Understanding Endometrial Cancer

Understanding Endometrial Cancer

What is Endometrial Cancer?
Endometrial cancer is cancer of the endometrium, the lining of the uterus. It is the most common type of cancer that affects the female reproductive organs. It develops when the cells of the endometrium start to grow too rapidly. The lining of the uterus may get thicker in places and form a mass of tissue called a tumor, and spread to nearby structures and to other areas of the body.

Types of Endometrial Cancer
Endometrial cancers are categorized into two main types:

• Type 1: These cancers are generally less aggressive and linked to excess estrogen. They typically grow slowly and are less likely to spread.

• Type 2: More aggressive and likely to grow and spread beyond the uterus. Type 2 cancers are not related to estrogen excess and have a poorer outlook.

Endometrial carcinomas are further classified based on microscopic cell appearance, known as histological subtypes. Common types include:

• Adenocarcinoma (most common)

• Adenosquamous carcinoma

• Uterine carcinosarcoma

• Clear-cell carcinoma

• Mucinous adenocarcinoma

• Undifferentiated carcinoma

Risk Factors for Endometrial Cancer
Various factors increase the risk of developing endometrial cancer:

• Age: Common in postmenopausal women.

• Hormone levels: Excess estrogen without adequate progesterone can thicken the endometrium.

• Overweight: A Higher body mass index (BMI) increases the risk.

• Genetics: Conditions like Lynch syndrome raise the risk of endometrial and other cancers.

• Hormone replacement therapy: Estrogen-only therapy may increase risk.

Symptoms of Endometrial Cancer
The most common symptom is abnormal uterine bleeding. This can include:

• Irregular bleeding or spotting

• Bleeding between menstrual periods (before menopause)

• Postmenopausal bleeding (any bleeding after menopause)

Advanced symptoms may include pelvic pain, bloating, feeling full quickly when eating, and changes in bowel or bladder habits.

Diagnosis and Screening
Endometrial cancer is usually diagnosed after the onset of symptoms. Screening tests are not commonly available, but tests used for diagnosis include:

• Transvaginal ultrasound: Measures the thickness of the endometrium and assesses uterine size.

• Endometrial biopsy: Involves removing and examining a tissue sample from the endometrium.

• Dilation and curettage (D&C) or hysteroscopy: Techniques to collect samples for a more thorough examination.

Treatment Options
Treatment for endometrial cancer typically involves surgery, such as removing the uterus (total hysterectomy) and both ovaries and fallopian tubes (salpingo-oophorectomy). Other options include:

1. Radiation Therapy
Radiation uses high-energy X-rays to stop cancer cell growth, often recommended for higher stages or to reduce recurrence risk.

2. Chemotherapy
Chemotherapy involves using drugs to kill cancer cells. It's often recommended for advanced stages or recurrent cancer and may be combined with radiation therapy.

Stages of Endometrial Cancer
After surgery, endometrial cancer is staged from I to IV. Stage IV is the most advanced, where cancer has spread to distant organs. Staging helps guide treatment and predict outcomes.