Endometrial Cancer
Endometrial cancer originates in the endometrium (the inner lining of the uterus that sheds with monthly menstrual periods). The most common cancer of the female reproductive organs, it was estimated that 40,100 new cases would be diagnosed in 2008 and 7,470 deaths would occur in the U.S. Endometrial cancers which arise from the lining of the uterus (the hollow, pear-shaped organ where a baby grows during pregnancy) are known as Uterine Sarcomas, and represent the majority of uterine cancers. Uterine sarcomas are uncommon. It was estimated that 40,100 new cases of uterine cancer would be diagnosed in the U.S. during 2008, but less than five percent will be uterine sarcomas.
Risk Factors
The majority of endometrial cancers are hormone-driven. Factors that increase a woman’s exposure to
estrogen are a significant risk factor for endometrial cancer. These include:
- Starting menstruation at an early age
- Late menopause
- Infertility or never having children
- Obesity, diabetes, and/or diet high in animal fat
- Being treated with tamoxifen for breast cancer
- Estrogen replacement therapy (ERT) without concurrent progesterone for treatment of the effects
of menopause - Having a family history of colon and/or endometrial cancer
- Other risk factors include age over 40, having a personal or family history of breast or ovarian cancer and undergoing prior radiation therapy for pelvic cancer.
Prevention
Besides being aware of the effects of obesity and heredity on the development of endometrial cancer,
women should watch for any symptoms of endometrial cancer, especially after menopause when the risk
increases. Routine pelvic exams and Pap tests rarely find this disease, but are still essential in ensuring
the overall health of the female reproductive system. Women may also consider using birth control pills,
which have been associated with a lowered risk for endometrial cancer. If a woman’s family history is suggestive of a hereditary cancer, she should ask her doctor about meeting with a genetic counselor.
Symptoms
Unusual bleeding, spotting, or other vaginal discharge, especially after menopause, is the most common
symptom of endometrial cancer and should be evaluated immediately. About nine out of 10 women with
endometrial cancer have some type of abnormal vaginal bleeding. Other symptoms of endometrial cancer
include:
- Difficulty with urination
- Pain during intercourse
- Pain and/or mass in the pelvic area
- Weight loss
Diagnosis
Diagnosis of endometrial cancer involves obtaining tissue from the endometrium, usually as an office
endometrial biopsy or as a dilation and curettage (D&C). A transvaginal ultrasound may also aid in
diagnosis.
Treatment
Surgery is the main treatment for women with endometrial cancer and typically includes a hysterectomy,
removal of the ovaries and fallopian tubes, and lymph node sampling. Chemotherapy, radiation therapy
and hormone therapy may be used in addition to surgery.