Endometrial Cancer: Symptoms, Causes and Treatment
Endometrium is the inner tissue lining of the uterus. Uterus is the pear shaped hollow organ located in the pelvis of female. It helps in conceiving child. The cancer associated with the inner lining of the uterus is known as endometrial cancer. They are categorized under a broad term of uterine cancer which also includes other types of cancer associated with the uterus like uterine sarcoma. It is easily diagnosed as most of the times, female’s complaints of abnormal bleeding from vagina. Endometrial cancer is one of the most common genital cancer of the women.
About 2.8% of women of US will be diagnosed with this cancer at some point of their life.
Symptoms of Endometrial Cancer
The signs and symptoms associated with the endometrial cancer are as follows
- Bleeding from vagina after menopause: it is the most common symptom as about 75% of women with the endometrial cancer are postmenopausal.
- Heavy menstrual bleeding in younger women
- Bleeding between periods
- Pain in the pelvis
Causes of Endometrial Cancer
Cause of endometrial cancer is not known but the combination of multiple risk factors has been identified in the patients suffering from the endometrial cancer. The accumulating change in genetic constitution of the cells of uterus makes them capable of uncontrolled proliferation and this lead to cancer.
Risk Factors for Endometrial Cancer
The factors which increases the chances of having endometrial cancer are
Abnormal hormonal balance: Estrogen and progesterone are the main female hormone produced by the ovaries of female body. Increased amount of estrogen due to any disease, condition or hormone replacement therapy relative to the levels of progesterone causes changes in the endometrium. These conditions include polycystic ovary syndrome, estrogen releasing tumor, obesity, only estrogen containing pills
Other body cancers: Women who are suffering from cancer in the other part of the body like breast, colon or ovary have an increased chanced of acquiring endometrial cancer later.
Early menstruation or late menopause: If a woman spends more years in her menstrual period then her endometrium would get more exposure to the estrogen and subsequently greater risk of having the endometrial cancer.
Obesity: more fat in the body alters the hormonal balance of the body producing more estrogen
Age: The older women are at more risk of having this type of cancer because they have attained the menopause and the estrogen concentration increases after menopause
Family history: The individuals with a family history of endometrial cancer have been identified at increased risk.
Diagnosis of Endometrial Cancer
Your doctor will use your medical history, conduct a physical examination and order some tests to establish a diagnosis
Pelvic examination: The doctor will examine the pelvic area of female, first looking at the external genitals and then inserts two lubricated gloved fingers in the vagina and will press the abdomen simultaneously with the other hand. This is done to feel the uterus and ovaries.
Ultrasonography: It is a simple imaging test where a device called as transducer emits ultrasound waves and the reflected sound waves will give us the picture of that organ. For a pelvis ultrasonography the transducer is placed on the skin of the lower abdomen and for transvaginal one it is placed in the vagina. Uterus is best seen in the transvaginal ultrasonography.
Endometrial tissue sampling: here some tissue of the endometrium is taken to look for any abnormalities like cancer cells or presence of certain mutations. It can be taken by the following procedure
- Biopsy: In endometrial biopsy, a thin tube is inserted in the uterus and a sample of the endometrial wall is taken by suction.
- Dilation and curettage: In this procedure, the opening of the cervix is enlarged and the wall is scrapped. The larger amount of tissue sample can be collected by this procedure.
- Other imaging tests: These can be done to look for the spread of the cancerous tissues to the other organs.
After diagnosis, growth and spread of cancer is assessed as it is associated with the different management and prognosis.
Treatment of Endometrial Cancer
The treatment options depend upon the stage of cancer and your preferences. The cancer team will discuss each treatment option with you. The four basic treatment options are
Surgery: The uterus is removed from the body and sometimes along with the fallopian tubes and the ovaries. After removal of the uterus you can’t have baby.
Radiation therapy: The ionizing radiations are used to kill the cancer cells. It can be recommended before the surgery to reduce tumor size or after the surgery to reduce the recurrence.
Hormone therapy: The goal of this therapy is to reduce the level of estrogen hormone and to increase the hormone level of progesterone.
Chemotherapy: These drugs are chemical which can be used to kill the cancer cells.
The benefits and risk of each therapy should be discussed with your doctors.
Prognosis of Endometrial Cancer
The outcome of the patient depends upon the stage of the cancer, treatment option and patient health. The 5-year survival rate for women goes on decreasing with the increasing stage of endometrial cancer. It is estimated that 11,350 deaths from this disease will occur this year
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