By Dr. Vani Ravikumar
Endometrial Cancer is a type of cancer arising in the uterus of women. The lining of the uterus is called Endometrium and cancer arising from these cells is endometrial Carcinoma.
Symptoms
The average age at diagnosis is about 63 years. 90% of patients have some form of vaginal discharge, usually bleeding. Non-cyclical abnormal vaginal bleeding may be seen. Patients with cervical stenosis may present with pelvic pain, or malignant cells may be found on a Pap smear. Women with advanced disease may have abdominal distension, pelvic pressure, or pain.
Endometrial cancers are of 2 types- Type 1 and Type 2
Risk Factors for type I cancer are:
Postmenopausal women with high concentrations of Oestrogens
Taking hormones after menopause that contain oestrogen but not progesterone increases the risk of endometrial cancer
Polycystic ovary syndrome
Oestrogen-producing ovarian tumours
Early age at menarche (before 12 years)
Late age at menopause
Nulliparity (never having been pregnant)
Hormone therapy, namely Tamoxifen, for breast cancer
Obesity
Familial Endometrial Cancer
Occurs in a much younger age group, around 40s, and is associated with Lynch syndrome and Cowden syndrome. Lynch Syndrome is a germline transmission of defective DNA mismatch repair genes called MSH2, MLH1, MSH6, and PMS2.
Protective Factors
Include late age at first birth and last birth, continuous combined hormone replacement therapy, oral contraceptives (high progestin potency), injectable progestins, intrauterine devices, smoking, and tubal ligation.
Tests and Procedures to Detect Endometrial Cancer
- Pelvic examination. 2. Transvaginal Ultrasound examination 3. Hysteroscopy 4. Endometrial Biopsy and D&C (Dilatation and Curettage)
Prognosis
It depends on the age at which this cancer is detected and also the stage of the disease, the extent of spread, and the grade of cancer (Low Grade or High grade).
Treatment
Treatment depends on the grade and also the stage of cancer. The various treatment modalities are:
- Surgery- removal of the uterus (hysterectomy), salpingo-oophorectomy (removal of tubes and ovaries)
- Radiotherapy- External beam radiation, internal radiation (brachytherapy)
- Chemotherapy – Chemotherapy uses chemicals to kill cancer cells. You may receive one chemotherapy drug, or two or more drugs can be used in combination. You may receive chemotherapy drugs by pill (orally) or through your veins (intravenously)
- Hormone Therapy – Hormone therapy involves taking medications to lower the hormone levels in the body. In response, cancer cells that rely on hormones to help them grow might die
- Targeted therapy – Targeted drug treatments focus on specific weaknesses present within cancer cells
- Immunotherapy – Immunotherapy is a drug treatment that helps your immune system to fight cancer
- Supportive (palliative) therapy- Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness
(The author is MBBS, MD, DNB, Pathologist, RV Metropolis Lab, Bangalore. Views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)