Understanding Endometrial Cancer: Types, Symptoms, and Treatment Procedures
What is Endometrial Cancer?
Endometrial cancer, also known as uterine cancer, begins in the lining of the uterus, known as the endometrium. It is the most common cancer of the female reproductive system, typically occurring after menopause. Early detection and treatment are vital to managing the disease effectively. Kingsway Hospital in Nagpur offers comprehensive care, from diagnosis to treatment, with a focus on improving outcomes and quality of life for patients with endometrial cancer.
Types of Endometrial Cancer
Endometrial cancer can be categorized into different types based on the appearance of cancer cells:
- Endometrioid Adenocarcinoma: The most common type of endometrial cancer, accounting for about 80% of cases. It typically grows slowly and is often detected early.
- Serous Carcinoma: A more aggressive and less common type of endometrial cancer, often diagnosed at a later stage.
- Clear Cell Carcinoma: Another rare and aggressive form of endometrial cancer that tends to have a poorer prognosis.
- Carcinosarcoma (Malignant Mixed Müllerian Tumor): A rare form of endometrial cancer that contains both carcinoma and sarcoma components and tends to grow quickly.
Risk Factors
Several factors can increase the risk of developing endometrial cancer:
- Age: Endometrial cancer is more common in women over the age of 50, particularly after menopause.
- Obesity: Excess body fat increases estrogen levels, which can stimulate the growth of endometrial cells, increasing the risk of cancer.
- Hormonal Imbalance: Conditions that lead to an imbalance in estrogen and progesterone, such as polycystic ovary syndrome (PCOS), can increase the risk.
- Diabetes: Women with type 2 diabetes have a higher risk of endometrial cancer, likely due to associated hormonal imbalances.
- Family History: A family history of endometrial, ovarian, or breast cancer may increase the risk of developing endometrial cancer, especially if it is associated with inherited conditions like Lynch syndrome.
- Estrogen Replacement Therapy: Long-term use of estrogen without progesterone, often used in hormone replacement therapy, may increase the risk of endometrial cancer.
- History of Endometrial Hyperplasia: A condition where the lining of the uterus becomes abnormally thick, which can increase the risk of cancer.
- Never Having Been Pregnant (Nulliparity): Women who have never been pregnant may have an increased risk of endometrial cancer.
- Previous Cancer History: Women who have had breast or ovarian cancer may have an increased risk of developing endometrial cancer.
Symptoms of Endometrial Cancer
The symptoms of endometrial cancer can vary, and early stages may not produce noticeable signs. Common symptoms include:
- Abnormal Vaginal Bleeding: This is the most common symptom of endometrial cancer. It includes bleeding after menopause or unusually heavy or prolonged periods before menopause.
- Pelvic Pain or Pressure: Pain in the pelvic region or a feeling of pressure may occur, especially in later stages of the disease.
- Unexplained Weight Loss: Significant weight loss without a known cause can be a sign of endometrial cancer.
- Pain During Intercourse: Pain during or after sexual activity may occur if the cancer has spread.
- Painful Urination or Difficulty Passing Urine: If the cancer spreads to nearby organs, it can cause urinary symptoms.
- Enlarged Abdomen: In advanced stages, the cancer may cause abdominal distension due to fluid buildup or metastasis.
Diagnosis of Endometrial Cancer
At Kingsway Hospital in Nagpur, a thorough diagnostic approach is employed to confirm the presence of endometrial cancer and determine its stage:
- Physical Exam: A pelvic exam is performed to check for any abnormalities in the uterus or surrounding organs.
- Transvaginal Ultrasound: This imaging test uses sound waves to create detailed pictures of the uterus and may help identify abnormal thickening of the endometrial lining, which could be a sign of cancer.
- Endometrial Biopsy: A small sample of tissue from the endometrium is taken and examined under a microscope to check for cancerous cells. This is often the first step in diagnosis.
- D&C (Dilation and Curettage): If an endometrial biopsy is inconclusive, a D&C procedure may be performed to scrape the lining of the uterus for tissue samples.
- Hysteroscopy: A procedure where a thin, lighted tube (hysteroscope) is inserted through the cervix to look inside the uterus and take biopsies.
- CT Scan or MRI: These imaging tests help determine if the cancer has spread to nearby lymph nodes or distant organs.
- Pelvic MRI: An MRI provides detailed images of the pelvic area and is useful in staging the cancer and planning treatment.
- PET Scan: A positron emission tomography (PET) scan can be used to detect cancer spread in the body, especially if the cancer has advanced.
Stages of Endometrial Cancer
The staging of endometrial cancer is based on the extent to which the cancer has spread:
- Stage I: Cancer is confined to the uterus and has not spread to nearby tissues or lymph nodes.
