Endometrial Cancer

Endometrial cancer refers to several types of malignancy which arise from the endometrium, or lining of the uterus. Endometrial cancers are the most common gynecologic cancers in the United States, with over 35,000 women diagnosed each year in the U. S. The most common subtype, endometrioid adenocarcinoma, typically occurs within a few decades of menopause, is associated with excessive estrogen exposure, often develops in the setting of endometrial hyperplasia, and presents most often with vaginal bleeding. Endometrial carcinoma is the third most common cause of gynecologic cancer death (behind ovarian and cervical cancer).

A total abdominal hysterectomy (surgical removal of the uterus) with bilateral salpingo-oophorectomy is the most common therapeutic approach. Endometrial cancer may sometimes be referred to as uterine cancer. However, different cancers may develop not only from the endometrium itself but also from other tissues of the uterus, including cervical cancer, sarcoma of the myometrium, and trophoblastic disease. Classification Most endometrial cancers are carcinomas (usually adenocarcinomas), meaning that they originate from the single layer of epithelial cells which line the endometrium and form the endometrial glands.

There are many microscopic subtypes of endometrial carcinoma, including the common endometrioid type, in which the cancer cells grow in patterns reminiscent of normal endometrium, and the far more aggressive uterine papillary serous carcinoma|papillary serous carcinoma and clear cell endometrial carcinomas. Some authorities have proposed that endometrial carcinomas be classified into two pathogenetic groups:[1] • Type I: These cancers occur most commonly in pre- and peri-menopausal women, often with a history of unopposed estrogen exposure and/or endometrial hyperplasia.

They are often minimally invasive into the underlying uterine wall, are of the low-grade endometrioid type, and carry a good prognosis. • Type II: These cancers occur in older, post-menopausal women, are more common in African-Americans, are not associated with increased exposure to estrogen, and carry a poorer prognosis. They include: • the high-grade endometrioid cancer, • the uterine papillary serous carcinoma, • the uterine clear cell carcinoma. In contrast to endometrial carcinomas, the uncommon endometrial stromal sarcomas are cancers which originate in the non-glandular connective tissue of the endometrium.

Uterine carcinosarcoma, formerly called Malignant mixed mullerian tumor, is a rare uterine cancer which contains cancerous cells of both glandular and sarcomatous appearance – in this case, the cell of origin is unknown. Signs & Symptoms Vaginal bleeding and/or spotting in postmenopausal women • Abnormal uterine bleeding, abnormal menstrual periods • Bleeding between normal periods in premenopausal women in women older than 40: extremely long, heavy, or frequent episodes of bleeding (may indicate premalignant changes) • Anemia, caused by chronic loss of blood.

(This may occur if the woman has ignored symptoms of prolonged or frequent abnormal menstrual bleeding. ) • Lower abdominal pain or pelvic cramping • Thin white or clear vaginal discharge in postmenopausal women. Risk Factors • high levels of estrogen • endometrial hyperplasia • obesity • hypertension • polycystic ovary syndrome • nulliparity (never having carried a pregnancy) • infertility (inability to become pregnant) • early menarche (onset of menstruation) • late menopause (cessation of menstruation)

• endometrial polyps or other benign growths of the uterine lining • diabetes • Tamoxifen • hyperplasia • high intake of animal fat • pelvic radiation therapy • breast cancer • ovarian cancer • heavy daily alcohol consumption Staging Endometrial carcinoma is surgically staged using the FIGO cancer staging system. • Stage IA: tumor limited to the endometrium • Stage IB: invasion of less than half the myometrium • Stage IC: invasion of more than half the myometrium • Stage IIA: endocervical glandular involvement only • Stage IIB: cervical stromal invasion.

• Stage IIIA: tumor invades serosa or adnexa, or malignant peritoneal cytology • Stage IIIB: vaginal metastasis • Stage IIIC: metastasis to pelvic or para-aortic lymph nodes • Stage IVA: invasion of the bladder or bowel • Stage IVB: distant metastasis, including intraabdominal or inguinal lymph nodes Treatment The primary treatment is surgical. Surgical treatment should consist of, at least, cytologic sampling of the peritoneal fluid, abdominal exploration, palpation and biopsy of suspicious lymph nodes, abdominal hysterectomy, and removal of both ovaries (bilateral salpingo-oophorectomy).

