Endometrial cancer

Overview – Endometrial cancer, also called uterine cancer is a type of cancer that begins in the uterus.

The exact cause of endometrial cancer is not known. The imbalance of female hormones (estrogen, progesterone) in the body can be a contributing factor to the development of cancer. There is an increase in the estrogen but not the level of progesterone, in the body. The factors that increase the risk of cancer include polycystic ovary syndrome, obesity, and diabetes; taking hormones after menopause that contains estrogen and not progesterone; never having been pregnant; taking the breast cancer drug tamoxifen; hereditary non-polyposis cancer (Lynch syndrome), obesity.

The protective factors that prevent endometrial cancer are pregnancy, breastfeeding, use of birth control pills, maintaining a healthy weight.

 

Symptoms

  • Abnormal vaginal bleeding – bleeding after menopause, bleeding in between periods, prolonged and heavy bleeding during periods.
  • Pelvic pain.

 

Diagnosis

  • The diagnosis of endometrial cancer is done with pelvic examination, a transvaginal ultrasound, hysteroscopy, endometrial biopsy. Transvaginal ultrasound is a wandlike device (transducer) that is inserted into your vagina. The transducer uses sound waves to create a video image of your uterus. Hysteroscope is a thin, flexible, lighted tube that is inserted through your vagina and cervix into your uterus to examine the inside of your uterus and the endometrium.
  • Other tests that may be done to determine the extent of the cancer are chest x-ray, CT scan, PET scan, and blood tests.

 

Lifestyle management

  • Follow a healthy diet and exercise program as recommended by your doctor.
  • Talk to your doctor about risks and benefits if you are considering hormone replacement therapy for menopausal symptoms. Replacing estrogen alone after menopause may increase the risk of endometrial cancer unless you’ve undergone a hysterectomy. Taking a combination of estrogen and progestin can reduce this risk of endometrial cancer.
  • Keep all your appointments with your doctor.

 

Medical management

  • Surgery is done to remove the uterus (hysterectomy), fallopian tubes, and ovaries (salpingo-oophorectomy).
  • Radiation therapy is done in people who are not healthy enough to undergo surgery or is recommended after surgery is some patients to reduce the risk of cancer recurrence.
  • Advanced endometrial cancer that has spread beyond the uterus is treated with chemotherapy. Chemotherapy is sometimes recommended after surgery if there’s an increased risk that cancer might return.
  • Hormone therapy is recommended if there is advanced endometrial cancer that has spread beyond the uterus.
  • Immune therapy is an option if the cancer is advanced and other treatments haven’t helped.
  • Palliative care focuses on providing relief from pain and other symptoms.

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