This cancer type starts in the uterus cells and it is called endometrial cancer. The uterus is a pelvic organ where fetal development occurs. When the cancerous cells begin in the endometrium (the lining of the uterus), this cancer type occurs. Sometimes, physicians call this cancer type uterine cancer.
There are other cancer types that may begin in the uterus (such as uterine sarcoma) but are far less common than endometrial cancer. Commonly, endometrial cancer is found early because it causes symptoms (such as irregular vaginal bleeding, which is often the first symptom). Fortunately, it is possible to cure this cancer type if it is identified early. Treatment usually involves surgery to remove the uterus but may include other options too.
Symptoms
People with endometrial cancer usually experience the following symptoms. For example:
- Pelvic pain
- Bleeding between periods
- Vaginal bleeding after menopause
- Fatigue (extreme tiredness)
- Nausea
- Lower abdomen pressure
- Urinating problems
If any of the previous symptoms occur, immediately visit your healthcare professional.
Causes
While the exact cause of endometrial cancer is not known, healthcare providers know that there are some changes that happen to cells in the uterus lining.
Approximately all cancer types usually begin when a DNA change (mutation) in cells occurs. In such cases, DNA changes happen to uterus lining cells. DNA contains instructions that tell a cell when to grow, multiply, and die. When DNA mutation happens, it gives cells different instructions, which leads to their abnormal multiply and growth. When the abnormal cells become too much, they form a mass usually called a tumor. Moreover, cancerous cells continue to live while healthy ones die. In addition, without early diagnosis and treatment, tumors may break and spread throughout the body (metastatic cancer).
Risk Factors
While anyone may develop this cancer type, there are some factors that may increase your risk. For example:
Hormonal Changes
There are two main hormones produced by ovaries (Estrogen and Progesterone). If any changes between these hormones occur, it may lead to endometrium changes.
A health condition that increases Estrogen production but Progesterone levels remain without changes may increase the risk of endometrial cancer. These include diabetes, obesity, irregular ovulation patterns often caused by polycystic ovary syndrome, and others. Women who follow hormone therapy with Estrogen without Progestin also are at increased risk of developing this cancer type.
Additionally, an ovarian tumor that occurs rarely and produces Estrogen also may increase your risk of developing uterine cancer.
Early Menstruation
If menstrual periods begin before 12 years old or menopause starts too late, you are at elevated risk of endometrial cancer. However, the risk increases as more menstrual periods you have had.
Pregnancy
Women who have never been pregnant are at higher risk of developing endometrial cancer compared to women who have been pregnant at least once.
Age
The risk of this cancer type increases with aging and happens most commonly in postmenopausal women.
Obesity
People with excessive body weight may experience hormonal changes due to extra fat. Thus, the risk of endometrial cancer increases.
Breast Cancer Hormone Therapy
The risk of uterine cancer also increases if you are taking Tamoxifen (a medicine used to treat breast cancer). However, it is advised to discuss with your healthcare professional about the risks and benefits of administering Tamoxifen.
Inherited Syndromes
There is an inherited disorder that may increase the risk of colon cancer and others (including endometrial cancer). This condition is called Lynch syndrome and it occurs due to a DNA change (mutation) that passes from biological parents. Therefore, it is advised to consult with your healthcare professional about this genetic disorder if a family member was diagnosed with Lynch syndrome.
How to Prevent Endometrial Cancer?
There is no sure way to prevent this cancer type but the following tips may help reduce the risk. For example:
- Women who consider hormone therapy to lessen menopause symptoms should talk with their doctor before because it may increase the risk of endometrial cancer. Do not take any hormone medicines without your doctor’s approval.
- Oral contraceptives (birth control pills) may reduce the risk of this cancer type if are used for at least one year. The reduced risk of endometrial cancer is thought to last a few years after you interrupt taking them.
- Try to get and maintain a healthy weight because excessive body weight may cause hormonal imbalances that may lead to endometrial cancer.
