Endometrial Cancer

The uterus is a female reproductive organ responsible for creating a safe and nurturing environment for the embryo to grow. It is about the size of a pear and is located between the bladder and the rectum.

The endometrium is a tissue that lines the uterus and is shed during menstruation. It aids in the embryo’s implantation and provides a place for the developing foetus to grow. Moreover, it protects the uterus from infection.

Endometrial cancer is a kind of cancer that develops in the lining of the uterus, the endometrium. This is one of the most common types of cancer that affect the female reproductive system.

Endometrial cancer is caused by abnormal cells in the uterine lining. These cells can make the uterine lining grow and thicken. Sometimes these cancerous cells can also grow outside the uterus and form a tumour.

The disease typically grows and spreads slowly. If not detected, it can eventually spread to other parts of the female reproductive system, such as ovaries, fallopian tubes, vagina, or other distant organs.

In some cases, endometrial cancer can also spread to the rectum or bladder. Research indicates that nearly 90% of uterine cancers originate in the endometrium.

Endometrial cancer can be classified into two different types – Type I and Type II.

• Type I: Endometrial cancer can be classified as type 1 if it’s not yet spread outside the uterus. It doesn’t spread too quickly to other parts of your body. Hence, the prognosis is usually good. The prognosis is based on the type of cancer, the stage of cancer, the type of treatment received, and the person’s age, general health, and other conditions.
• Type II: Endometrial cancer can be classified as type 2 if it has spread outside the uterus to other body parts (metastasized). Compared to type 1 endometrial cancer, it quickly spreads outside the uterus. Therefore, the prognosis is not usually good.

Symptoms of endometrial cancer may include:

• Bleeding from the vagina that is abnormal, heavy, or irregular.
• Bleeding after menopause (postmenopausal bleeding).
• Pelvic pain
• Painful intercourse
• Painful urination or a change in bladder habits, such as having to urinate more frequently or urgently than usual.

Endometrial cancer is often caught early due to frequent and abnormal vaginal bleeding. Because of this early discovery, endometrial cancer can be cured through surgical removal of the uterus.

What causes this cancer is not always obvious and can be difficult to discern. Like any cancer, it is caused due to genetic mutation. In endometrial cancer, the DNA mutation occurs in the inner lining of the uterus.

Cancerous cells don’t die, unlike healthy cells. Without timely diagnosis and intervention, they begin to invade healthy cells nearby. What triggers this mutation is not known.

However, there are certain risk factors for endometrial cancer, including:

• Family history: Some people with a family history of the disease are at a higher risk of developing endometrial cancer than others.
• Obesity: The prevalence of obesity has become a great concern in recent years. Obesity changes the hormonal balance in a woman’s body. These hormones play a key role in the growth and spread of endometrial cancer.
• Polycystic ovary syndrome (PCOS): It is a disorder that causes the ovaries to produce more androgens and estrogen than usual. PCOS is one of the most common and popular causes of infertility and can increase the risk of endometrial cancer.
• Older age: Endometrial cancer often occurs in women after menopause.

The endometrial cancer diagnosis includes a general physical exam and a review of family/medical history.

Doctors may also recommend the following:

• Internal pelvic exam: It helps identify changes in the uterus’s shape and formation of lumps.
• Endometrial biopsy: In this procedure, we take a small sample of tissue from the uterus lining to detect the presence of cancerous cells.
• Dilation and curettage (D&C): A D&C test is done by inserting a thin, flexible tube into the vagina and up the uterus. The cervix is dilated, and a thin, spoon-shaped instrument called a curette is used to scrape the inside of the uterus. A tissue sample is sent to a lab for examination by a pathologist.
• Transvaginal ultrasound: In this endometrial cancer test, a probe is inserted into the vagina and used to take images of the inside of the female reproductive system.

Endometrial cancer treatment depends on the type of cancer, your medical history, overall health, prognosis, tolerance of therapies, procedures, and medications.

Listed below are the treatment options we recommend:

• Surgery to remove the uterus (hysterectomy).
• Surgery to remove ovaries and uterus tubes (salpingo-oophorectomy).
• Surgery to remove lymph nodes from the pelvic region (pelvic lymph node dissection).
• Radiation therapy (the use of high-energy x-rays or gamma rays to kill cancer cells).
• Chemotherapy (the use of certain drugs to treat cancer).
• Hormone therapy is typically done in tandem with chemotherapy and radiation. It is generally administered through oral, transdermal, or vaginal routes.

Although the exact cause is not known, avoiding certain risk factors may help prevent endometrial cancer. For instance, maintaining a healthy weight is necessary to prevent endometrial cancer, especially after menopause.

Using oral contraceptives can also aid in prevention. However, do not use contraceptives without consulting a doctor, as they may cause certain side effects.

Endometrial cancer is a malignant tumour that occurs in the uterus lining. Identifying the early signs of endometrial cancer, such as abnormal vaginal bleeding, is crucial in further diagnosis and treatment.

Most patients have type 1 endometrial cancer, which spreads slowly. Therefore, accurate diagnosis and timely intervention are key to saving lives.

Gynae Cancers are fast rising, posing a major threat for women and triggering multiple complications in their body. For precise endometrial cancer tests and an effective treatment plan, visit the CK Birla Hospital and book an appointment with Dr Jyoti Bhat.