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Endometrial Cancer - Causes, Symptoms, Risk Factors, Stages, Diagnosis, and Treatment

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Endometrial Cancer - Causes, Symptoms, Risk Factors, Stages, Diagnosis, and Treatment

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Endometrial cancer is a condition that affects the female reproductive system. Read this article to know more about the symptoms, causes, diagnosis, and treatment

Written by

Dr. Lochana .k

Medically reviewed by

Dr. Richa Agarwal

Published At January 22, 2021
Reviewed AtFebruary 17, 2023

What Is Endometrium?

In medical terms, the endometrium refers to the inner lining of the uterus. This layer thickens before the occurrence of menstruation and begins shredding during the menstrual cycle. If conception has occurred, the endometrium will grow into a thick layer, making it prepared for the implantation process. It is an essential layer that plays a vital role in reproductive systems.

What Is Endometrial Cancer?

Endometrial cancer is one that begins in the inner walls of the uterus. In general terms, endometrial cancer is also referred to as uterine cancer. It is the most common type of cancer that can occur in the uterus. Other types of uterine cancers are very rare. Reports from the National Cancer Institute suggests that three out of a hundred women have the chance of getting uterine cancer in their life. The good news is that more than eighty percent of the people with uterine cancer survived and lead a happy life.

What Are the Causes of Endometrial Cancer?

The precise cause of endometrial cancer is not identified to date. Researchers suggest that genetic mutations might contribute to the conversion of normal healthy cells into abnormal ones. The cancer cells tend to separate from the initial site and spread to other regions through metastasis.

What Are the Symptoms of Endometrial Cancer?

The common symptom experienced by patients with endometrial cancer is excessive vaginal bleeding. This can be seen even after menopause. The vaginal bleeding can be hefty during the menstrual cycles, and spotting is also seen. Women who are affected by endometrial cancer have a menstrual period that is longer than usual. The other symptoms that are associated with endometrial cancer are:

  • Pain in the pelvis.

  • Physical discomfort.

  • Inability to walk properly.

  • Pain in the involved site.

  • Painful sexual intercourse.

  • The vaginal discharge might be seen along with blood or watery discharge.

The patient must pay attention to these symptoms because they might result in severe complications. You have to visit your gynecologist as soon as possible.

What Are the Risk Factors for Endometrial Cancer?

The risk factors associated with endometrial cancer are:

Endometrial Cancer

Family History:

Endometrial cancer tends to run in families. People having close relatives with endometrial cancer or colorectal cancer are at higher risk of developing cancer. This disorder is otherwise known as Lynch syndrome or hereditary nonpolyposis colon cancer, which is caused by a defect in either the repair gene MLH1 or the gene MSH2.

Age:

The risk of developing endometrial cancer is higher in older adults who are above the age of 55 years.

Exposure to Excess Endogenous and Exogenous Estrogen Levels:

Women taking estrogen therapy to treat the symptoms of menopause can increase the risk of developing endometrial cancer, especially when estrogen is taken alone without Progesterone.

Associated Factors:

  • Dietary Factors:

A high fat diet can increase the risk of developing many cancers, including endometrial cancer, as fatty foods are also high in calories and can lead to obesity which is the major risk factor for endometrial cancer. Having more fat tissues can increase women’s estrogen levels, making them more likely to develop endometrial cancer.

  • Medications:

Medications like Tamoxifen which is used to treat and prevent breast cancer acts like estrogen in the uterus, increasing the risk of developing cancer.

  • Breast or Ovarian Cancer:

Women who have had cancers such as breast cancer or ovarian cancer previously have a higher risk of developing endometrial cancer, too, because some of the dietary, hormone and reproductive risk factors for breast and ovarian cancer increases the risk of endometrial cancer.

In a study, it was found that endometrial cancer is twice as common in women with type 2 diabetes. And diabetes is more common in people who are obese and less active, which are other risk factors for endometrial cancer.

