Endometrial Cancer – An In-depth Insight Into Diagnosis Staging And Treatment Options

Endometrial Cancer – An In-depth Insight Into Diagnosis Staging And Treatment Options

Diagnosis of cancers has been increasing on a worldwide scale in recent years. Though it’s a good sign, it is also showing how deeply cancers have been emerging into our lives. One of the common types of cancers in women is endometrial cancer, early diagnosis of which is really important to fight the disease effectively.

Diagnosis of Endometrial Cancer

At the first appointment, your doctor will ask you about your medical history followed by physical examination. The doctor might also order urine and blood tests for further clues. The evaluation of endometrial cancer would include:

  1. Pelvic examination – The doctor will be checking the uterus, bladder, vagina, and rectum for any abnormal growths.
  2. Pap Smear test – This procedure analyzes unusual cells from the cervix and the upper part of the vagina.
  3. Transvaginal ultrasound – Pap smear test is mostly ineffective. In this case, the doctor may perform a transvaginal ultrasound that uses high-frequency sound waves to produce the picture of the uterus. This will help determine the thickness of the endometrium. The doctor may also infuse saline solution before performing ultrasound in order to get clearer pictures of any abnormalities.
  4. Hysteroscopy – This procedure involves inserting an endoscope through the cervix and into the uterus to visualize the uterine lining.
  5. Endometrial Biopsy – In this clinical procedure, an instrument is inserted through the vagina to get a scraping or small sample of the uterus for lab examination. The doctor may also recommend dilation and curettage, a procedure that opens up your cervix using dilator tools and hollow tube to remove tissue from the uterus. This procedure can give a better sample of the uterine lining.

Staging in Endometrial Cancer

After you have been diagnosed with endometrial cancer, the next step would be accurate staging. It will let your doctor determine the best treatment plan. Staging is typically done keeping the size of the tumor and its aggressiveness in perspective. According to some experts, tumor bigger than 2 cm in size, is considered as large. Also, the chances of survival are maximum in people having tumor sized less than or equals to 2 cm.

Like other types of cancers, endometrial tumors are also rated as ‘TNM’ in which T is the size of the tumor, N represents the involvement of nearby or distant nodes while M signifies metastases or spread of the cancer to distant organs.

If the cancer has metastasized or spread to distant parts of the body such as bladder and rectum, the doctor may conduct additional tests such as cystoscopy/proctoscopy, CT scan, MRI, positron emission tomography (PET) and X-rays to look for more evidence.

Similar to the other solid tumors, endometrial cancer is graded into 4 stages.

  1. Stage 1 – Cancer is confined to the uterus and hasn’t invaded the cervix and other areas of the pelvis
  2. Stage 2 – The cancer has spread to the cervix but still not invaded other parts of the body.
  3. Stage 3 – The cancer has spread outside the uterus but it is still confined to the pelvic region
  4. Stage 4 – The cancer has gone beyond the pelvic region and has affected the bladder, rectum and more distant body parts.

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What are the Treatment Options for Endometrial Cancer?

The treatment will be based on the characteristics of the tumor, stage and other general health preferences. The options include:

Surgery

The most common method to treat endometrial cancer is surgically removing the tumor. The surgical procedure involves removing the entire uterus, also known as hysterectomy. In other cases, the ovaries and fallopian tubes might also be removed, a procedure known as salpino-oophorectomy.

Surgery also helps the doctor inspect deeply inside the uterus and how far cancer has spread. Remember, hysterectomy will permanently take your capability of bearing a child in future. Moreover, once your ovaries are removed, you will go through menopause, if you haven’t already.

Radiation Therapy

This procedure uses powerful energy beams to kill cancer cells. There are basically two types of radiation therapy in vogue.

External beam radiation therapy

The high beam energy is delivered to the tumor through a machine which is outside of your body. The machine directs radiation to specific points.

Internal radiation or brachytherapy

This method involves placing a small radiation material or device such as wires and cylinders inside the vagina or uterus for a short period of time. The radiation used in this method works only at short distances. This lets your doctor give a high dose of radiation, causing less effect on the healthy tissues. Brachytherapy is often used in the initial stage of cancer after surgery. 

While in later stages of the disease, it is combined with chemotherapy to minimize the risk of cancer recurrence after surgery. Many women, who are not healthy enough to undergo surgery, opt for radiotherapy combined with chemotherapy.

Hormone Therapy

Under this treatment, certain medicines are given that affect hormone levels in the body. This treatment is often advised to those people who are in advanced stage of cancer. This type of treatment is not commonly used as it is less effective as compared to other treatments. Following options are included in this therapy.

  1. Progesterone increasing medication – Synthetic progestin, a type of hormone progesterone is given to prevent rapid growth of cancer cells.
  2. Estrogen reducing medication – Another form of this therapy can reduce the estrogen levels or make it tough for the body to use the available amount of estrogen. The cancer cells which rely on this hormone for growth can die in response to this medication.

Chemotherapy

This therapy uses chemicals to kill cancer cells. Chemotherapy is not typically required in the early stage endometrial cancer, but in cases where cancer has spread beyond the uterus. You might be given chemotherapy treatment via pills or drugs delivered intravenously (through veins). You might get one or more drug depending on your case.

Can a woman reduce the risk of endometrial cancer?

Yes, by following below-mentioned prevention tips, you can reduce the chances of endometrial cancer right to some extent.

  • Check with your gynecologist and go through regular pelvic exams and pap smears
  • Consider taking oral contraceptive pills for at least one year. Discuss with your doctor about using birth control pills and its side effects.
  • Obesity can not only lead to several types of cancers but also a risk factor for various other health conditions. So, always maintain a healthy weight.
  • If you are in the menopausal phase, don’t forget to talk to your doctor about risks of hormone therapy.