Endometrial Cancer

One kind of cancer that starts in the uterus is endometrial cancer. The pear-shaped, hollow pelvic organ known as the uterus is where fetal development takes place.

The layer of cells that makes up the uterine lining (endometrium) is where endometrial cancer first manifests itself. Uterine cancer is another name for endometrial cancer. Uterine sarcoma is one of the several cancers that can develop in the uterus, however, it is considerably less prevalent than endometrial cancer.

Since it typically results in irregular vaginal bleeding, endometrial cancer is frequently found at an early stage. When endometrial cancer is caught early, it may frequently be treated surgically by removing the uterus.

Endometrial Cancer: Causes

The exact etiology of endometrial cancer is unknown. What is known is that something takes place to cause modifications (mutations) in the DNA of the cells that make up the endometrium, or uterine lining.

Normal, healthy cells become aberrant cells as a result of the mutation. Healthy cells develop and proliferate at a specific pace before dying at a specific period. Abnormal cells do not undergo a predetermined death; instead, they proliferate and reproduce out of control. A mass of aberrant cells develops as they accumulate (tumor). Cancerous cells can spread throughout the body by separating from an initial tumor and invading surrounding tissues (metastasizing).

Endometrial Cancer: Symptoms

The patient with endometrial cancer mainly presents with the following symptoms that include −

• Bleeding after menopause in the vagina

• Bleeding in between cycles

• Pelvic discomfort

When to Visit a Doctor?

If you notice any recurring signs or symptoms that bother you, schedule a visit with your doctor.

Endometrial Cancer: Risk Factors

Several factors play an important role in the development of endometrial cancer which includes −

• Alterations in the body's female hormone balance. Progesterone and estrogen are the two primary female hormones produced by the ovaries. The endometrium changes as a result of changes in the hormone balance.

• Your chance of developing endometrial cancer might rise if you have an illness or condition that raises the levels of progesterone but not estrogen in your body. Examples include obesity, diabetes, and polycystic ovarian syndrome, which can cause irregular ovulation patterns. The risk of endometrial cancer is increased when estrogen-only hormones are used after menopause.

• The risk of endometrial cancer can also rise in uncommon ovarian tumors that release estrogen.

• More menstrual cycles throughout time. Endometrial cancer risk is increased by early menstruation (before age 12) and delayed onset of menopause. The more estrogen your endometrium has been exposed to, the more periods you've had.

• Never having given birth. You are more likely to get endometrial cancer if you have never been pregnant than if you have at least one pregnancy under your belt.

• Age. The chance of developing endometrial cancer rises with age. After menopause, endometrial cancer most frequently develops.

• Obesity. Obesity raises your chance of developing endometrial cancer. This could happen as a result of your body's hormone balance being altered by extra body fat.

• Breast cancer hormone treatment. Tamoxifen, a hormone treatment medication used to treat breast cancer, can raise the risk of endometrial cancer. Talk to your doctor about this risk if you use tamoxifen. The advantages of tamoxifen often outweigh the little risk of endometrial cancer.

• A hereditary condition of colon cancer. The syndrome known as Lynch raises the risk of endometrial cancer as well as colon and other malignancies. Lynch syndrome is also known as hereditary nonpolyposis colorectal cancer (HNPCC). A gene mutation that is transmitted from parents to children is the cause of Lynch syndrome. Discuss your risk of developing the genetic syndrome with your doctor if a family member has been identified as having Lynch syndrome. Ask your doctor what cancer screening procedures you should have if you have been given a diagnosis of Lynch syndrome.

Endometrial Cancer: Diagnosis

The diagnosis of endometrial cancer is mainly done based on history and some of the tests may be required for confirmation and to rule out underlying causes

• The pelvis is being examined. Your doctor will carefully examine the vulva, the outside area of your genitalia, and will then place two fingers of one hand inside the vagina while pressing the other hand against your belly to feel your uterus and ovaries.

• Make an image of your uterus out of sound waves. To check the thickness and texture of the endometrium and help rule out other issues, your doctor can advise transvaginal ultrasound.

• Inspect your endometrium using a scope.

• Removing a tissue sample for analysis.

Endometrial Cancer: Treatment

The treatment is based on the severity of the symptoms. Your doctor may advise conservative or surgical treatment.

Conservative Treatment

To destroy cancer cells, radiation treatment employs powerful energy beams like protons and X-rays. In rare cases, your doctor could advise radiation to lower your chance of developing cancer again following surgery.

Chemotherapy kills cancer cells by using chemicals. One chemotherapy medicine may be administered to you, or two or more drugs may be combined. You can take chemotherapy medications orally or intravenously (intravenously).

Surgical Treatment

Surgical treatment may be required in severe cases. The most common form of treatment for endometrial cancer is a hysterectomy, which also entails the removal of the ovaries, fallopian tubes, and uterus (salpingo-oophorectomy). Future pregnancies are not feasible for you if you get a hysterectomy. Also, if you haven't already gone through menopause, you will when your ovaries are removed.

Endometrial Cancer: Prevention

Some of the measures that can help to prevent endometrial cancer include −

• Discuss the dangers of hormone replacement treatment with your doctor. Consult your doctor about the advantages and disadvantages of hormone replacement therapy before deciding whether to use it to help manage menopausal symptoms. During menopause, supplementing estrogen on your own may raise your risk of endometrial cancer unless you've had a hysterectomy. This risk can be decreased by taking estrogen and progestin together. Discuss the advantages and disadvantages of hormone treatment with your doctor as other dangers are involved.

• Take into account using birth control tablets. Endometrial cancer risk may be decreased by using oral contraceptives for at least a year. If you stop using oral contraceptives, the risk decrease is believed to continue for several years. But, oral contraceptives might have negative effects, so talk to your doctor about the advantages and disadvantages.

• Keep a healthy weight. Maintaining a healthy weight is important since it lowers the chance of endometrial cancer. Increase your physical activity and cut back on your daily calorie intake if you need to lose weight.

Conclusion

An interprofessional team composed of bariatric surgeons, oncology and gynecologist nurses, pharmacists, and nutritionists provides the best care for endometrial cancer patients. The best course of action after diagnosis is total excision. The results are positive for individuals with isolated lesions, while the prognosis is questionable for those with big and invasive lesions.

The best course of action is to avoid this malignancy, thus patients have to be urged to alter their lifestyles, lose weight, and adopt a healthy diet.