Endometrial cancer diagnosis and treatment
Endometrial cancer diagnosis, prevention and treatment can be complicated. Modern medicine developed diagnostic tests and effective methods of treatment which can insure long survival rates. Pelvic examination is frequently normal, especially in the early stages of disease. Changes in the size, shape, or feel of the uterus or surrounding structures may be seen when the disease is more advanced.
Tests that may be done include:
- Endometrial aspiration or biopsy
- Dilation and curettage (D&C)
- Pap smear (may raise a suspicion for endometrial cancer, but does not diagnose it)
If cancer is found, other tests may be done to determine how widespread the cancer is and whether it has spread to other parts of the body. This is called staging.
Stages of endometrial cancer:
Stage 1 – The cancer is only in the uterus.
Stage 2 – The cancer is in the uterus and cervix.
Stage 3 – The cancer has spread outside of the uterus but not beyond the true pelvis area. Cancer may involve the lymph nodes in the pelvis or near the aorta (the major artery in the abdomen).
Stage 4 – The cancer has spread to the inner surface of the bowel, bladder, abdomen, or other organs.
Endometrial cancer treatment
Endometrial cancer treatment options involve surgery, radiation therapy, and chemotherapy.
The main treatment for endometrial cancer at its early stages is surgery – to remove the uterus plus the cervix, ovaries, and fallopian tubes. The doctor will also remove pelvic and aortic lymph nodes to see if the cancer has spread. A woman whose cancer has spread may also have:
- Chemotherapy to kill cancer cells.
- Hormone therapy (progestin hormone) to block cancer growth.
- Radiation therapy to kill cancer cells.
Surgery combined with radiation therapy is often used to treat women with stage 1 disease that has a high chance of returning, has spread to the lymph nodes, or is a grade 2 or 3. It is also used to treat women with stage 2 disease.
Chemotherapy may be considered in some cases, especially for those with stage 3 and 4 disease.
Endometrial cancer prognosis
- Endometrial cancer is usually diagnosed at an early stage. The 1-year survival rate is about 92%.
- The 5-year survival rate for endometrial cancer that has not spread is 95%. If the cancer has spread to distant organs, the 5-year survival rate drops to 23%.
- Endometrial cancer complications may include anemia due to blood loss. A perforation (hole) of the uterus may occur during a D&C or endometrial biopsy.
- There can also be complications from hysterectomy, radiation, and chemotherapy.
Endometrial cancer – when to contact your doctor
Call for an appointment with your health care provider if you have abnormal vaginal bleeding or any other symptoms of endometrial cancer. This is particularly important if you have any associated risk factors (see above) or if you have not had routine pelvic exams.
Any of the following symptoms should be reported immediately to the doctor:
- Bleeding or spotting after intercourse or douching
- Bleeding lasting longer than 7 days
- Periods that occur every 21 days or more
- Bleeding or spotting after 6 months or more of no bleeding at all
Endometrial cancer prevention
All women should have regular pelvic exams beginning at the onset of sexual activity (or at the age of 21 if not sexually active) to help detect signs of infection of abnormal development.
Women should have Pap tests beginning 3 years after becoming sexually active.
Women with any risk factors for endometrial cancer should be followed more closely by their doctors. Frequent pelvic examinations and screening tests such as a Pap smear and endometrial biopsy should be considered.
Women who are taking estrogen replacement therapy should have regular pelvic examinations and Pap smears.
Endometrial cancer risk reduction
There are some measures that can lower your risk for developing endometrial cancer.
- Taking birth control pills that contain both estrogen and progestin for longer than 1 year. Similarly, taking estrogen with progestin for menopausal symptoms lowers your cancer endometrial risk. (You have no risk for cancer endometrial if you have had your uterus removed, or hysterectomy.)
- Staying at a healthy body weight.
- Being physically active.
- Eating a diet rich in fruits, vegetables, and fiber.
- Lowering the amount of animal fats you eat.
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