Endometrial cancer

Endometrial cancer is a type of cancer that begins in the lining of the uterus, called the endometrium. It is the most common type of uterine cancer and primarily affects postmenopausal women. This article explores the causes, symptoms, diagnosis, treatment, and prevention of endometrial cancer, offering a comprehensive overview of this significant health concern.

Definition

Endometrial cancer is the abnormal growth of cells in the endometrium, the inner lining of the uterus. It often manifests as adenocarcinoma, which originates from glandular cells in the lining.

Causes

Risk factors contributing to endometrial cancer include:

1. Hormonal Imbalance:

   • Excess estrogen without the balance of progesterone can stimulate the endometrium, increasing cancer risk.

2. Age:

   • Most common in postmenopausal women, typically diagnosed between ages 55 and 64.

3. Obesity:

   • Fat tissue can produce estrogen, raising endometrial cancer risk.

4. Genetic Factors:

   • Family history of endometrial or colorectal cancer can increase risk.
   • Genetic conditions like Lynch syndrome also heighten risk.

5. Reproductive History:

   • Never having been pregnant can increase risk due to prolonged exposure to estrogen.

6. Medical Conditions:

   • Conditions such as polycystic ovary syndrome (PCOS), diabetes, and hypertension.

7. Hormone Therapy:

   • Use of estrogen-only hormone replacement therapy (HRT) after menopause.

Symptoms

Common symptoms of endometrial cancer include:

1. Abnormal Vaginal Bleeding:

   • Postmenopausal bleeding is the most common symptom.
   • Heavy menstrual periods or bleeding between periods in premenopausal women.

2. Pelvic Pain:

   • Pain or cramping in the lower abdomen or pelvis.

3. Unusual Vaginal Discharge:

   • Watery or blood-tinged discharge.

4. Pain During Intercourse:

   • Discomfort or pain during sexual activity.

5. Weight Loss:

   • Unexplained weight loss.

Diagnosis

Diagnosing endometrial cancer involves several steps:

1. Medical History and Physical Examination:

   • Review of symptoms, medical, and family history.
   • Pelvic examination to check for abnormalities.

2. Imaging Studies:

   • Transvaginal Ultrasound: To measure endometrial thickness and detect abnormalities.
   • MRI or CT Scan: To determine the extent of the disease.

3. Endometrial Biopsy:

   • Removal of a tissue sample from the endometrium for microscopic examination.

4. Hysteroscopy:

   • A procedure using a thin, lighted tube to view the inside of the uterus and perform a biopsy if needed.

5. Dilation and Curettage (D&C):

   • Surgical procedure to scrape and examine the uterine lining.

Staging

The staging of endometrial cancer is based on how far the cancer has spread:

1. Stage I:

   • Cancer confined to the uterus.

2. Stage II:

   • Cancer has spread to the cervix but not beyond the uterus.

3. Stage III:

   • Cancer has spread to nearby pelvic structures.

4. Stage IV:

   • Cancer has spread to the bladder, rectum, or distant organs.

Treatment

Treatment options for endometrial cancer include:

1. Surgery:

   • Hysterectomy: Removal of the uterus, often including the ovaries and fallopian tubes.
   • Lymph Node Dissection: Removal of nearby lymph nodes to check for spread.

2. Radiation Therapy:

   • External Beam Radiation: Directed at the pelvic area.
   • Brachytherapy: Internal radiation delivered directly to the cancer site.

3. Hormone Therapy:

   • Use of progesterone or other hormonal treatments to slow cancer growth.

4. Chemotherapy:

   • Use of drugs to kill cancer cells, often used in advanced stages or recurrent cancer.

5. Targeted Therapy:

   • Drugs that target specific molecules involved in cancer growth.

Prevention

Preventive measures for endometrial cancer include:

1. Maintain a Healthy Weight:

   • Regular exercise and a balanced diet to reduce obesity risk.

2. Manage Medical Conditions:

   • Proper management of diabetes, hypertension, and PCOS.

3. Hormone Balance:

   • Use of combined estrogen-progestin therapy if undergoing hormone replacement therapy.

4. Regular Check-ups:

   • Routine gynecological exams, especially if you have risk factors.

5. Healthy Lifestyle:

   • Avoid smoking and limit alcohol consumption.

When to See a Doctor

Seek medical attention if experiencing:

• Postmenopausal bleeding.
• Heavy or irregular menstrual periods.
• Pelvic pain or discomfort.
• Unusual vaginal discharge.

Conclusion

Endometrial cancer is a serious condition that requires timely diagnosis and treatment to ensure the best possible outcome. Awareness of the risk factors, symptoms, and preventive measures can help in early detection and effective management of this disease.

In summary, endometrial cancer is a type of cancer that affects the lining of the uterus. Early detection through awareness of symptoms and risk factors, combined with prompt medical care, can significantly improve the prognosis for individuals affected by this condition. Regular gynecological check-ups and maintaining a healthy lifestyle are essential components of prevention and early intervention.