abnormal vaginal bleeding (usually postmenopausal). In premenopausal women, the symptoms of endometrial cancer include:

 

  • Changes in the length and pattern of periods
  • Vaginal bleeding between periods

 

Other symptoms of endometrial cancer include:

  • Watery or blood-tinged vaginal discharge
  • Pain in the pelvic region
  • Painful sex
  • Painful urination
  • Sudden or unexpected weight loss
  • Weakness and pain in the abdomen and back (occurs when endometrial cancer has spread to other organs)

 

Endometrial cancer rarely occurs before menopause but can occur during it. So, if you experience one or more of these symptoms, visit your doctor. Though these symptoms are not exclusive to endometrial cancer, it is best to get them checked up.

 

Diagnosis

When you visit your doctor with possible symptoms of endometrial cancer, they will take a complete medical and family history, followed by a thorough physical examination to determine any abnormalities in the uterus. Next, a transvaginal ultrasound (an imaging test) is performed, during which a small ultrasound probe is inserted into your vagina to visualise the uterus internally. If case of any abnormality, your doctor may advise tissue sampling by an endometrial biopsy, hysterectomy or dilatation and curettage.

 

The tissue sample collected are sent for laboratory analysis. If the samples test positive for cancer, they are further staged and graded to determine endometrial cancer treatment options available to you. In the case of advanced or stage 3 and stage 4 endometrial cancer, a pelvic ultrasound, CT scan, MRI, PET scan, or cystoscopy may be recommended to determine the extent and spread of cancer. 

 

A CA-125 blood test may be advised, along with routine blood tests. CA-125 is a substance released into the blood by some endometrial and ovarian cancers. High CA-125 levels indicate that endometrial cancer has spread beyond the uterus. CA-125 levels are also monitored to determine how to treat endometrial cancer before surgery and understand if the treatment is working.

Treatment

Though chemotherapy and endometrial cancer are often discussed together, the decision of how to treat endometrial cancer depends on multiple factors. There are many endometrial cancer treatment options, but your doctor will create the best treatment plan for you based on your cancer’s stage, type, and spread. 

 

The primary treatment options for endometrial cancer are – Surgery, Radiation Therapy, Chemotherapy and Hormone Therapy. Other treatment options include targeted therapy and immunotherapy.

 

Surgery is always the first choice of treatment for endometrial cancer and may involve the removal of the uterus (stage I) and uterus with the fallopian tubes and ovaries (stage 2). Depending upon the stage of cancer, radiation and chemotherapy may be performed before or after the surgery.

 

In stage 3 and stage 4 endometrial cancer, cancer has spread outside the uterus. The treatment of these advanced high-grade cancers includes surgical removal of the uterus, fallopian tubes, ovaries and the affected lymph nodes. The surgery is followed up by radiation therapy, chemotherapy or a combination of both.  

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