Medically Reviewed By:
Last Updated on May 5, 2023 by Shabnam Sengupta
Endometrial cancer, also known as uterine cancer, is a cancerous condition affecting the uterus/womb. It is one of the common cancers in females worldwide.
The uterus is a pear-shaped, hollow organ and is a part of the female reproductive system. It is the site for the growth of the fetus during pregnancy. The uterus consists of three different layers of tissue starting from inside they are endometrium, myometrium and perimetrium.
Since uterine cancer usually begins from the endometrial layer, it has been named so.
Signs and symptoms
Endometrial cancer starts from the innermost lining i.e endometrium.
As the endometrial lining is made up of numerous blood vessels and connective tissue and its monthly shedding is responsible for menstrual flow, the signs and symptoms of uterine cancer are similar but abnormal:
- Bleeding in between the menstrual cycle
- Bleeding after menopause
- Pelvic pain
- Heavy bleeding during periods
- Loss of appetite
- Fatigue
- Nausea
- Unintentional weight loss
- Pain in legs and back
- Blood while passing urine
- Pain during sexual intercourse
- Lump on the lower abdominal region
- Heavy and foul vaginal discharge
Causes
Contrary to popular belief that only females can get uterine cancer, anyone with a uterus has a risk of developing endometrial cancer including trans-men, and non-binary people.
Higher levels of oestrogen cause excessive stimulation of growth of the endometrial tissue and thus is the most common risk factor for uterine cancer. The following factors can cause an increase in the oestrogen level in the body:
- Obesity
- Hormonal replacement therapy after menopause
- Polycystic ovarian syndrome
Other factors that may influence cancer development are:
- Age: It usually develops after the age of 40 around the time of menopause
- Diabetes
- Family history of cancer
- Radiation exposure
- A genetic disorder like lynch syndrome
- Medication history of tamoxifen
- No pregnancy throughout life
- Late menopause with extended reproductive phase
Stages
There are a total of four stages on the basis of the spread of the tumor:
- Stage 1 – The cancer is still contained inside the womb (uterus) and hasn’t shown any spread in the nearby structures.
- Stage 2 – The cancer has spread to the neck of the womb called the cervix.
- Stage 3 – The cancer has spread outside the womb into nearby tissues in the pelvis or the lymph nodes.
- Stage 4 – The cancer has spread to the soft tissues of the abdomen, or into other organs, such as the bladder, bowel, liver, or lungs distant to the primary site of origin.
Diagnosis
- Physical examination of the pelvis: The doctors examine the uterus by inserting fingers into the vagina and placing the other hand over the abdomen to feel the uterus between both hands.
- Transvaginal USG scan: A small instrument called a transducer is inserted into the vagina which emits high-frequency sound waves. The reflection of these waves helps in visualising any tumour if present.
- Hysteroscopy: a small tube with a camera fitted at the end is inserted inside the uterus and the entire lining is carefully checked for any abnormal tissue growth. A small sample of tissue is also cut out for microscopic examination.
- Biopsy: The small tissue sample taken doing hysteroscopic examination is sent to be examined under the microscope. If cancer cells are seen, then it confirms malignancy.
- Dilatation and curettage: The cervix is dilated and the inner walls of the uterus are scraped to obtain tissue that can be examined under the microscope.
- Blood tests: The blood can be tested for certain tumour markers which are the special proteins secreted by the cancer cells.
Further testing can be done with:
- CT scan – to visualise the location and dimensions of the tumour
- MRI – helps in predicting the extent of tissue involved
- PET- CT – helps to visualise the areas and extent of metastasis
Complications
As uterine cancer causes extensive bleeding it can lead to complications like:
- Anaemia which can lead to fatigue, palpitations, headache, etc.
Treatment
The exact treatment protocol is decided with respect to the type of cancer, the extent of tissue involved, the presence of metastasis etc.
The commonly used treatment methods are:
- Surgery: The uterus with ovaries and fallopian tubes are usually removed.
- Chemotherapy: Anti-cancer medications can be given either intravenously or orally that kill the rapidly diving cancerous cells in the body.
- Radiotherapy: Waves carrying high energy are made to pass through the body which specifically kills the malignant cells.
- Immunotherapy: Special antibodies targeted against the cancer cells are given to the patient.
- Targeted medications: Medicines specifically made in order to kill the uterine cancer cells can also be tried out.
- Hormone therapy: The cancer cells of the uterus have a hormone-dependent growth, which means if the supply of oestrogen and progesterone are cut off, it can help in tumour regression.
Prevention
- General preventive measures include maintaining a healthy diet and BMI within the normal range.
- Being physically active
- Consumption of birth control pills as a contraceptive measure also reduces the risk.
- Avoid taking hormone replacement therapy after menopause for a very long period of time.
Disclaimer: Medical Science is an ever evolving field. We strive to keep this page updated. In case you notice any discrepancy in the content, please inform us at [email protected]. You can futher read our Correction Policy here. Never disregard professional medical advice or delay seeking medical treatment because of something you have read on or accessed through this website or it's social media channels. Read our Full Disclaimer Here for further information.
