What is Endometrial Cancer?The endometrium is the lining of the uterus and is composed of tissue that is rich in blood vessels. Each month in a menstruating woman, that lining is built up in preparation of for a potential pregnancy, then shed as menses if pregnancy does not occur. The cancer is staged according to where the cancer cells are found, from Stage I being completely within the uterus, to Stage IV, where the cancer has spread beyond the boundaries of the pelvis. While endometrial cancer typically is curable, factors such as the stage and effect of hormones on the cancer can determine each individual's prognosis.
Symptoms of Endometrial CancerThe most common symptom of endometrial cancer is unusual vaginal bleeding, or discharge. If you are experiencing abnormal bleeding that is not related to your period, it is important to have it evaluated by your doctor.
Diagnosis of Endometrial CancerDoctors can use two procedures to diagnose endometrial cancer. Both methods involve studying the cells of the endometrium to look for abnormalities of cell shape, structure or growth. The first is an endometrial biopsy. The doctor will remove a few cells of the endometrium, usually in his office, to study them under a microscope. The second is a surgical procedure, known as a D&C or Dilation and Curettage. Under anesthesia, the cervix is dilated, and endometrial cells are extracted. This allows the doctor to examine the cells and look for signs of cancer. If a diagnosis is made, your doctor may order other testing to determine if the cancer has spread outside of the uterus.
PCOS and Endometrial CancerWhile small, women with PCOS do have a higher chance for developing endometrial cancer. The more irregular and few periods a woman has, the greater her risk becomes. During a normal menstrual cycle, the endometrium is exposed to hormones, like estrogen, which cause the lining to proliferate and thicken. When ovulation does not occur, which is typical in PCOS, the lining is not shed and is exposed to much higher amounts of estrogen causing the endometrium to grow much thicker then normal. This is what increases the chance of cancer cells beginning to grow. If you do not get regular periods, keep a calendar documenting when and how often you do get your period so you can speak with your doctor. There are many options that can help reduce your risk.
Treatment of Endometrial CancerIf you are diagnosed with endometrial cancer, it is imperative to speak with a specialist as soon as possible. A number of treatments are available, and your doctor can help determine your best option.
- Surgery: The doctor may elect to remove your uterus, known as a hysterectomy. If the cancer has spread, they may need to remove other organs such as the fallopian tubes, ovaries, part of the vagina or lymph nodes, depending on where the cancer is. Even if surgery is performed, the doctor may feel that chemotherapy or radiation treatment is necessary as well to prevent the cancer from spreading.
- Radiation: This type of therapy involves exposing the cancer cells to high energy radiation, either from a machine which sends the radiation through the body towards the cancer cells or internally with seeds, needles or cathe ters which are placed directly in contact with the cancer.
- Chemotherapy: When this type of treatment is utilized, special chemicals are introduced into the body, either by mouth or intravenously, which directly kill the cancer cells. Sometimes chemotherapy can be placed into a body cavity, or into a more localized part of the body to better target the cancer. Again, it is up to the doctor and your type of cancer to determine which will work best for you.
- Hormone therapy: If the cancer responds to hormonal stimulation, there are medications which can help block the hormone from interacting with the cancer. This can help prevent further growth of the cancer.
Alvaro, Ruben, and Schlaff, William. Reproductive Endocrinology and Infertility: The Requisites in Obstetrics and Gynecology. Page 74. Mosby: Philadelphia 2007.
Endometrial Cancer Treatment: Patient Version. 19 June 2006. U.S. National Institutes of Health: National Cancer Institute. 26 December 2007. http://www.cancer.gov/cancertopics/pdq/treatment/endometrial/patient.htm.