Endometrial cancer is a type of uterine cancer that starts in the inner lining of the uterus. This lining is called the endometrium.
If you have endometrial cancer, early diagnosis and treatment increases your chances of remission.
Symptoms of Endometrial Cancer
The most common symptom of endometrial cancer is abnormal vaginal bleeding. This can include changes in the length or heaviness of menstrual periods, vaginal bleeding or spotting between menstrual periods or vaginal bleeding after menopause.
Other potential symptoms of endometrial cancer are watery or blood-tinged vaginal discharge, pain in the lower abdomen or pelvis and pain during sex.
If you experience any of these symptoms, make an appointment with your doctor. These symptoms aren’t necessarily a sign of serious condition, but it’s important to get them checked out.
Abnormal vaginal bleeding is often caused by menopause or other non-cancerous conditions. But in some cases, it’s a sign of endometrial cancer or other types of gynecological cancer.
Your doctor can help you identify the cause of your symptoms and recommend appropriate treatment, if needed.
Stages of Endometrial Cancer
Over time, endometrial cancer can potentially spread from the uterus to other parts of the body.
The cancer is classified into four stages based on how much it has grown or spread:
Stage 1: The cancer is only present in the uterus.
Stage 2: The cancer is present in the uterus and cervix.
Stage 3: The cancer has spread outside the uterus, but not as far as the rectum or bladder. It might be present in the fallopian tubes, ovaries, vagina and/or nearby lymph nodes.
Stage 4: The cancer has spread beyond the pelvic area. It might be present in the bladder, rectum, and/or distant tissues and organs.
When a person is diagnosed with endometrial cancer, the stage of the cancer affects what treatment options are available and the long-term outlook. This type of cancer is easier to treat in the early stages of the condition.
Causes of Endometrial Cancer
In most cases, the exact cause of endometrial cancer is unknown. However, experts believe that changes in the level of estrogen and progesterone in the body often play a part.
When the levels of those sex hormones fluctuate, it affects your endometrium. When the balance shifts towards increased levels of estrogen, it causes endometrial cells to divide and multiply.
If certain genetic changes occur in endometrial cells, they become cancer. Those cancer cells rapidly grow and proliferate to form a tumor.
Scientists are still studying the changes that cause normal endometrial cells to become cancer cells.
How Endometrial Cancer is Diagnosed
If you develop symptoms that might be endometrial cancer, make an appointment with your gynecologist. A gynecologist is a special type of doctor that focuses on the female reproductive system.
Your doctor will ask you about your symptoms and medical history. They will perform a pelvic exam to look and feel for abnormalities in your uterus and other reproductive organs. To check for tumors or other abnormalities, they may order a transvaginal ultrasound exam.
An ultrasound exam is a type of imaging test that uses sound waves to create pictures of the inside of your body. To perform a transvaginal ultrasound, your doctor or other healthcare professional will insert an ultrasound probe into your vagina. This probe will transmit images onto a monitor.
If your doctor detects abnormalities during the ultrasound exam, they may order one or more of the following tests to collect a sample of tissue for testing:
Endometrial Biopsy: In this test, your doctor inserts a thin flexible tube through your cervix into your uterus. They apply suction to remove a small piece of tissue from your endometrium through the tube.
Hysteroscopy: In this procedure, your doctor inserts a thin flexible tube with a fiber-optic camera through your cervix into your uterus. They use this endoscope to visually examine your endometrium and biopsy samples of abnormalities.
Dilation and curettage (D&C): If the results of a biopsy are unclear, your doctor might collect another sample of endometrial tissue using D&C. To do so, they dilate your cervix and use a special tool to scrape tissue from your endometrium.
After collecting a sample of tissue from your endometrium, your doctor will send it to a laboratory for testing. A laboratory professional will examine the sample under a microscope to learn if it contains cancer cells.
Treatment
Treatment options may include one or more of the following: surgery, radiation, hormone therapy and chemotherapy.
Treatment depends on the uterine cancer stage, your age, and general health with uterine cancer stage IV as the most extensive and usually caused by the most aggressive type of cancer cells. You and your doctors can decide what treatment plan is best for you.
Surgical therapy usually involves removal of the uterus, ovaries, fallopian tubes, adjacent lymph nodes and part of the vagina.
Radiation therapy may be by external radiation or by internal radiation (brachytherapy).
Chemotherapy usually requires IV administration of drugs designed to kill cancer cells. Most chemotherapy treatments need to be done in repeated cycles of drug administration followed by a rest period.
Hormone therapy (usually progesterone) is used on uterine cancer cells that require another hormone (estrogen) for growth.
