Endometrial Cancer

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Endometrial cancer is a type of cancer that starts in the endometrium of the uterus (womb). The uterus is an organ where a foetus grows and develops when a woman is pregnant.

Endometrial cancer begins in the layer of cells that line the uterus called endometrium. Endometrial cancer is also called as uterine cancer. This cancer belongs to the group of cancers called carcinomas. Most of the endometrial carcinomas are adenocarcinomas, which is the cancer of the cells that form glands in the endometrium.

Endometrial Cancer

When the cancer begins in the muscle layer or in the connective tissue of the uterus, it belongs to the group of cancers called sarcomas. Sarcomas are less common than adenocarcinomas contributing about 2 % of uterine body cancers.

Endometrial cancer is found in the women of age 60 to 70. It is rare in women under the age of 45.

Causes of Endometrial Cancer

The exact cause of endometrial cancer is not known. However there are certain factors that increase the risk of getting this cancer.

Imbalance of hormones

During normal reproductive age, ovaries produce two main female hormones:

  1. Estrogen
  2. Progesterone

The secretion of these hormones changes during a menstrual cycle each month which keeps the endometrium healthy.  During menopause, the secretion of progesterone decreases and an increased level of estrogen causes growth of the endometrium. This leads to the risk of endometrial cancer.

Early menarche/puberty

Starting of the period in a female before the age of 12 increases the risk of endometrial cancer.

Late menopause

Menopause after the age of 50 also raises the risk for the cancer.

Hormone replacement therapy

This therapy is used to treat the symptoms of menopause. When only estrogen is administered without progesterone, it is found that it raises the risk of endometrial cancer. Hence, a combination therapy (estrogen + progesterone) reduces this risk.

Infertile or never being pregnant

Pregnancy protects a woman against endometrial cancer. Since during pregnancy there is increase in progesterone which causes the protection.

Obesity

Estrogen is produced by the ovaries as well as fatty tissue. Hence when a woman is obese, her estrogen level is high due to the secretion of estrogen from the fat tissue.

Tamoxifen

It is a drug used to treat breast cancer.  The role of tamoxifen is like estrogen, which increases the lining of the uterus in menopausal women. The increase in the lining leads to endometrial cancer.

Family history of endometrial cancer

This cancer tends to run in families.

Women with following disease conditions are at high risk for developing endometrial cancer

  • Polycystic ovarian syndrome (PCOS)
  • Breast cancer
  • Diabetes
  • Endometrial hyperplasia
  • Hypertension

Signs and symptoms of Endometrial Cancer

Unusual vaginal bleeding, spotting or discharge- This is the most common symptom of the cancer. Any abnormal bleeding between periods or after menopause should be reported to the doctor immediately.

Endometrial cancer is often detected at an early stage because it frequently produces abnormal vaginal bleeding, which prompts women to see their doctors. If endometrial cancer is discovered early, removing the uterus surgically often cures endometrial cancer.

Symptoms of endometrial cancer include:

  • Abnormal bleeding from the vagina, including bleeding between periods or spotting/bleeding after menopause
  • Pain in lower abdomen
  • Feeling of lump in lower abdomen and losing weight are symptoms that come later stages of cancer

Tests for Diagnosis of Endometrial Cancer

  • Endometrial biopsy
  • Hysteroscopy
  • Dilation and curettage (D and C)
  • Imaging tests to detect endometrial cancer:
  • Transvaginal sonography
  • CT (Computed Tomography) scan
  • MRI (Magnetic resonance imaging)
  • Blood tests that may indicate endometrial cancer:
  • CBC (Complete blood count) that may show anemia due to loss of blood.
  • CA 125 level

The spread of cancer to other parts of the body indicate staging. The systems used for staging endometrial cancer,

  1. FIGO (International Federation of Gynecology and Obstetrics) system and
  2. American Joint Committee on Cancer TNM staging system

Treatment of Endometrial Cancer

Treatment for women with endometrial cancer are

  • Surgery: Hysterectomy (removal of uterus and cervix) is the main treatment.
  • Radiation therapy: High-energy radiation (such as x-rays) are used to kill cancer cells.
  • Hormonal therapy: Hormone blocking drugs are administered to fight cancer.
  • Chemotherapy: Cancer-fighting drugs are given into a vein or by mouth.

Prevention of Endometrial Cancer

Endometrial cancer may be prevented by:

  • Maintaining ideal body weight
  • Adopting active physical lifestyle

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