- Stage IA: Cancer is limited to the endometrium or inner lining of the uterus.
- Stage IB: Cancer has spread to the myometrium (muscular layer of the uterus).
- Stage II: Cancer has spread to the cervix but not beyond the uterus.
- Stage III: Cancer has spread to nearby tissues, such as the ovaries, fallopian tubes, or lymph nodes.
- Stage IIIA: Cancer has spread to the serosa (outer layer of the uterus) or the vagina.
- Stage IIIB: Cancer has spread to the lymph nodes or vagina.
- Stage IIIC: Cancer has spread to the pelvic or para-aortic lymph nodes.
- Stage IV: Cancer has spread to distant organs such as the bladder, rectum, or other parts of the body.
- Stage IVA: Cancer has spread to the bladder or rectum.
- Stage IVB: Cancer has spread to distant organs, such as the liver, lungs, or bones.
Treatment Options for Endometrial Cancer
At Kingsway Hospital in Nagpur, treatment for endometrial cancer is tailored to the individual’s condition, taking into account the cancer stage, type, and the patient’s overall health. Treatment options include:
Surgery
Surgery is the primary treatment for endometrial cancer, especially for early-stage cancer:
- Hysterectomy: Removal of the uterus, including the cervix, is the standard treatment for endometrial cancer. In some cases, the ovaries and fallopian tubes may also be removed (bilateral salpingo-oophorectomy).
- Lymph Node Dissection: If cancer has spread to the lymph nodes, they may be removed during surgery to prevent further spread.
- Omentectomy: Removal of the omentum (a layer of fatty tissue covering the organs) may be done if the cancer has spread.
Radiation Therapy
Radiation therapy uses high-energy rays to kill cancer cells:
- External Beam Radiation: Radiation is directed at the pelvic area from outside the body. It may be used after surgery to kill remaining cancer cells or for more advanced cancers.
- Brachytherapy: Internal radiation therapy, where a radioactive source is placed directly into the uterus, may be used for localized cancers.
Chemotherapy
Chemotherapy uses drugs to kill or shrink cancer cells:
- Adjuvant Chemotherapy: Chemotherapy may be used after surgery to treat any remaining cancer cells and reduce the risk of recurrence, particularly for high-risk cancers.
- Neoadjuvant Chemotherapy: Chemotherapy may be used before surgery to shrink the tumor, making it easier to remove.
Hormonal Therapy
Hormonal therapy uses medications to block hormones that fuel the growth of some types of endometrial cancer:
- Progestins or Medroxyprogesterone: These medications can shrink tumors by mimicking the action of the hormone progesterone.
- Tamoxifen: Often used in cases where the cancer cells test positive for hormone receptors.
Targeted Therapy
Targeted therapy uses drugs that specifically target cancer cells with minimal effects on normal cells. This type of treatment is generally used for advanced or recurrent endometrial cancer.
Immunotherapy
Immunotherapy helps the immune system recognize and fight cancer cells:
- Checkpoint Inhibitors: Drugs like pembrolizumab (Keytruda) may be used in advanced stages of cancer to help boost the body’s immune response against cancer cells.
Supportive Care and Rehabilitation
Kingsway Hospital in Nagpur provides comprehensive supportive care to improve the quality of life for endometrial cancer patients, including:
- Pain Management: Techniques to manage pain, ensuring patients remain comfortable during and after treatment.
- Nutritional Support: Dietitians help patients maintain a balanced diet to support overall health and well-being during treatment.
- Psychosocial Support: Counseling and support groups for patients and families to help cope with the emotional and psychological effects of cancer.
- Physical Rehabilitation: Rehabilitation programs to help patients regain strength and mobility following surgery or treatment.
Preventive Measures
While there is no surefire way to prevent endometrial cancer, certain strategies can reduce the risk:
- Maintain a Healthy Weight: Managing obesity and maintaining a healthy weight reduces the risk of endometrial cancer.
- Regular Gynecological Checkups: Regular visits to a gynecologist for screening and examination can help in early detection.
- Hormonal Balance: Using hormonal therapy judiciously and under medical supervision can help balance the hormones associated with increased cancer risk.
- Exercise and Diet: A balanced diet rich in fruits, vegetables, and fiber, along with regular physical activity, can lower the risk.
Endometrial cancer is a significant health issue for women, but early detection and treatment offer a high chance of successful recovery. Kingsway Hospital in Nagpur offers expert care, advanced treatments, and personalized approaches to managing endometrial cancer. If you or a loved one are at risk or experiencing symptoms, schedule a consultation at Kingsway Hospital for comprehensive care and support.
