Description

Endometrial cancer is a type of cancer that begins as a growth of cells in the uterus. The uterus is the hollow, pear-shaped pelvic organ where fetal development occurs.

Endometrial cancer begins in the layer of cells that form the lining of the uterus, called the endometrium. 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.

Endometrial cancer is often found at an early stage, since the cause of the symptoms. Often, the first symptom is irregular vaginal bleeding. If endometrial cancer is found early, the surgical removal of the uterus is often a cure.

Symptoms

The symptoms of endometrial cancer may include:

  • Vaginal bleeding after menopause.
  • Bleeding between periods.
  • Pain in the pelvis.

When to see a doctor

Make an appointment with a health care professional if you experience any symptoms that worry you.

Causes

The cause of endometrial cancer is not known. What is known is that something happens to the cells in the lining of the uterus, changes in the cancer cells.

Endometrial cancer starts when cells in the lining of the uterus, called the endometrium, the changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. The changes that indicate cells that multiply rapidly. The changes also tell the cells to continue living when healthy cells would die as part of their natural life cycle. This causes a large amount of cells. The cells may form a mass called a tumor. The cells can invade and destroy healthy body tissue. At the time, cells can break away and spread to other parts of the body.

Risk factors

The factors that increase the risk of endometrial cancer include:

  • Changes in the balance of hormones in the body.The two main hormones of the ovaries are estrogen and progesterone. Changes in the balance of these hormones produce changes in the endometrium. A disease or condition that increases the amount of estrogen, but not progesterone level in the body can increase the risk of endometrial cancer. Examples include obesity, diabetes, and irregular ovulation patterns, which could occur in the polycystic ovary syndrome. Taking hormone therapy medicine that contains estrogen, but not progesterone after menopause increases the risk of endometrial cancer. A rare type of ovarian tumor that produces estrogen may also increase the risk of endometrial cancer.
  • More years of menstruation. Starting menstruation before age 12 years of age or the onset of menopause later increases the risk of endometrial cancer. The greater the number of periods that we've had, the greater exposure of your endometrium has had to estrogen.
  • Never having been pregnant. If you have ever been pregnant, you have a higher risk of endometrial cancer than someone who has had at least one pregnancy.
  • Advanced age. As you get older, your risk of endometrial cancer increases. Endometrial cancer occurs most commonly after menopause.
  • Obesity. Being obese increases the risk of endometrial cancer. This can happen because the excess fat in the body can alter the body's balance of hormones.
  • Hormone therapy for breast cancer. Taking the medicine, hormonal therapy with tamoxifen for breast cancer can increase the risk of developing endometrial cancer. If you are taking tamoxifen, discuss the risk with your health care team. For most, the benefits of tamoxifen outweigh the small risk of endometrial cancer.
  • A hereditary syndrome that increases the risk of cancer. Lynch syndrome increases the risk of colon cancer and other cancers, including endometrial cancer. Lynch syndrome is caused by a change in DNA that is passed from parents to children. If a family member has been diagnosed with Lynch syndrome, ask your health care team about your risk of this genetic syndrome. If you have been diagnosed with Lynch syndrome, ask what cancer screening tests you need.

Changes in the balance of hormones in the body. The two main hormones of the ovaries are estrogen and progesterone. Changes in the balance of these hormones produce changes in the endometrium.

A disease or condition that increases the amount of estrogen, but not progesterone level in the body can increase the risk of endometrial cancer. Examples include obesity, diabetes, and irregular ovulation patterns, which could occur in the polycystic ovary syndrome. Taking hormone therapy medicine that contains estrogen, but not progesterone after menopause increases the risk of endometrial cancer.

A rare type of ovarian tumor that produces estrogen may also increase the risk of endometrial cancer.

Prevention

To reduce your risk of endometrial cancer, you may want to:

  • Talk with your health care team about the risks of hormone therapy after menopause. If you are considering hormone replacement therapy to help control the symptoms of the menopause, ask about the risks and benefits. Unless you have had your uterus removed, the replacement of estrogen alone after menopause can increase the risk of endometrial cancer. A hormone therapy of the medicine that combines estrogen and progestin may reduce this risk. Hormone therapy involves other risks, so you should weigh the risks and benefits with your health care team.
  • Consider the possibility of taking birth control pills. The use of oral contraceptives for at least a year, you can reduce the risk of endometrial cancer. Oral contraceptives are contraceptives which are taken in pill form. Also called birth control pills. The risk reduction is designed to last for several years after stopping oral contraceptives. Oral contraceptives have side effects, though, so discuss the benefits and risks with your health care team.
  • Maintain a healthy weight. Obesity increases the risk of endometrial cancer, so work to achieve and maintain a healthy weight. If you need to lose weight, increase physical activity and reduce the number of calories you eat each day.