What Are the Stages in Endometrial Cancer?

Endometrial cancer can begin from the uterus and spread to the different parts of the body. The initial site where cancer occurs is known as primary cancer, and the regions where cancer can spread are known as secondary cancer. Endometrial cancer is basically classified into four stages. They are:

  • Stage 1: In stage 1, the cancer is seen only in the uterus.

  • Stage 2: In stage 2, the cancer is present in both the uterus and the cervix.

  • Stage 3: In the third stage, cancer begins spreading from the uterus, but it would not have reached the bladder or the rectal region. It might be seen on the ovaries, vagina, and fallopian tube. In addition to this, there will be involvement of the nearby lymph nodes.

  • Stage 4: This is the last stage where cancer has spread beyond the pelvic region. There will be involvement of the bladder and the rectum. Tissues and organs that are present from the uterus are also affected.

These four stages are very helpful in formulating a treatment plan for the patient. Endometrial cancer that is in the initial stage can be easily treated. If secondary cancer occurs, then the treatment options are very restricted, and the outcome becomes unpredictable sometimes.

How Is Endometrial Cancer Diagnosed?

The diagnosis for endometrial cancer would require a specialist for a female reproductive system. The gynecologist will help you in identifying the symptoms that are related to endometrial cancer. They will undergo a physical examination of the pelvis to identify the abnormalities present in the uterus and the surrounding areas. The other methods to identify the presence of endometrial cancer are:

  • Transvaginal Ultrasound Examination: In this method, the sound waves used to create the pictures are sent inside the body. It will detect the abnormalities present in the cervix, ovaries, vagina, uterus, and fallopian tube.

  • Abdomen Scan: An ultrasound procedure of the abdomen will use an instrument called a transducer to identify the problems in the pelvis. The ultrasound probe is inserted into the vaginal canal.

  • Hysteroscopy: In the hysteroscopy procedure, a thin fiber-optic camera is inserted into the cervical region into the uterus. The flexibility of the tube and the thin nature helps in passing the tube deep inside. This endoscope can help in the visual examination of the endometrium, and the samples of the biopsy can also be collected.

  • Endometrial Biopsy: Biopsy is a procedure in which a small part of the tissue is removed from the required site. Here, instruments are used to remove the endometrial tissue for diagnosis. In some cases, suction might also be used to remove the tissue.

  • Dilation and Curettage: For collecting the samples from the endometrial valve, the doctor will perform a dilation and curettage procedure. The cervix is dilated using specialized tools to scrape off the tissues from the endometrium. After the sample is collected, it is sent to the laboratory for histological analysis.

  • Blood Test: In cancer conditions, there will be an increase in the number of inflammatory cells and white blood cells (WBC). This will help in making an initial diagnosis of endometrial cancer.

  • X-ray: X-ray is a trustworthy diagnostic procedure in which the exact site and bone involvement during cancer conditions can be detected. To a certain extent, the soft tissues can also be visualized.

What Are the Treatment Options for Endometrial Cancer?

The various treatment options for endometrial cancer are:

  • Hysterectomy: It is a procedure in which surgery is performed to remove the uterus completely. The complication associated with this surgery is that the patient loses their ability to become pregnant in the future.

  • Salpingo-Oophorectomy: If the hysterectomy procedure is done along with the removal of ovaries and fallopian tubes, then the procedure is known as a salpingo-oophorectomy.

  • Radiation Therapy: Radiation therapy will help in reducing the risk of cancer by killing cancer cells.

  • Chemotherapy: In chemotherapy, medications are prescribed for oral consumption. Intravenous administration is also done. This will contribute to killing the cancer cells.

In addition to this, immunotherapy, targeted drug therapy, and hormonal therapy might be needed. The patient will also require emotional and physical support from family and friends.

What Are the Precautionary Measures to Be Followed for Endometrial Cancer?

