Endometrial Cancer

Endometrial cancer is a type of cancer that begins in the uterus. Endometrial cancer is sometimes called uterine cancer. Other types of cancer can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer.

SIGNS AND Symptoms

Signs and symptoms of endometrial cancer may include:

  • Vaginal bleeding after menopause
  • Bleeding between periods
  • An abnormal, watery or blood-tinged discharge from your vagina
  • Pelvic pain

Risk factors for uterine cancer

Certain factors can make you more likely to get uterine cancer. These are called risk factors. But just because you have one or more risk factors does not mean you will definitely get uterine cancer. In fact, you can have all the risk factors and still not develop the disease. Or you can have no risk factors and still get uterine cancer. Here are the main risk factors for uterine cancer. Many of these risk factors are for endometrial carcinoma. These risks involve having too much exposure to the hormone estrogen:

  • Polycystic ovarian syndrome (PCOS). Women with PCOS have abnormal hormone levels. These imbalances can increase the risk of uterine (endometrial) cancer.
  • Obesity. Women who are obese get uterine (endometrial) cancer 3 times more often than women who are not obese. Obesity is a leading risk factor for endometrial cancer. Health conditions linked to obesity, such as diabetes, also increase your risk.
  • Early menstruation. Women who had their first period before they were 12 have a higher risk for uterine (endometrial) cancer.
  • Late menopause. Women who reach menopause after age 50 have a higher risk for uterine (endometrial) cancer.
  • Older age. Most women who get uterine (endometrial) cancer are older than age 50.
  • Endometrial hyperplasia. Women who have endometrial hyperplasia have a higher risk of getting uterine (endometrial) cancer. Endometrial hyperplasia means that there are more cells than there should be in the lining of the uterus. This is called a precancerous condition because it might turn into cancer. Women with endometrial hyperplasia may have unusual bleeding.
  • No pregnancies. Women who have never been pregnant have a higher chance of uterine (endometrial) cancer.
  • Family history of uterine (endometrial) cancer. Women with family members who have had uterine or colon cancer are more likely to get it.
  • Previous radiation therapy to the pelvis. If you have had pelvic radiation in the past, your risk for developing uterine cancer (sarcoma and endometrial) is increased.
  • Tamoxifen use:  Tamoxifen is a drug used to treat women who have breast cancer and is used to help prevent breast cancer in women at high risk. Women who take tamoxifen have a higher risk of getting uterine (endometrial) cancer.

Diagnosis of uterine cancer

To check your symptoms, your doctor will ask about your medical history and do a physical examination. This will include a pelvic examination.

  • An endometrial biopsyis needed to confirm a diagnosis of endometrial cancer. A biopsy removes a small sample of the lining of the uterus (endometrium) to be looked at under a microscope.

Other tests may include:

  • A transvaginal pelvic ultrasound. This uses sound waves to create images of the uterus. The images can show how thick the endometrium is. A thick endometrium can be a sign of cancer in post-menopausal Ultrasound also can help show whether cancer has grown into the uterine muscle.
  • A hysteroscopy. This allows your doctor to view the inside of the uterus and get an endometrial tissue sample.
  • Dilation and curettage(D&C). This test is done to get a sample of tissue from the inside of the uterus. It may be done at the same time as a hysteroscopy.

Treatments for uterine cancer?

Treatments for uterine cancer include surgery, radiation therapy, hormone therapy, and chemotherapy.

  1. Surgery  is the most common treatment for women with uterine cancer, and often the only treatment needed. A standard surgery for endometrial cancer is the removal of the uterus (hysterectomy), with removal of the attached ovaries and fallopian tubes. In many cases, your doctor will also recommend removal of lymph nodes from the abdomen and pelvis to see if the cancer has spread. The complete surgery of hysterectomy with lymph node removal is called surgical staging. Surgical staging can be performed through an incision on your abdomen (laparotomy, open procedure) or by laparoscopy (minimally invasive surgery using cameras to help with the surgery) Your doctor will discuss which approach is best and why.
  2. Radiation uses high-energy beams directed to an area in the body (for endometrial cancer, the pelvis) to kill cancer cells. Radiation is most frequently used after surgery, but in some cases is used before surgery.
  3. Chemotherapy  is the use of anticancer drugs typically administered by vein to kill cancer cells. Chemotherapy is a systemic therapy (travels from head to toe) which works throughout the body, while radiation therapy only works on the area where the radiation is given. Chemotherapy may given to patients whose cancer has spread at the time of their diagnosis or to treat a cancer which comes back (recurs).
  4. Hormone therapy  is a type of drug therapy frequently using a class of hormones called progestins. The drugs are given by mouth or by injection. They travel through the body in the blood and can work on special targets on cancer cells called hormone receptors. Hormone therapy is used to treat widespread disease or cancers that return (recur).