Womb cancer or cancer of the uterus is also known as uterine cancer. Endometrial cancer is cancer which involves the inner lining of the uterus. Endometrial cancer is not only the most common uterine cancer but also the most common cancer of the female reproductive system. Endometrial cancer can be cured if detected early. Endometrial cancer commonly affects post-menopausal women. Post-menopausal women are women who no longer have periods. Endometrial cancer can still affect women of any age group although it is less common. Understanding the structure of the uterus will help us to better understand this disease. Cancer after hysterectomy is possible but unlikely if the disease is treated at a very early stage.
The uterus is a pear-shaped organ. This organ is located in the pelvis, between the bladder and rectum. Uterus has three layers. The innermost layer is the endometrium, the middle layer is the myometrium (muscle), and the outermost layer is the perimetrium. There is a list of signs and symptoms if a woman is suffering from endometrial cancer. The clinical features are:
- Abnormal vaginal bleeding
- Heavy menstrual bleeding
- Bleeding between menses
- Vaginal bleeding in postmenopausal women
- Loss of weight
- Loss of appetite
If you have abnormal vaginal bleeding, please see a doctor. Doctors usually will advise you to go for a certain test to detect endometrial cancer. There are two tests available. The tests are:
- Endometrial biopsy
- Dilatation and curettage with hysteroscopy
Both of the mentioned tests are aiming to take endometrial tissue as a sample. The tissue is later put under a microscope for analysis and observation. History taking and physical examination are also needed on top of the investigation (test) to confirm a diagnosis of endometrial cancer. The risk factors for endometrial cancer are:
- Estrogen therapy in postmenopausal women
- Taking tamoxifen
- Never pregnant and give birth (nulliparous)
- Diabetes mellitus
- Old age
- Cowden syndrome
- Late menopause
- Polycystic ovary syndrome
- Lynch syndrome
Once a diagnosis of endometrial cancer is confirmed, staging will be done. Staging is a method used to classify the spread of cancer. The staging for endometrial cancer is based on how deep the invasion of cancer into the muscle layer of the uterus and whether cancer spread to other organs. There are four stages for endometrial cancer. Stage 1 is when cancer has not spread beyond the lining of the uterus. Stage four is when cancer has affected other organs.
Surgery is the main treatment option for endometrial cancer. There are many types of surgery available depending on the extent of the disease. Some patients can go for only the removal of cancer, while some may need to remove their uterus, fallopian tubes, and ovaries. The surgical approach can be either open surgery with large wounds and scars or laparoscopic surgery which is minimally invasive. If surgery can’t be done for whatever reason, radiation therapy alone will be done.
Chemotherapy is sometimes given before surgery to shrink cancer. Women in the United States of America have a lifetime risk of 2.8 in getting endometrial cancer. 62 years old is the average age of American women who are diagnosed with endometrial cancer.