Endometrial cancer is a form of cancer that starts in the layer of cells forming the uterine lining (endometrium). The uterus, a pear-like hollow organ located above the pelvis, is where fetal development occurs.
Though endometrial cancer is occasionally referred to as uterine cancer, other less common cancers, like uterine sarcoma, can also develop in the uterus.
This type of cancer is often detected early since it causes noticeable symptoms. Irregular vaginal bleeding is the first and most common sign. When diagnosed in its early stages, surgical removal of the uterus effectively resolves the problem.
In the United States, approximately 66,200 new endometrial cancer cases are diagnosed annually, representing about 3.4% of new cancers.
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Endometrial cancer symptoms may include the following:
The exact cause of endometrial cancer is unclear. However, it is believed that changes occur in the cells of the uterine lining, turning them into cancerous cells.
Endometrial cancer begins when the DNA of cells in the endometrium undergo changes. The DNA contains the instructions for cell functions. Therefore, any changes trigger the cells to multiply rapidly. Also, while the healthy cells naturally die as part of the life cycle, the alterations instruct the cells to keep living.
This results in many cells, which may develop into a mass known as a tumor. These cells can invade and damage the healthy tissues in the body. Eventually, they separate and metastasize to other body areas.
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Endometrial cancer normally causes noticeable symptoms, enabling doctors to identify it while in its early stages. This increases the chances of a successful recovery and a good prognosis.
Currently, there are no screening methods for early detection or prevention of endometrial cancer. However, if symptoms appear, a gynecologist may recommend one or more of the following tests to diagnose the condition:
During a pelvic exam, the vagina and cervix are examined for abnormalities. The ovaries and uterus size and shape are also assessed to identify potential issues.
A tiny wand is inserted into the vagina to transmit sound waves, which enables a thorough evaluation of the uterus and ovaries. This test allows doctors to assess the thickness of the uterine lining and detect tumors or ovarian cysts.
During a pelvic exam, the doctor collects a small sample of tissue from the lining of the uterus with a flexible tube or small brush. The tissue is then taken to a pathologist to look for cancerous cells.
In a hysteroscopy, a tiny, flexible tube with attached light, called a hysteroscope, is inserted into the uterus via the vagina and cervix. The device has a lens that enables the provider to look closely at the inner uterus as well as the endometrium.
If a biopsy doesn’t obtain sufficient tissue or the results are indistinct, a procedure called dilation and curettage (D&C) may be recommended. In this procedure, tissue is removed from the uterine lining and analyzed for cancerous cells under a microscope.
Although this isn’t a screening method for endometrial cancer, a Pap smear can sometimes reveal abnormal signs in the endometrium. This test involves collecting cell samples from the cervix to check for cervical cancer.
The staging of endometrial cancer categorizes the disease depending on tumor size, whether it has reached the lymph nodes, and if it has metastasized (spread) to other body areas.
Doctors usually create a treatment plan for endometrial cancer according to factors such as:
Surgery is often the first and most common step when it comes to endometrial cancer treatment. Your oncologist can suggest a surgical procedure to take out the cancerous cells or assess its stage and determine if other treatments like chemotherapy or radiation are necessary following the surgery. For early-stage endometrial cancer, surgery generally involves:
Removal of the cervix, uterus, ovaries, and bilateral fallopian tubes (a total hysterectomy with bilateral salpingo-oophorectomy)
Lymph node evaluation during surgery. This can be performed in different ways, including:
Further treatments may be suggested before or after the procedure. The options include:
Persons detected with early-stage endometrial cancer at a young age may still get pregnant in certain cases. Those who wish to preserve their fertility and meet specific criteria may undergo hormonal therapy under the guidance of a gynecologic oncologist. If the treatment is effective, they may have the chance to become pregnant. It is essential to talk about your reproductive objectives with your oncologist before starting any treatment.
Endometrial cancer prognosis differs significantly depending on the histologic subtype. The stage of the cancer is the most crucial factor influencing general survival. The 5-year survival rates for people who have endometrial cancer are:
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