Diagnosis

The diagnosis of endometrial cancer

Tests and procedures used to diagnose endometrial cancer include:

  • The examination of the pelvis.A pelvic exam checks the reproductive organs. On many occasions is done during a routine medical check-up, but may be necessary if you have symptoms of endometrial cancer. During the test, a health care professional to inspect carefully the external genital organs. Two fingers of one hand are inserted into the vagina and with the other hand exerts pressure on the abdomen to feel your uterus and ovaries. A device called a speculum is inserted into the vagina. The device opens the vaginal canal so that the health care professional can check for signs of cancer or other problems.
  • Imaging tests. Imaging tests make pictures of the inside of the body. They can tell you to your health care team about your cancer, the location and the size. A test image may be a transvaginal ultrasound. In this procedure, similar to rods a device called a transducer is placed in the vagina. The transducer uses sound waves to create a video image of the uterus. The image shows the thickness and texture of the endometrium. The ultrasound can help your health care team for signs of cancer and rule out other causes of your symptoms. Other imaging tests such as magnetic resonance imaging and computed tomography can also be suggested.
  • The use of an endoscope to examine the endometrium, called a hysteroscopy. During a hysteroscopy, a health care professional inserts a thin, flexible, lighted tube through the vagina and cervix into the uterus. This tube is called a hysteroscope. A goal in the hysteroscope allows the health professional to examine the inside of the uterus and the endometrium.
  • The removal of a sample of tissue for testing, called a biopsy. In an endometrial biopsy, a sample of tissue is removed from the wall of the uterus. An Endometrial biopsy is often done in a professional of the health of the office. The sample is sent to a lab for testing to see if it is cancer. Other special tests to give more details on the cancer cells. Your health care team uses this information to make a treatment plan.
  • Performing surgery to remove tissue for analysis. If a sufficient amount of tissue cannot be obtained during a biopsy or if the biopsy results are not clear, it is likely that you will need to undergo a procedure called dilation and curettage, also called a D&C. During the D&C , the tissue is scraped from the lining of the uterus and examined under a microscope to look for cancer cells.

The examination of the pelvis. A pelvic exam checks the reproductive organs. On many occasions is done during a routine medical check-up, but may be necessary if you have symptoms of endometrial cancer.

During the test, a health care professional to inspect carefully the external genital organs. Two fingers of one hand are inserted into the vagina and with the other hand exerts pressure on the abdomen to feel your uterus and ovaries. A device called a speculum is inserted into the vagina. The device opens the vaginal canal so that the health care professional can check for signs of cancer or other problems.

If endometrial cancer is located, probably refers to a doctor who specializes in the treatment of cancers that involve the reproductive system, called a gynecologist oncologist.

The staging of endometrial cancer

Once the cancer has been diagnosed, your health care team working to determine the extent of your cancer, called the stage. The tests used to determine stage of cancer may include a chest x-ray, ct scan, blood tests and positron emission tomography, also called PET scan. Stage of cancer may not be known until after the surgery to treat his cancer.

Your health care team uses the information from these tests and procedures to assign the cancer a stage. Stages of endometrial cancer are indicated with numbers ranging from 1 to 4. The lowest stage means that the cancer has not grown beyond the cervix. In stage 4, the cancer has grown to involve nearby organs, such as the bladder or has spread to distant areas of the body.

Treatment

Endometrial cancer is usually treated with surgery to remove the cancer. This may include the removal of the uterus, fallopian tubes, and ovaries. Other treatment options may include radiation therapy, or treatments, the use of drugs to kill cancer cells. Options for the treatment of cancer of the endometrium, will depend on the characteristics of your type of cancer, such as stage, your general state of health and your preferences.

Surgery

The treatment for endometrial cancer usually requires an operation to remove the uterus, called a hysterectomy. The treatment usually consists of the removal of the fallopian tubes and the ovaries, called a bilateral salpingo-oophorectomy. A hysterectomy makes it impossible for you to become pregnant in the future. Also, once the ovaries are removed, you will have the experience of menopause if you haven't already.

During the surgery, the surgeon will inspect the areas around your uterus to look for signs that the cancer has spread. The surgeon may also remove the lymph nodes of the test. This helps determine the stage of the cancer.

Radiation therapy

Radiation therapy uses powerful energy to kill cancer cells. The energy can come from X-rays, protons or other sources. In certain situations, we may recommend radiation therapy before surgery. Radiation therapy can reduce the size of a tumor and make it easier to remove.

If you are not healthy enough to undergo the surgery, you can opt for the radiotherapy alone.

The radiation therapy may involve:

  • The radiation from a machine outside the body. During external beam radiation, you lie on a table while a machine that directs radiation to specific points in the body.
  • The radiation is placed on the inside of your body. The internal radiation called brachytherapy, which consists of a radiation-filled devices, such as small seeds, wires, or a cylinder. This device is placed inside the vagina during a short period of time.

