Endometrial Cancer

Endometrial cancer is the type of cancer in which there is an uncontrolled growth of cells in the lining of the womb.

Associated Anatomy

The endometrium / the inner lining of the uterus

Alternate Name of Endometrial Cancer

Endometrial Carcinoma

Signs or Symptoms of Endometrial Cancer

• Unusual discharge or bleeding through the vagina that has no relation with menstruation
• Bleeding through the vagina during the post-menopausal period
• Pain and discomfort during urination
• Presence of a painful mass in the pelvic region
• Painful intercourse
• Alteration in menstrual flow and duration of the menstrual period
• Abdominal pain
• Enlargement of the uterus
• Weight loss with no detectable cause

Causes of Endometrial cancer

The exact causes of endometrial cancer are still not clear, but the following factors deserve a particular mention:

• Fluctuating levels of sex hormones can stimulate the division and multiplication of endometrial cells.
• Metabolic syndrome involves higher levels of fasting blood sugar, central obesity, hypertension, higher levels of triglycerides, and lower levels of HDL
• Type 2 diabetes
• Beginning of menstruation at a young age of fewer than twelve years
• Delay in the onset of menopause
• Endometrial hyperplasia (endometrial overgrowth)
• History of ovarian cysts
• History of breast or ovarian cancer

Various Stages of Endometrial Cancer

The stage of endometrial cancer determines the spread of cancer and influences the Endometrial Cancer treatment and possible outlook.

• Stage I- In this stage, endometrial cancer is present in the uterus.
• Stage II- The cancer is spreading from the uterus to involve the cervix
• Stage III- The stage indicates that the endometrial cancer is spread to lymph nodes in the surrounding area along with ovaries, fallopian tubes, and vagina
• Stage IV- Cancer spreads across the rectum and bladder. It may even involve distant organs and tissues.

Endometrial Cancer Treatment

There are several options to treat endometrial cancer. The physician considers the individual’s age, general health, the cancer spread, and other factors to choose the suitable Endometrial Cancer Treatment

• Surgery- surgical removal of the womb is a standard treatment of endometrial cancer. The doctor may consider performing more surgeries to arrest cancer spread to other regions.
• Radiation therapy- It is helpful after the surgery or along with chemotherapy to kill cancer cells effectively. It also helps treat large cancers that are not likely to spread further.
• Chemotherapy- As the term suggests, chemotherapy involves using potent chemicals through oral or intravenous routes. Chemotherapy is suitable for treating endometrial cancer in the advanced stage. It also helps reduce the size of cancer for ease of surgical removal.
• Hormone therapy- Using progesterone may result in retarding the spread of endometrial cancer. It is helpful in widespread cancers.
• Immunotherapy- It aims to stimulate the body’s natural ability to fight the cancer

Risk Factors That May Cause Endometrial Cancer

• Obesity causes an imbalance of sex hormones. It may increase the risk of endometrial cancer.
• Consumption of a diet that is high in animal fat
• No history of pregnancy because of infertility and other reasons
• The use of anti-estrogen agents like tamoxifen for treating breast cancer can increase endometrial cancer risk
• Genetic factors like Lynch syndrome can increase the risk of cancers
• Using Hormone Replacement Therapy containing only estrogen
• Family history of endometrial cancer
• Old age

Possible Complications of Endometrial Cancer

The most common complication of endometrial cancer is anaemia. It can also cause heavy bleeding through the vagina that has no association with menstruation. The spread of endometrial cancer to female reproductive organs, lungs, and liver are also some possible complications of this cancer. The spreading of cancer to other organs is known as metastasis.

Typical Tests for Diagnosis of Endometrial Cancer

Transvaginal ultrasound helps detect abnormalities in the lining of the uterus. The physician may recommend an endometrial biopsy. It involves tissue removal from the uterine lining for further examination. The biopsy can detect the presence of cancerous cells to confirm the diagnosis of endometrial cancer. PET scan is also a useful diagnostic measure to detect endometrial cancer.

Prevention of Endometrial Cancer

Primary Prevention of Endometrial Cancer

• Maintain a Healthy Weight- Aiming to reduce weight can help since obesity is one of the risk factors for endometrial cancer.
• Understanding the Risk of HRT- Hormone Replacement Therapy can cause endometrial cancer.
• Treating Abnormal Bleeding in Time- Irregular vaginal bleeding may indicate the presence of hyperplasia. It needs timely treatment to prevent the development of endometrial cancer.
• Genetic Testing- Ladies with a family history of Lynch syndrome should undergo genetic testing. Physicians may suggest the removal of the uterus, ovaries, and fallopian tubes to prevent the possibility of uterine cancer.

Secondary Prevention of Endometrial Cancer

One should consider the following to reduce the risk of recurrence after successful treatment of endometrial cancer:

• Adopting a Healthy Lifestyle- Regular exercise and a healthy diet can help
• Maintain a Healthy Weight- Prevent obesity because it is one of the risk factors of endometrial cancers
• Understanding The Risks of HRT- Hormone Replacement Therapy is a vital risk factor, and one should stay away from the same

Epidemiology of Endometrial Cancer

• High incidence- The incidence of endometrial cancer across the globe is the second-highest among all forms of gynaecological cancers.
• Common in older women- Endometrial cancer is more women in the post-menopausal age group (median age -60 years). Endometrial cancer is rare in women less than 45 years of age.

Prognosis of Endometrial Cancer

Expected Prognosis of Endometrial Cancer

Endometrial cancer is a treatable condition, and the outlook is much better with early diagnosis and treatment. Stage I and Stage II endometrial cancers are treatable with surgery alone. There are fair chances of survival. Average survival rates of five years are possible in 95% of patients with localized endometrial cancer.

The Natural Progression of Endometrial Cancer

Untreated endometrial cancer may spread to other female reproductive organs. It may involve:

• Ovaries
• Fallopian tubes
• Vagina
• Bladder
• Rectum
• Endometrial cancer can spread to the pelvis with no treatment.
• The spread of endometrial cancer to distant organs like the lungs and liver is possible in the later stages.

Pathophysiology of Endometrial Cancer

Researchers are trying to find what causes the endometrial DNA to mutate and become cancerous. The presence of higher estrogen levels than progesterone results in the thickening of the lining of the womb. A continuous buildup of the inner lining can offer a suitable environment for the growth of endometrial cancer cells.