Endometrial cancer also called uterine cancer, is a type of cancer that begins in the uterus. Most cases of endometrial cancer begin in the layer of cells that makes up the endometrium. There are other types of cancer that can form in the uterus, including uterine sarcoma, but they are much less common than endometrial cancer.
Endometrial cancer is often detected at an early stage. This is because it often results in abnormal vaginal bleeding. If endometrial cancer is discovered early, surgical hysterectomy is often the best option for endometrial cancer.
Symptoms
Signs and symptoms of endometrial cancer may include:
- Vaginal bleeding after menopause
- Bleeding between menstrual periods
- Pelvic pain
Causes
Doctors do not know the exact cause of endometrial cancer; however, it is known that something is going on that leads to a genetic mutation of DNA inside the endometrium – the inner part of the uterus.
A genetic mutation transforms normal and healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, and eventually die at a specific time. The abnormal cells grow and multiply at an uncontrolled rate and do not die within the specified time. Anomalous cells accumulated because of an internal tumor. Cancer cells invade nearby tissues and can separate from the primary tumor to spread elsewhere in the body.
Risk factors
Factors that increase your endometrial cancer include:
Changes in the balance of female hormones in the body
The ovaries secrete two main female hormones – estrogen and progesterone. Any fluctuations in the balance of these two hormones cause changes in the endometrium.
Long-term menstruation
The onset of menstruation at an early age or beginning menopause at a later age can increase the risk of endometrial cancer. The more menstrual cycles you had, the greater the exposure of the endometrium to estrogen.
You didn’t get pregnant before
If you haven’t had a pregnancy before, your risk of developing endometrial cancer is higher than a woman who has given birth at least once.
Old age
As you get older, your risk of developing endometrial cancer increases. Endometrial cancer most often occurs after menopause.
Obesity
Excess weight increases the risk of endometrial cancer. This may happen because excess fat changes the balance of hormones in the body.
Hormonal treatment for breast cancer
Taking tamoxifen for hormonal treatment of breast cancer can increase the risk of endometrial cancer. If you are taking this medication, discuss its risk with your doctor. For most, tamoxifen benefits outweigh the risk of endometrial cancer.
Diagnosis
Pelvic examination
During a pelvic exam, your doctor carefully examines the outside of your genitals (female vulva), then inserts two fingers into the vagina and at the same time presses the other hand on your abdomen to feel the uterus and ovaries. Your doctor also places an intra-vaginal device called a speculum, which allows your doctor to see vaginal and cervical anomalies.
Ultrasound
Your doctor may recommend an ultrasound to inspect the thickness and texture of the endometrium wall and help rule out other conditions. During this procedure, sound waves are used to create a detailed video of your uterus. This test helps your doctor detect abnormalities in the uterine wall.
Hysteroscopy
During hysteroscopy, the doctor places a thin, flexible, light tube through your vagina and cervix to the womb. A lens in a hysteroscope allows your doctor to examine the inside of the uterus and the endometrium.
Tissue sample testing
To obtain a sample of cells from inside the uterus, you will likely undergo an endometrial biopsy. This includes tissue removal from the uterus wall for laboratory analysis. An endometrial biopsy can be done inside the doctor’s office, and usually does not require anesthesia.
Treatment
Endometrial cancer is usually treated surgically by removing the uterus, fallopian tubes and ovaries. Another option is radiation therapy with powerful energy beams. Medicinal treatments for endometrial cancer include chemotherapy with powerful medications and hormonal therapy to restrict the hormones that cancer cells depend on. Other treatment options may include drug-directed treatment that attacks specific areas of cancerous cells or immunotherapy that helps your immune system fight cancer.
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