Chemotherapy

Chemotherapy uses strong drugs to kill cancer cells. Some people receive a chemotherapy drug. Others receive two or more drugs together. The majority of chemotherapy drugs are given through a vein, but some are taken in pill form. These drugs enter the bloodstream and then travel through the body, killing cancer cells.

Chemotherapy is sometimes used after surgery to decrease the risk that the cancer may return. Chemotherapy may also be used before surgery to reduce the size of the cancer. This makes it more likely that the cancer is completely removed during surgery.

Chemotherapy can be recommended for the treatment of advanced endometrial cancer that has spread beyond the uterus, or to treat cancer that has come back.

Hormone therapy

Hormone therapy involves taking medications to lower levels of hormones in the body. In response, cancer cells that depend on hormones to help grow could die. Hormone therapy may be an option if you have an advanced endometrial cancer that has spread beyond the uterus.

Targeted therapy

Targeted therapy uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, specific treatments can cause cancer cells to die. Targeted therapy is usually combined with chemotherapy for the treatment of advanced endometrial cancer.

Immunotherapy

Immunotherapy uses of medicine that helps the body's immune system destroys the cancer cells. The immune system fights diseases by attacking the germs and other cells that should not be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells. For endometrial cancer, immunotherapy might be considered if the cancer is advanced and other treatments have not helped.

Palliative care

Palliative care is a special type of health care that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve the pain and other symptoms. Palliative care is performed by a team of health professionals. This may include doctors, nurses and other specially trained professionals. Your goal is to improve the quality of life for you and your family.

Palliative care specialists work with you, your family and your health care team to help you to feel better. They provide an extra layer of support, while you have cancer treatment. You can have palliative care at the same time so strong cancer treatments, such as surgery, chemotherapy or radiation therapy.

When palliative care is used along with all other appropriate treatments, people with cancer may feel better and live longer.

Coping and support

After receiving a diagnosis of endometrial cancer, you may have many questions, fears and concerns. Each person who finally found a way to deal with an endometrial cancer diagnosis. In time, you'll find what works for you. Until then, you can try:

  • To find out enough about endometrial cancer to make decisions about your care. To find out enough about your cancer so that you feel comfortable about the decision making of treatment. Ask your health care team about the case and its treatment options and their side effects. Ask your care team to recommend places that you can go to get more information about the cancer. Good sources of information include the National Cancer Institute and the American Cancer Society.
  • Maintain a strong support system. Strong relationships can help you to deal with the treatment. Speak with close friends and family members about how you feel. Connect with other cancer survivors through support groups in your community or online. Ask your health care team about support groups in your area.
  • Stay involved in your usual activities when you can. When you feel up to it, try to stay engaged in their usual activities.

Preparing for your appointment

Make an appointment with a member of your health care team or to a gynecologist if you have symptoms that concern you. If you are diagnosed with endometrial cancer, it is likely to be referred to a doctor who specializes in cancers of the reproductive system, called a gynecologist oncologist.

Because appointments can be brief and there's often a lot to discuss, it is a good idea to be prepared. Here's some information to help you prepare, and what you can expect from your health care team.

What you can do

  • Write down any symptoms you're experiencing, including any that do not appear to be related to the reason for your appointment.
  • Make a list of all the medicines, vitamins, and supplements you are taking. Also keep in mind if you have used any type of hormone therapy in the past, including birth control pills, tamoxifen or other hormonal treatments.
  • Ask a family member or friend to accompany you. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their health care team.

Your time with your doctor is limited, so preparing a list of questions in advance can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For endometrial cancer, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • There are other possible causes of the symptoms?
  • What tests do I need to diagnose endometrial cancer?
  • There are other tests for cancer staging?
  • What treatments are available? What side effects can I expect from each treatment? How these treatments affect my sexuality?
  • What do you think is the best course of action for me?
  • What are the alternatives to the primary approach you're suggesting?
  • I have other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Has my cancer spread? What stage is it?
  • What is my prognosis?
  • You should see a specialist? What will that cost, and will my insurance cover it?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

In addition to the questions you have prepared, do not hesitate to ask questions during your appointment.

What to expect from your doctor

Be prepared to answer some questions about your symptoms. The questions may include:

  • Have you experienced any unusual vaginal bleeding or discharge? How often does that occur?
  • Do you have any pelvic pain?
  • Have you had any other symptoms?
  • The symptoms been continuous or occasional?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • You took estrogen-only hormone therapy for menopause symptoms?
  • Do you have any personal history of cancer?
  • Have other members of your family has been diagnosed with cancer? At what age did your family when you were diagnosed? What types of cancer?
Symptoms and treatment of Endometrial cancer