Diagnosis
Physicians usually diagnose uterine cancer by performing the following tests and procedures. For example:
- Pelvis examination – This procedure is often done to check reproductive organs but may be used if you have endometrial cancer symptoms. During this examination, doctors use a device called a speculum that is inserted into the vagina. Thus, it helps open the vaginal canal, which allows the doctor to check for uterine cancer symptoms.
- Imaging tests – Physicians usually perform a transvaginal ultrasound, CT (computerized tomography) scan, or MRI (magnetic resonance imaging) scan. These tests help doctors get detailed images of the reproductive organs and exclude other health problems that cause similar symptoms.
- Hysteroscopy – This procedure involves a small and flexible tube that is inserted through the vagina and cervix into the uterus. It helps your doctor examine inside the uterus and endometrium.
- Endometrial biopsy – This involves the removal of a small sample of uterine tissue and testing under a microscope for cancer cells.
In most cases, people who were diagnosed with this cancer type are referred to a specialist trained in treating reproductive system cancers (gynecologic oncologist).
Treatment
In most cases, the first treatment for endometrial cancer is surgery to remove the cancer. It includes removal of the uterus, fallopian tubes, and ovaries. However, doctors may prescribe additional treatments including radiation therapy, chemotherapy, and others to destroy cancer cells that may remain after surgery.
Surgery
This procedure is called hysterectomy and removal of the fallopian tubes and ovaries (a procedure called salpingo-oophorectomy). After these surgeries, you cannot become pregnant and make menopause start right after surgery. Menopause occurs due to a lack of Estrogen production caused by ovary removal.
During a hysterectomy, surgeons may remove lymph nodes and send them to the laboratory for testing. This test helps determine the cancer stage.
Radiation Therapy
This treatment option involves powerful energy beams that often come from X-rays, protons, or other sources to destroy cancer cells. Sometimes, this therapy can be recommended by doctors before surgery to shrink the tumor.
For some people, radiation therapy may be the only treatment because surgery cannot be performed.
Chemotherapy
This treatment option involves strong medications usually given intravenously to kill cancer cells. Sometimes, this procedure is recommended along with radiation therapy either before or after surgery. However, a pill form also is available. Chemotherapy medications work by traveling through the body and destroying cancer cells.
In some cases, chemotherapy is used to treat advanced endometrial cancer that has spread throughout the body.
Hormone Therapy
These medications are used to reduce hormone levels in the body that help destroy cancer cells that rely on hormones. This therapy also can be used in people with advanced endometrial cancer that has spread to other body parts.
Targeted Therapy
This treatment involves medications that block a specific protein in the cancer cells causing them to die. Doctors may prescribe targeted therapy and chemotherapy medicines to be taken at the same time. Healthcare professionals may perform some tests to determine whether targeted therapy is effective for you.
Immunotherapy
This involves specific medicines that boost the immune system to fight against cancer cells. However, cancerous cells can survive for long periods because produce a substance that helps them hide from the immune system. Doctors often prescribe immunotherapy in people with advanced endometrial cancer or when other treatment options have not helped.
Frequently Asked Questions
Can endometrial cancer be cured?
Yes, in most cases, this cancer type is cured by surgery that removes the uterus, fallopian tubes, and ovaries. However, you may need additional treatment such as radiation therapy or chemotherapy to destroy the remaining cancer cells.
What is the primary endometrial cancer symptom?
Approximately 90% of women with this cancer type experience the following symptoms. For example abnormal or unusual vaginal bleeding, spotting, or other discharge.
What are the main risk factors for endometrial cancer?
If you have excessive body weight or are obese, your risk of developing uterine cancer increases significantly. However, there are other risk factors too such as older age, family history, health conditions (such as polycystic ovary syndrome), certain medications (such as Tamoxifen), and others. If you have additional questions, ask your healthcare provider.
