In this article, you’ll get everything you need to know about Endometrial cancer.
Endometrial cancer, sometimes called uterine cancer, is a type of cancer that begins in the endometrium, which is the inner layer of the uterus. The most common types of endometrial cancer are adenocarcinomas. One of its main symptoms is vaginal bleeding, which allows the patients to report their problem, diagnose endometrial cancer early. When cells from the inner layer of the uterus start growing out of control, they can spread to other tissues, as well. Another type of tumor that develops in the body of the uterus is uterine sarcoma.
How common is endometrial cancer?
Endometrial cancer is the most common type of cancer that occurs in the reproductive organs of women in the US. The American Cancer Society estimates 65,620 new cases of uterine cancer in the US. Also, about 12,590 women will die from tumors found in the body of the uterus. However, these estimates refer to both endometrial cancer and uterine sarcoma. The average age that women may present with endometrial cancer is about 60 years old. The disease is not common in females less than 45 years old. White women are more likely to develop it than black women. However, the latter group tolerates it worse and is more likely to die from it.
Endometrium and the uterus
The uterus is a hollow organ that has an inner lining called the endometrium. The uterus consists of the body and the cervix. However, when we talk about uterine cancers, we do not refer to cancer of the cervix. Cervical cancer is a different clinical entity. The uterus is where a fetus grows during pregnancy. Talking about the body of the uterus, it consists of two layers called the endometrium and the myometrium. The endometrium regenerates itself each time a woman finishes her menstrual flow. The myometrium is the muscle responsible for the contractions of the uterus during the menstrual flow and delivery. The serosa is a third thin layer that covers the outside of the uterus.
Endometrioid cancer, the most common type of endometrial cancer
Most endometrial cancers are adenocarcinomas. Endometrioid cancer is the most common type of uterine adenocarcinoma. It originates from the glands of the body of the uterus and resembles a healthy endometrial lining. There are many subtypes of endometrioid cancer that require different management.
Risk factors for endometrial cancer
Risk factors increase an individual’s chance to develop a disease. Some of the most well-known risk factors for endometrial cancer are the following:
- Early menstruation, late menopause, or both increase your risk for endometrial cancer. The more years of menstruation, the higher the chance of developing endometrial cancer due to prolonged estrogen exposure.
- No having been pregnant never in your life increases your chance of developing endometrial cancer in the future, in comparison with those that had at least one pregnancy.
- Being older increases your chance of presenting with endometrial cancer. The average age that women develop the disease is 60 years old.
- Being obese increases your risk for endometrial cancer. Fat tissue produces additional levels of estrogen, raising the exposure of your body to it.
- Having received hormone therapy for breast cancer raises your chance of developing the disease.
- Lynch syndrome. Also called hereditary nonpolyposis colorectal cancer (HNPCC), Lynch syndrome increases your risk for colon cancer, and other types of cancers, including the one that appears in your endometrium.
Vaginal bleeding, the most common symptom of endometrial cancer
Most women with endometrial cancer present with vaginal bleeding, which is unusual and appears in random phases. Sometimes, it might look like spotting or vaginal discharge mixed with blood. Other symptoms and signs may include pelvic pain, unintentional weight loss, or a newly formed mass. However, these symptoms are more prevalent as the disease progresses.
Types of endometrial cancer
We can classify endometrial cancer in various subtypes according to how their cells look under the microscope. The following are some of the most well-known types of endometrial cancer:
- Uterine carcinosarcoma
- Squamous cell carcinoma
- Small cell carcinoma
- Transitional carcinoma
- Serous carcinoma
Diagnosis of endometrial cancer
There are various tests and investigations that your doctor may perform to diagnose endometrial cancer. Except for history and physical examination, the following are some of the most widely-used tests and procedures to diagnose endometrial cancer:
- Pelvic exam. During a pelvic exam, your doctor examines your outer and inner genitals. To check your pelvis, she or he inserts one or two fingers into your vagina and presses against its walls. Using the other hand, she or he applies pressure on your lower abdomen to check for any abnormalities or tumors.
- Transvaginal ultrasound. This intervention creates an image of your uterus and its walls. Your doctor can visualize any potential tumors, as well as the thickness of your uterine walls.
- Hysteroscopy. This intervention uses a scope to see the inside of your uterus, which your doctor inserts through your vagina.
- Biopsy. During a biopsy, your doctor takes a sample of tissue from your uterus to examine under the microscope, and search for abnormal cancerous cells.
- Dilation & curettage (D&C). When the biopsy is not sufficient to diagnose endometrial cancer, you may undergo a D&C, during which your doctor scrapes some tissue from your uterus to examine it.
Treatment of endometrial cancer
The most commonly used therapeutic method is surgery to remove the uterus, along with the fallopian tubes and the ovaries. Other options are radiation therapy, chemotherapy, and hormone therapy. Some people may benefit from targeted therapy or immunotherapy. Doctors may combine some of these methods to further improve the outcome of the treatment.