By following the below tips, it is possible to overcome the condition of endometrial cancer. It can also help in the prevention of any other types of cancer.

  • Healthy lifestyle. It is necessary to stick to a healthy diet plan. You should consume more fruits and vegetables. This will help you in maintaining a healthy weight. If your BMI is normal, then it is a sign that you are physically healthy.

  • For maintaining a mentally healthy state, practice yoga and meditation regularly. Physical exercises also help you in keeping mentally fresh.

  • Do not use contraceptive pills excessively. This should also not keep you away from having sexual intercourse. You can adopt alternative contraceptive methods like female and male condoms.

  • If you notice any mild variation in your menstrual periods, it is essential to notify your doctor immediately.

Frequently Asked Questions

1.

Is Rapid Spreading Associated With Endometrial Cancer?

Accelerated spreading is associated with type 2 endometrial cancer, which is usually rare, whereas the most common type 1 endometrial cancers have a slower spreading rate.

2.

Which Area Is First Affected by the Spread of Endometrial Cancer?

Endometrial cancer is a tumor of the uterus which metastasizes to the bladder or rectum initially and may also further spread to fallopian tubes, ovaries, and vagina.

3.

How Can We Identify Endometrial Cancer Spread?

Signs of metastatic endometrial cancer include:
- Vaginal bleeding.
- Anemia.
- Frequent painful urination.
- Pain during intercourse.
- Unexplained weight loss.
- Persistent pelvic cramping.

4.

Can Endometrial Cancer Recur After Hysterectomy?

Recurrence of endometrial cancer is likely in supracervical or subtotal hysterectomy where only the upper part of the cervix is removed, whereas in complete hysterectomy, recurrence is not possible.

5.

Is Chemotherapy Needed for Endometrial Cancer?

Stage three and stage four endometrial cancers usually require chemotherapy when uterine carcinosarcomas, serous cancers, or clear cell tumors are diagnosed. In endometrial cancer, chemotherapy is given after surgery to destroy the remaining cancer cells and support radiation therapy.

6.

What Are the Consequences of Untreated Endometrial Cancer?

Although endometrial cancer, if left untreated, spreads to the rectum, bladder, ovaries, fallopian tubes, vagina, and other distant organs, the spreading rate is slow and can be identified before it metastasizes.

7.

How Prevalent Is Endometrial Cancer?

Endometrial cancer is the most commonly occurring gynecologic cancer. The fourth most common cancer in females is uterine cancer, and endometrial cancer occupies about 90% of all uterine cancers.

8.

How Can We Diagnose Endometrial Cancer?

Pelvic examination, a transvaginal ultrasound, endometrial biopsy, hysteroscopy, and biopsy by dilatation and curettage help diagnose endometrial cancer.

9.

What Reduces Endometrial Cancer Risk?

The risk of endometrial cancer is minimized by gestation, breastfeeding, using hormonal contraceptive pills, maintaining ideal body weight, and regular exercise.

10.

What Increases the Risk of Endometrial Cancer?

Endometrial hyperplasia, Tamoxifen, obesity, diabetes, hyperlipidemia, increased estrogen, family history, and genetic disorders like Lynch syndrome, Cowden syndrome, and polycystic ovary syndrome increase the endometrial cancer risk. Estrogen level is raised by Estrogen-only hormone therapy, never being pregnant, early menstruation, and late menopause.

11.

What Foods Should Be Avoided in Endometrial Cancer?

Refined sugar or white flour-containing foods raise the glycemic load of the person, which eventually increases the risk of endometrial cancer.

12.

Why Is Tamoxifen Associated With Endometrial Cancer?

Tamoxifen prevents breast cancer in high-risk women that is a selective estrogen receptor modulator (SERM). It behaves like estrogen in a few of the body's tissues, such as the uterus, and raises the risk of endometrial cancer if taken for more than two years. The chance is much increased in postmenopausal women.
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Dr. Lochana .k
Dr. Lochana .k

Dentistry

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