Contributed by: Abshar Faheem
Understanding of endometrial (uterine) cancer
Uterus, a hollow organ and shaped like an upside-down pear, is located in the pelvis commonly called the womb. The uterus or womb is the place where the baby grows when a woman is pregnant. The top of the uterus is the fundus, the middle is the corpus, the bottom is the cervix and the inner linings of the uterus are called the endometrium. When cancer grows in the inner lining( endometrium) of the uterus, it is called endometrial cancer.
There are several types of uterine cancer but most cancers of the uterus are endometrial cancer. Around 3 in 100 women have been diagnosed with uterine cancer at some point in their life. After receiving a diagnosis, more than 80 percent of people with uterine cancer can survive for five years or longer. If it is left untreated, endometrial cancer can spread to other parts of the body including the rectum, vagina, fallopian tubes, ovaries, and other organs. It grows gradually and with a routine checkup, it can be detected in the early stages.
Symptoms of endometrial or (uterine) cancer
Some women do not feel the symptoms until cancer has spread to other organs of the body. Although, endometrial cancer is diagnosed with the appearance of the symptoms. The most typical symptom of endometrial cancer is abnormal vaginal bleeding or discharge including:
- Changes in duration or heaviness of menstrual periods,
- Before menopause, having irregular menstrual periods or vaginal bleeding between menstrual period
- And, vaginal bleeding after menopause
Other potential symptoms of endometrial cancer include:
- Trouble urinating
- Pelvic pain
- Pain during intercourse
- An enlarged uterus
- Unexpected weight loss
- Feeling pain and weakness in the lower abdomen, back, or legs. It can occur when endometrial cancer spreads to organs of the body.
- Vaginal discharge can be pink, foul, smelly, thick, and watery.
If you feel any of these symptoms, get an appointment with your doctor. These symptoms are not always necessarily an indication of a severe condition, but it’s essential to get them checked out early.
Abnormal vaginal bleeding is usually caused by menopause or other non-cancerous conditions. Although, in some cases, it is an indication of endometrial cancer or maybe other types of gynecological cancer. Your doctor can assist you to identify the cause of your symptoms and suggest proper treatment if needed.
Causes and risk factors of endometrial cancer
Researchers and experts are still trying to find out the exact cause behind endometrial cancer while they believe that mutations in the levels of progesterone and estrogen can play some role in its occurrence. The mutation in the levels of sex hormones ( progesterone and estrogen) can affect the endometrium. When the hormonal balance shifts towards the estrogen level, it may cause endometrial cells to divide and multiply.
If there are some genetic changes in the endometrial cells, the cells can become cancerous. Those cancer cells can grow quickly and form a tumor. Experts are still trying to figure out the cause behind the changes that cause normal endometrial cells to become cancer cells. However, the risk of endometrial cancer may also enhance with other factors including,
- Having certain genetic conditions such as colon cancer, and Lynch syndrome
- Diabetes ( especially type 2)
- Endometrial hyperplasia
- Other cancers including breast cancer, colon cancer, or ovarian cancer
- Consumption of certain drugs such as tamoxifen to treat breast cancer
- Radiation therapy
- Diet or nutrition
- Taking estrogen-only hormone replacement therapy after menopause
- Having metabolic syndrome
- Having a polycystic ovarian syndrome
- Granulosa cell tumors ( a type of ovarian tumor)
Endometrial cancer often occurs in women after their menopause and more than 95 percent of this cancer can occur in women over 40. Women after menopause are more likely to get endometrial cancer if they
- Got their first period earlier or before 12
- Went through menopause late in life
- have few or no children
- Have a history of infertility and irregular periods
- Have a family history of endometrial, colorectal, or breast cancer
Diagnosis and treatment
Uterine cancer is diagnosed with a pelvic exam, Pap test, a transvaginal ultrasound exam, and biopsy. Sometimes, CT or MRI can also be done to validate the diagnosis. Uterine cancer stages from 0 to 4rth are determined by biopsy, chest x-ray, and CT or MRI scans. 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, personal preferences, and general health with uterine cancer stage IV as the most comprehensive and normally caused by the most aggressive type of cancer cells. Each treatment has associated potential benefits and risks so discussing with your doctor may help you to decide what treatment plan is best for you.
How can you lower the risk of endometrial cancer?
Some strategies may help you to manage and lower the risk of endometrial cancer including:
- Manage and control your obesity
- Make dietary changes
- Quit smoking
- Manage fatigue
- Get regular exercise
- Seek treatment for abnormal vaginal bleeding
- Check the pros and cons of hormone therapy before taking
- Talk to your doctor about the benefits of contraceptive pills
- Tell your doctor if you have a family history of Lynch syndrome
The bottom line
If you have symptoms of endometrial cancer, initial diagnosis and treatment may increase your possibilities of remission. In addition, taking care of your general health and adopting other strategies may also help you to reduce the risk of endometrial cancer.