Important Answers about Endometrial Cancer
- Endometrial Cancer Overview
- What Is Endometrial Cancer?
- Endometrial Cancer Risk Factors
- Minimizing Risks
- Endometrial Cancer Symptoms
- Diagnosing Endometrial Cancer
- Treating Endometrial Cancer
Endometrial Cancer Overview
Endometrial cancer starts in the uterus on the endometrium lining when abnormal (malignant) cells begin to develop. The disease can be identified in its early stages when women become alarmed by abnormal vaginally bleeding. When discovered in its early stage, endometrial cancer is often cured by surgically removing the uterus, a necessary organ for women wishing to get pregnant.
Endometrial cancer ranks fourteenth overall of the most common types of cancers and ranks sixth as the most common type of cancer in women. The American Cancer Society says that 320,000 new cases of Endometrial Cancer will be diagnosed in America this year.
What Is Endometrial Cancer?
The endometrium is both spongy and soft and a necessary component of the menstrual cycle. The lining of the endometrium thickens when the ovaries secrete estrogen hormone. Near the middle of the menstrual cycle, the ovaries begin secreting progesterone hormone, preparing the endometrium for childbearing should conception occur. There are two types of endometrial cancers that include:
- Endometrial Adenocarcinomas – This type originates from secreting glandular tissue.
- Uterine Sarcomas – This type originates in the uterus muscles or connective tissue.
Cancer can develop in the endometrium any time the lining undergoes a malignant transformation or degenerative change. Endometrium cells can begin to grow abnormally which causes the formation of a cancerous growth or malignant tumor cancer can become significantly dangerous and life-threatening to the woman when it deprives nutrients and oxygen to healthy cells. If left untreated, endometrial cancer can metastasize (spread) to other tissue organs in the body, causing significant damage.
It is important to note that not every endometrial tumor is cancerous. Many women experience benign (non-cancerous) tumors of the uterus without it spreading to other areas of the body. Alternatively, cancerous tumors can invade lymph nodes and other nearby organs and bones by traveling through lymph fluid passages and the bloodstream to reach distant organs like the lungs and brain. Metastatic tumors tend to be the most aggressive and often result in life-threatening changes in the body.
Endometrial Cancer Risk Factors
Scientists and physicians remain unsure of what exactly causes endometrial carcinoma. However, there been various risk factors associated with the disease, but having one or more risk factors does not mean the individual has the potential of developing endometrial cancer. That said, the risk of developing the disease might be higher than others void of the risk factors. The most common endometrial cancer risk factors include:
- Obesity – Women 50 pounds higher than their ideal body weight have a 10-fold greater potential of developing endometrial cancer compared to women at their ideal weight. This is because an increase of body fat enzymes that convert hormones to estrogen is believed to increase the potential risk of developing the disease.
- Early Puberty – Young women who menstruate prior to their twelfth year have an increased risk of developing endometrial cancer.
- Never Becoming Pregnant – Statistics reveal that women who have never been pregnant have a 2 to 3 times greater potential of developing the disease compared to childbearing women.
- Late Menopause – Women who become menopausal after their 52nd year are more likely to develop the disease compared to those who have already gone through menopause.
- High Levels of Estrogen – Polycystic Ovarian Syndrome and other estrogen-related conditions can increase levels of unopposed estrogen (no opposing progesterone), which have been proven to increase the potential of developing the disease.
- Unopposed Estrogen Treatment – Women on estrogen replacement therapy who do not take progesterone hormones have an increased risk of endometrial cancer.
- Family History – Genetics plays an important part on the increased potential of developing endometrial cancer.
- Surgery Using Morcellators – The use of morcellator devices in hysterectomy and myomectomy procedures are thought to increase endometrial cancer rates when there are dormant cancer cells present at the surgical site.
Using birth control pills (oral contraceptives) can decrease the potential risk of developing endometrial cancer. Other factors to minimize this risk includes:
- The protection generated by taking oral contraceptives is thought to continue for at least a decade after its last use. This protection seems significantly beneficial for women who have never conceived.
- To be an effective protection against endometrial cancer, the oral contraception must have been taken for at least one year.
- Research indicates that women using birth control pills at any point have half the potential risk of developing endometrial cancer compared to women who have never taken birth control pills.
Endometrial Cancer Symptoms
There are numerous symptoms associated with uterine endometrial cancer (endometrial carcinoma) that include:
- Vaginally Bleeding – Any abnormal vaginally bleeding must be evaluated by a physician, especially for pre-menopausal women or those who are currently experiencing menopause. This is because it is often difficult to distinguish abnormal bleeding from typical menstrual bleeding.
- Pelvic Pain
- Unintentional Weight Loss
- Lump or Swelling Mass in the Pelvic
Any woman experiencing a considerable change in the frequency, duration or amount of their menstrual periods should consider seeking medical care. Understanding why the bleeding is abnormal or excessive is crucial to catch the disease in its early stage.
Diagnosing Endometrial Cancer
In addition to obtaining a complex medical, pregnancy and menstrual history along with discussing symptoms and concerns, the gynecologist or oncologist will conduct tests including imaging studies, and laboratory/diagnostic tests to determine if endometrial cancer is present. The most common tests and studies involve:
- Routine Blood Testing – The doctor will evaluate blood chemistry, kidney and liver function, and a blood cell count, especially if the patient requires surgery or other therapy.
- Imaging Studies – The doctor may choose to perform a transvaginal ultrasound or a hysterosonogram to obtain a visual image of internal organs.
- Endometrial Biopsy – Ruling out cancer might require an endometrium sample through a biopsy where a tiny portion of body tissue is removed and examined by a laboratory pathologist.
- Dilation and Curettage – If the endometrial biopsy result is inconclusive, a D & C (dilation and curettage) with sedation or general anesthesia may be conducted. This type of procedure generally causes minimal discomfort and recovery time.
- Hysteroscopy – The doctor might insert an endoscope (a tube with a camera and tiny light) into the uterus through the patient’s cervix to have an up-close view of the interior of the uterus while obtaining samples of endometrial tissue.
Treating Endometrial Cancer
The level of treatment the oncologist or gynecologist recommends will vary on the stage of the endometrial cancer. The recommended surgery might involve a complete abdominal hysterectomy where the cervix and entire uterus is removed along with the ovaries and fallopian tubes. During this type of treatment, the doctor will usually collect cells from the peritoneal cavity and have it examined for cancer. Lymph nodes in the pelvis area might also be removed. In addition to surgery or in lieu of surgery the doctor may also recommend therapies including radiation and chemotherapy.
Specific chemotherapy drugs have proven to be effective in some cases of endometrial cancer. These drugs include Paraplatin (carboplatin), Taxol (paclitaxel) and Adriamycin PFS (doxorubicin), along with “off-label” medications including Torisel (torsirolimus) and Avastin (bevacizumab).