Statistically, 3 out of 100 women are diagnosed with endometrial cancer at some point in their lives, with endometrial cancer being the sixth most common type of cancer globally and the 14th most common cause of death in women. Find out what screening is and how it helps diagnose cancer?
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What is endometrial cancer?
The uterus has 3 tunics made up of different types of tissue, an outer one, called the perimeter, which surrounds the uterus, a middle one, called the myometrium and made up of muscle tissue, and an inner one, which lines the uterine cavity and is the functional layer, shed by the woman at each menstrual cycle. Unlike the rare form of uterine cancer, which affects the middle layer (uterine sarcoma), endometrial cancer formed within the endometrium occurs much more commonly in women. We also recommend what is uterine fibroid and when should it be operated?
Endometrial cancer is cancer originating in the cells of the endometrium, the lining of the uterus, which is shed by menstrual bleeding when fertilization of the egg has not taken place.
The causes of endometrial cancer are still uncertain. Normally, any malignant tumor results from a defect (mutation) in the DNA of the cells in the tissue concerned or a defect in DNA replication, which also spreads to the daughter cells. These mutations turn healthy cells into cancer cells, which do not follow the rules of a healthy cell and divide uncontrollably, accumulating and forming the tumor.
What symptoms accompany endometrial cancer?
The most prominent symptom of endometrial cancer is abnormal vaginal bleeding. Some of its characteristics may be:
- Changes in the length of menstrual periods;
- Bleeding outside the menstrual period;
- Bleeding after menopause.
Other symptoms that may indicate endometrial cancer:
- Abnormal vaginal discharge;
- Pain in the pelvis and lower abdomen;
- Pain during sexual intercourse.
These symptoms can also be caused by other, less serious, non-cancerous conditions, but it is important to call your doctor for a consultation when they occur.
How is endometrial cancer staged?
Stage 1: The cancer is present only in the uterus.
Stage 2: Cancer is present in the uterus and cervix.
Stage 3: Cancer has spread outside the uterus, but not to the rectum or bladder. It may be present in the fallopian tubes, ovaries, vagina and/or nearby lymph nodes.
Stage 4: Cancer has spread beyond the pelvic area. May be present in the bladder, rectum and/or distant tissues and organs.
Cancer is often found early due to more obvious symptoms than in other types. It is important to know that 85%-90% of cases detected early go into remission, with the chances of cure decreasing as diagnosis is delayed.
Treatment options for endometrial cancer
The first step in treating a tumor is excision, and surgery is the most common course of treatment for endometrial cancer. A total hysterectomy, which involves the complete removal of the uterus, including the cervix, may be used.
If the uterus and cervix are removed through the vagina, the operation is called a vaginal hysterectomy. If the uterus and cervix are removed through a large incision (cut) in the abdomen, the operation is called a total abdominal hysterectomy. If the uterus and cervix are removed through a small incision (cut) in the abdomen using a laparoscope, the operation is called a total laparoscopic hysterectomy.
Radical hysterectomy: surgery to remove the uterus, cervix and part of the vagina. The ovaries, fallopian tubes or nearby lymph nodes may also be removed.
Lymph node dissection: a surgical procedure in which lymph nodes are removed from the pelvic area and a sample of tissue is checked under a microscope for signs of cancer. This procedure is also called lymphadenectomy.
After the doctor removes all the cancer that can be seen at the time of surgery, depending on the stage and spread of the cancer, some patients may continue treatment with radiotherapy or hormone treatment to kill the remaining cancer cells after surgery. Treatment given after surgery to reduce the risk of the cancer returning is called adjuvant therapy.
Endometrial cancer and the Pap test
The pap smear test involves taking a sample of cells from the cervix to look for abnormalities that could lead to cancer or to identify a range of non-cancerous conditions. Although the popular belief is that the Pap test identifies any type of cervical cancer, this could not be further from the truth. The test cannot identify any predictive signs of endometrial cancer or any other cancer of the female reproductive system.
How can we reduce the risk of endometrial cancer?
There is no one solution that can guarantee with certainty prevention of this type of cancer, but there are some aspects of one’s life that may help to reduce the risk.
- Keep your weight within normal limits! Women with a very high body mass index are 3 times more likely to get endometrial cancer than those of normal weight.
- Exercise! Studies have linked higher levels of physical activity with lower risks of endometrial cancer.
- Discuss the risks of hormone therapy with your gynecologist! If you are considering hormone replacement therapy to control menopausal symptoms, discuss the risks and benefits with your doctor. If you have not had a hysterectomy, estrogen replacement alone after menopause may increase your risk of endometrial cancer.
- Consider taking oral contraceptives! Using birth control for at least a year may reduce the risk of endometrial cancer. The reduction in risk is thought to last for a few years after you stop taking oral contraceptives. They do, however, have side effects, so discuss the benefits and risks with your doctor before you start taking them.