Endometrial Cancer

By: Rachel Lalaine Marie G. Sialana, SN

What is Endometrial Cancer?

refers to several types of malignancies that arise from the endometrium, or lining, of the uterus. This is the most common cancer found in the female pelvis; it occurs more than twice as often as cervical cancer. Endometrial cancer occurs more frequently in older women (peak ages of 55-65 years), with only a 20% to 5% incidence among women younger than 40 years of age.

What are the causes of Endometrial Cancer?

By now the medical field still cannot define the exact causes of endometrial cancer. Generally it is believed that multi-factors have contributed the occurrence of endometrial cancer, which include: cervical erosion, frequent sexual behavior, disordered sex life, ignoring sexual behavior cleaning as well as menstruation, redundant prepuce of sex partner, herpes type II virus infection as well as HPV infection, venereal disease, mantle bacterial infection, etc.

Risk factors of Endometrial Cancer

obesity - the larger the woman, the larger the risk high levels of estrogen endometrial hyperplasia hypertension polycystic ovary syndrome nulliparity (never having carried a pregnancy) infertility (inability to become pregnant) early menarche (onset of menstruation) late menopause (cessation of menstruation) endometrial polyps or other benign growths of the uterine lining diabetes Tamoxifen high intake of animal fat pelvic radiation therapy breast cancer ovarian cancer anovulatory cycles age over 35 lack of exercise heavy daily alcohol consumption (possibly a risk factor)

Symptoms of Endometrial Cancer

Vaginal bleeding and/or spotting in postmenopausal women. Abnormal uterine bleeding, abnormal menstrual periods. Bleeding between normal periods in premenopausal women in women older than 40: extremely long, heavy, or frequent episodes of bleeding (may indicate premalignant changes). Anemia caused by chronic loss of blood.

Symptoms of Endometrial Cancer

Lower abdominal pain or pelvic cramping. Thin white or clear vaginal discharge in postmenopausal women. Postcoital bleeding. Enlarged lymph nodes.

Diagnostic Procedure
Pap Smear Endometrial biopsy Dilatation and Curettage Transvaginal ultrasonography

Dilatation and curettage (D and C). A speculum is inserted into the vagina to widen it in order to look at the cervix (first panel). A dilator is used to widen the cervix (middle panel). A curette is put through the cervix into the uterus to scrape out abnormal tissue (last panel).

Endometrial Biopsy

Stage I
In stage I, cancer is found in the uterus only. Stage I is divided into stages IA and IB, based on how far the cancer has spread. Stage IA: Cancer is in the endometrium only or less than halfway through the myometrium (muscle layer of the uterus). Stage IB: Cancer has spread halfway or more into the myometrium.

Stage II

In stage II, cancer has spread into connective tissue of the cervix, but has not spread outside the uterus.

Stage III
Stage IIIA: Cancer has spread to the outer layer of the uterus and/or to the fallopian tubes, ovaries, and ligaments of the uterus. Stage IIIB: Cancer has spread to the vagina or to the parametrium (connective tissue and fat around the uterus). Stage IIIC: Cancer has spread to lymph nodes in the pelvis and/or around the aorta (largest artery in the body, which carries blood away from the heart).

Stage IV
Stage IVA: Cancer has spread to the bladder and/or bowel wall. Stage IVB: Cancer has spread to other parts of the body beyond the pelvis, including the abdomen and/or lymph nodes in the groin.

Treatment (Surgery)
Total hysterectomy- removal of uterus and cervix. Bilateral salpingo-oophorectmy removal of both ovaries and both fallopian tubes. Radical hysterectomy- removal of the uterus, cervix and the part of the vagina as well as the nearby tissue including the lymph nodes.

Radiation Therapy
a cancer treatment that uses highenergy x-rays or other types of radiation to kill cancer cells or keep them from growing. 2 Types of Radiation Therapy 1. External Radiation Therapy 2. Internal Radiation Therapy

Hormone Therapy
is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing.

Chemotherapy
a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. 2 Types of Chemotherapy 1. Systemic Chemotherapy 2. Regional Chemotherapy

Prognosis
The prognosis for endometrial cancer depends on the clinical stage of the disease when it is discovered and its histologic grade and type. With early diagnosis and treatment, the 5-year survival rate is approximately 90%. This decreases to 20% for more advanced stages of the disease.