Endometrial Cancer

Endometrial cancer starts in the lining of the uterus, which is called the endometrium. Imagine the uterus as a hollow, pear-shaped organ in your pelvis. It's where a baby grows during pregnancy. This cancer begins as a collection of abnormal cells growing in this lining.

It's a type of cancer that forms within the uterus. Sometimes endometrial cancer is also called uterine cancer. While other types of cancer, like uterine sarcoma, can also affect the uterus, endometrial cancer is far more common.

One good thing about endometrial cancer is that it often shows up early. This is because it frequently causes noticeable symptoms. A common first sign is unusual bleeding from the vagina. This might be heavier bleeding than usual, bleeding between periods, or bleeding after menopause. If caught early, endometrial cancer is often treated successfully with surgery to remove the uterus. This procedure frequently leads to a cure.

Endometrial cancer can have several warning signs. One common symptom is bleeding from the vagina after menopause. This is a noticeable change from the usual, and it's important to get it checked. Another sign is bleeding between menstrual periods. This can also be a reason to see a doctor. Pelvic pain is another possible symptom. This pain might be in the lower abdomen or pelvis. If you notice any of these signs, or any other unusual changes, it's a good idea to schedule an appointment with your doctor or other healthcare provider. Don't wait to get checked if you have concerns.

If you're feeling unwell or have any symptoms that concern you, it's important to schedule a visit with a doctor or other healthcare provider. This could be a doctor, nurse practitioner, or other medical professional. Don't ignore any unusual or persistent symptoms. Seeing a healthcare professional is a good way to get a proper diagnosis and treatment plan.

The exact reason why endometrial cancer develops isn't understood. However, we do know that something goes wrong with the cells lining the uterus, turning them into cancer cells.

Endometrial cancer begins when cells in the uterine lining (called the endometrium) experience changes in their DNA. DNA is like a set of instructions for the cell, telling it what to do. These changes tell the cells to grow and multiply much faster than normal. They also tell the cells to keep living even when healthy cells would naturally die. This leads to an excessive buildup of cells. These extra cells can form a lump, called a tumor. The abnormal cells can invade and damage surrounding healthy tissue. Eventually, these cells can detach and travel to other parts of the body, a process called metastasis.

The female reproductive system is made up of the ovaries, fallopian tubes, uterus, cervix, and vagina. Problems with this system can sometimes lead to endometrial cancer. Several factors increase the risk of this type of cancer.

Hormonal Imbalance:

The ovaries produce estrogen and progesterone, two important hormones. If the balance between these hormones shifts, it can affect the lining of the uterus (endometrium), potentially increasing the risk of cancer. Conditions that increase estrogen without increasing progesterone are a concern. Examples include:

• Obesity: Extra body fat can disrupt hormone balance.
• Diabetes: This condition can also affect hormone levels.
• Irregular Periods (e.g., Polycystic Ovary Syndrome): Problems with ovulation can lead to an imbalance.
• Hormone Therapy (after menopause): Taking estrogen-only hormone replacement therapy after menopause can lead to a higher risk.
• Rare Ovarian Tumors: Certain ovarian tumors produce estrogen, which can also disrupt the hormonal balance.

Menstruation History:

The longer a woman has menstrual periods, the more likely she might be to develop endometrial cancer. Starting periods before age 12 or having menopause later in life also increases the risk. This is because the endometrium is exposed to estrogen for a longer duration.

Pregnancy History:

Women who have never been pregnant have a slightly higher risk of endometrial cancer compared to those who have had at least one pregnancy.

Age:

The risk of endometrial cancer generally increases with age, particularly after menopause.

Other Risk Factors:

• Hormone Therapy for Breast Cancer: Taking tamoxifen, a medication used to treat breast cancer, can increase the risk of endometrial cancer. However, for most women, the benefits of tamoxifen usually outweigh this small risk. It's crucial to discuss this with your doctor.
• Inherited Cancer Syndromes: Some genetic conditions, like Lynch syndrome, increase the risk of various cancers, including endometrial cancer. If you have a family history of these conditions, it's important to talk to your doctor about your risk and appropriate screening.

It's important to remember that these are risk factors, not guarantees of developing endometrial cancer. Talking to your doctor about your personal health history and family history is key to understanding your individual risk and taking appropriate preventive measures.

To lower your chances of getting endometrial cancer, you might want to:

1. Talk to your doctor about hormone therapy after menopause. If you're thinking about hormone replacement therapy to manage menopausal symptoms, discuss the possible risks and benefits with your doctor. If you haven't had your uterus removed, taking just estrogen after menopause might slightly increase your risk of endometrial cancer. Taking a combination of estrogen and progestin can help lower this risk. However, hormone therapy can have other potential downsides, so carefully consider the pros and cons with your doctor.

2. Consider birth control pills. Using birth control pills for at least a year might lower your risk of endometrial cancer. Birth control pills work by preventing pregnancy. The protective effect likely lasts for several years after you stop taking them. Birth control pills can have side effects, so it's important to discuss the benefits and risks with your doctor.

3. Keep a healthy weight. Being overweight or obese increases your risk of endometrial cancer. Aim to maintain a healthy weight. If you need to lose weight, a combination of regular exercise and a balanced diet can help. Talk to your doctor about a safe and effective weight loss plan.

Diagnosing Endometrial Cancer: Tests and Procedures

Endometrial cancer is a type of cancer that affects the lining of the uterus. Doctors use several tests and procedures to diagnose it, understand its spread, and create a treatment plan.

Visualizing the Pelvic Organs:

• Transvaginal Ultrasound: A doctor or technician uses a wand-like device (transducer) inserted into the vagina. This device sends sound waves to create a picture of the organs in the pelvis, including the uterus. The picture shows the thickness and texture of the uterine lining (endometrium). This helps doctors see if there are any signs of cancer and rule out other possible causes for symptoms. Other imaging techniques like MRI and CT scans may also be used.

• Hysteroscopy: A thin, flexible, lighted tube (hysteroscope) is inserted into the vagina and cervix and then into the uterus. This allows doctors to directly view the inside of the uterus and the endometrium, looking for abnormalities.

Taking Tissue Samples for Testing:

• Endometrial Biopsy: A small tissue sample is taken from the uterine lining. This is often done in a doctor's office and sent to a lab to check for cancer cells. Other lab tests may be done on the cells for more information about the cancer.

• Dilation and Curettage (D&C): If a biopsy doesn't provide enough tissue or the results are unclear, a D&C may be needed. This procedure involves scraping tissue from the uterine lining for examination under a microscope to identify cancer cells.

Additional Examinations:

• Pelvic Exam: A physical examination of the reproductive organs, often part of a routine checkup, can be helpful if someone has symptoms of endometrial cancer.

Cancer Staging:

If endometrial cancer is found, a doctor specializing in reproductive cancers (gynecologic oncologist) will likely take over care. The doctor will determine the extent of the cancer, known as staging.

• Staging Tests: Various tests help determine the stage, including:
  • Chest X-ray: Checks for cancer spread to the lungs.
  • CT Scan: Provides detailed images of the body, helping to see if the cancer has spread.
  • Blood Tests: Can provide information about the cancer.
  • PET Scan: A specialized imaging technique that can help detect cancer spread.
• Surgery and Staging: Sometimes, the stage of the cancer isn't fully known until after surgery is performed.

Cancer Stages:

Stages are numbered 1 through 4. Lower stages mean the cancer hasn't spread beyond the uterus. Stage 4 means the cancer has grown into nearby organs (like the bladder) or spread to other parts of the body.

The information gathered from these tests and procedures helps the medical team determine the best course of treatment.