Endometrial Cancer

Overview

The endometrium is the lining of the inner and muscular walls of the uterus. Endometrial cancer affects this lining, most commonly in the inner uterine wall. It is a common form of uterine cancer that affects postmenopausal women. Premenopausal women can also develop endometrial cancer; however, these cases are comparatively rarer. Endometrial cancer develops out of the epithelial cells that line the endometrium and create the epithelial glands. In its early stages, the disease is easily curable.

Types

There are many different sub-types of endometrial cancers. These subtypes have to do with the pattern in which the cancer cells grow. Cells can actually grow in the same pattern as the endometrial glands. Even aggressive cancer cells can grow in the same pattern as the normal endometrial lining. There are two classifications for endometrial cancer.

• Type I: With type I endometrial cancer, outbreaks are most common among women who have not gone through menopause. These types of cancers are not aggressive, and they are accompanied by a positive prognosis since many patients tend to recover when the cancer is caught early.
• Type II: This type of endometrial cancer is most common among postmenopausal women. It is a high-grade cancer, which means that the disease is aggressive. For many patients, this type of endometrial cancer does not have a positive prognosis.

Symptoms

The most common symptoms include vaginal bleeding or spotting, even when the woman has gone through menopause. Premenopausal women may experience irregularities with their period. Because of vaginal bleeding, many endometrial cancer patients experience anemia. White or clear discharge, cramping, and abdominal pain are other common symptoms. A woman might also experience excessive pain during sex or while urinating.

Causes/Risk Factors

Endometrial cancer results in the endometrial glands, which are formed by the endometrium lining. When a woman is exposed to excessive amounts of estrogen, she is at risk for developing endometrial cancer.

Tests/Diagnosis

Doctors who suspect endometrial cancer will begin with a routine physical exam to ask a series of health related question. The doctor might ask you about your personal and family history with cancer, so you should have this information available. A doctor may then conduct a Pap smear, which is recommended as a routine test for most women. With a pap smear, the doctor takes a sample of the cells from the cervix and the top part of the vagina. A lab test can then confirm the presence of abnormal endometrial cells. A Pap smear does not always show accurate results, especially since a Pap smear does not collect the cells inside of the uterus. A doctor may choose to perform a biopsy and collect a tissue sample from the inside of the vagina or endometrium. Patients do not need to be sedated for this type of biopsy. A doctor might also want to perform a transvaginal ultrasound to explore the vagina. An ultrasound might help the doctor decide whether to perform a biopsy.

Treatment

Most women with endometrial cancer must undergo a hysterectomy, which is the removal of the uterus. A hysterectomy can be done vaginally or laparoscopically through abdominal incisions. A doctor might choose to remove the ovaries and fallopian tubes in addition to the uterus.

If the cancer cells have spread anywhere else in the body, the doctor might prescribe hormone therapy in the form of progesterone in order to prevent additional abnormal cells from going. Hormone treatments are effective for women with an early diagnosis.

Radiation therapy is a localized treatment that inhibits additional cancer cell growth. Radiation therapy typically takes months to complete, and treatments require daily administration. Some patients may need to undergo chemotherapy in addition to radiation.