Lymphadenectomy, or removal of pelvic and para-aortic lymph nodes, is sometimes performed for tumors that have high risk features, such as pathologic grade 3 serous or clear-cell tumors, invasion of more than 1/2 the myometrium, or extension to the cervix or adnexa. Sometimes, removal of the omentum is also performed. Abdominal hysterectomy is recommended over vaginal hysterectomy because it affords the opportunity to examine and obtain washings of the abdominal cavity to detect any further evidence of cancer.

Women with stage 1 disease who are at increased risk for recurrence and those with stage 2 disease are often offered surgery in combination with radiation therapy. Chemotherapy may be considered in some cases, especially for those with stage 3 and 4 disease. hormonal therapy with progestins and antiestrogens has been used for the treatment of endometrial stromal sarcomas. The antibody Herceptin, which is used to treat breast cancers that overexpress the HER2/neu protein, has been tried with some success in a phase II trial in women with uterine papillary serous carcinomas that overexpress HER2/neu.

Radiation therapy for endometrial cancer Radiation therapy is the use of high-dose X-rays to destroy cancer cells. Radiation therapy may be used to treat endometrial cancer after hysterectomy or as the primary therapy, particularly for women who cannot have surgery. The two types of radiation therapy that may be used to treat endometrial cancer are: • Internal radiation therapy (brachytherapy), in which radioactive materials (radioisotopes) are placed into the uterus or other areas where the cancer cells are found.

• External beam radiation therapy, in which radiation comes from a machine outside the body. In brachytherapy, tiny tubes of radioactive material are inserted through the vagina and left in the uterus for 2 to 3 days. Brachytherapy may be done in the hospital or as on an outpatient basis. External beam radiation therapy is usually done in an outpatient treatment center. A typical therapy course is radiation treatments 5 days a week for 4 to 6 weeks. Radiation therapy may cause side effects, including: • Fatigue. • Dryness, itching, tightening, and burning in the vagina.

• Red, dry, tender, itchy skin. • Moist, weepy skin (later in the treatment). • Hair loss in the treated area. • Loss of appetite. • Diarrhea. • Frequent and uncomfortable urination. • Reduced white blood cell count. Long term risks. Having radiation therapy to any part of the pelvis can cause side effects such as bladder irritation. These side effects may stop after treatment is finished. Other side effects of radiation can include:3 • Bowel obstruction. • Abdominal cramps. • Frequent bowel movements or diarrhea. • Chronic bladder irritation.

• Vaginal scarring (vaginal fibrosis). Radiation therapy may make sexual intercourse uncomfortable. Patient may have to wait until after treatment is finished to resume sexual intercourse. Why is Radiation Therapy done?? Radiation therapy is usually given after surgery (adjuvant therapy) for endometrial cancer. Adjuvant radiation may be recommended for women who have a high risk for the spread of the cancer. If a woman cannot undergo surgery, she may receive radiation therapy alone, but cure rates are slightly lower than with surgery.

Radiation therapy may be used at different points of treatment, depending on the stage and grade of the endometrial cancer. • Stage I: Radiation therapy is not usually used if surgery effectively removes the cancer. If cancer is found deep in the uterine muscle (myometrium), radiation of the pelvis may be given. • Stage II: Radiation therapy may be used before or after surgery. If cancer is present in the cervix, radiation may be used after surgery. • Stage III: Radiation therapy and surgery are the standard treatment options.

If surgery is not recommended, radiation therapy alone may be used. Radiation therapy may also be used if more extensive cancer is discovered during surgery. • Stage IV: Radiation therapy may be used if the cancer is contained in the pelvic region but is usually not recommended if the cancer has spread (metastasized) to other parts of the body. Endometrial cancer may recur. Radiation therapy may be used to control symptoms and increase comfort. Radiation therapy may cure your cancer if the cancer is confined to your vagina and radiation therapy has not been used before.

Cancer that forms in the tissue lining the uterus (the small, hollow, pear-shaped organ in a woman’s pelvis in which a baby grows). Most endometrial cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other …

10 cancer symptoms that women should know. Women need to be especially careful of any signs and symptoms that their body could manifest. Many gynecological cancers cause symptoms that occur early enough to be successfully treated. Ladies, watch your bodies! …

Lung cancer is a complex disease that indiscriminately chooses its hosts and will Complicate the lives of the people it infects. Although lung cancer accounts Only for 15% of newly diagnosed cancer in the United States, it is the leading …

Hysteroscopic surgery is an operative procedure in which a slender tube (known as ‘hysteroscopy’) is inserted through the cervical canal to view the inside of the uterus (womb) and conduct operations. The hysteroscope is a fiber-optic tube that allows observation …

David from Healtheappointments:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out https://goo.gl/chNgQy